Analgesic

Question 1

A client receives intrathecal morphine to control severe postoperative pain. Which action will the nurse include as part of the client’s initial 24-hour postoperative care plan?
A. Monitoring of respiratory rate hourly
B. Assessing the client for tachycardia
C. Administering naloxone every 3 to 4 hours
D. Observing the client for signs of central nervous system (CNS) excitement

Answer 1

A. Monitoring of respiratory rate hourly

Question 2

A nurse is caring for a client who is postoperative following abdominal surgery and reports incisional pain. The surgeon has prescribed morphine 4 mg IV bolus every 6 hr as needed. Before administering this medication, the nurse should complete which priority assessment?

A. Blood pressure
B. Apical heart rate
C. Respiratory rate
D. Temperature

Answer 2

C. Respiratory rate

Question 3

A nurse is caring for a client who is postoperative following abdominal surgery and reports incisional pain. The surgeon has prescribed morphine 4 mg IV bolus every 6 hr as needed. Before administering this medication, the nurse should complete which priority assessment?

A. Blood pressure
B. Apical heart rate
C. Respiratory rate
D. Temperature

Answer 3

C. Respiratory rate

Question 4

A nurse is preparing to administer morphine to a client with chronic pain. Which assessment finding would prompt the nurse to withhold the medication?
A. Heart rate of 117 beats/min
B. Urine output of 35 ml/hr
C. Oxygen saturation of 92%
D. Respiratory rate of 11 breaths/min

Answer 4

D. Respiratory rate of 11 breaths/min

Question 5

The nurse is teaching a client who is postoperative cesarean section about prescribing morphine via a patient-controlled device. Which statement should the nurse include in client teaching about the medication?
A. It is normal for this medication to cause burning at the IV site
B. You will probably experience some itching each time you administer a dose
C. Tell your family members to press the administration button if you are feeling tired
D. Let a staff member know if you experience any trouble breathing

Answer 5

D. Let a staff member know if you experience any trouble breathing

Question 6

Which adverse effect of morphine indicates the need for naloxone administration?
A. Blurred vision
B. Urinary retention
C. Mental confusion
D. Respiratory depression

Answer 6

D. Respiratory depression

Question 7

A client takes morphine sulfate for severe metastatic bone pain. The nurse will assess the client for which adverse effect?
A. Diarrhea
B. Addiction
C. Respiratory depression
D. Diuresis

Answer 7

C. Respiratory depression

Question 8

The nurse is caring for a client with acute pain and realizes a medication error has occurred. The client received twice the ordered dose of morphine an hour ago. Which nursing problem is the priority at this time?
A. Chronic pain
B. Respiratory depression
C. Constipation
D. Tolerance

Answer 8

B. Respiratory depression

Question 8

Which client should the nurse identify as being at highest risk for complications during the use of an opioid analgesic?
A. An older client with Type 2 diabetes mellitus.
B. A client with chronic rheumatoid arthritis.
C. A client with a open compound fracture.
D. A young adult with inflammatory bowel disease.

Answer 8

D. A young adult with inflammatory bowel disease.

Question 9

A client who has been diagnosed with a myocardial infarction receives digoxin, fluoxetine, morphine, and docusate sodium. Which medication would the nurse identify as a risk factor for straining due to constipation?
A. Digoxin
B. Morphine
C. Docusate
D. Fluoxetine

Answer 9

B. Morphine

Question 10

A nurse is reviewing the medication administration records of four clients who have a prescription for morphine PRN. Which of the following findings should the nurse identify as a contraindication to this medication?

A. The client is experiencing a myocardial infarction.
B. The client who is 24 hr postoperative following hip arthroplasty.
C. The client who has bronchitis pleurisy.
D. The client has a paralytic ileus (frozen intestines)

Answer 10

D. The client has a paralytic ileus (frozen intestines)

Question 11

The nurse is preparing an education session for a client prescribed opioids for intractable cancer pain. The nurse should include strategies to help prevent which common side effect associated with long-term use of opioids?
A. Sedation.
B. Constipation.
C. Urinary retention.
D. Respiratory depression.

Answer 11

D. Respiratory depression.

Question 12

The nurse is assessing a client who is taking prescribed opioids for pain. Which finding should indicate to the nurse that the client is having a side effect of the medication?
A. Decreased skin turgor
B. No bowel movement for four days
C. Hypertension
D. Increased respiratory effort

Answer 12

B. No bowel movement for four days

Question 13

A hospice nurse is caring for a client who has terminal cancer and takes PO morphine for pain relief. The client reports that he had to increase the dose of morphine this week to obtain pain relief. Which of the following scenarios should the nurse document as the explanation for this situation?

A. The client not been taking the medication properly.
B. The client is experiencing episodes of confusion.
C. The client has become addicted to the medication.
D. The client developed a tolerance to the medication.

Answer 13

D. The client developed a tolerance to the medication.

Question 14

A client with a known history of opioid addiction has a surgical repair of multiple stab wounds to the abdomen. After surgery, the client’s pain is not relieved by the prescribed morphine injections. Which phenomenon is the client experiencing when they fail to achieve pain relief?
A. Tolerance
B. Habituation
C. Physical addiction
D. Psychological dependence

Answer 14

A. Tolerance

Question 15

A terminally ill client is receiving a morphine drip that exceeds the typical recommended dosage. The client’s spouse tells the nurse that the client is again uncomfortable and needs the morphine increased. The prescription states to titrate the morphine to comfort level. Which action will the nurse take?
A. Add a placebo to the morphine to appease the spouse.
B. Discuss with the spouse the risk for morphine addiction.
C. Assess the client’s pain before increasing the dose of morphine.
D. Check the client’s heart rate before increasing the morphine to the next level.

Answer 15

C. Assess the client’s pain before increasing the dose of morphine.

Question 16

A client who had a myocardial infarction receives 15 mg of morphine sulfate for chest pain. Fifteen minutes after receiving the medication, the client complains of feeling dizzy. Which action will the nurse take?
A. Determine if this is an allergic reaction.
B. Elevate the client’s head and keep the extremities warm.
C. Place the client in the supine position and take the vital signs.
D. Tell the client that this is not a typical sensation after receiving morphine sulfate.

Answer 16

C. Place the client in the supine position and take the vital signs.

Question 17

After surgery the client has a prescription for morphine sulfate via intravenous (IV) route every 3 hours as needed for pain. The client’s preoperative blood pressure was 128/76 mm Hg. Postoperative assessments reveal that the client’s blood pressure ranges between 80/60 mm Hg and 100/70 mm Hg. Which action will the nurse take if the client requests medication for pain?
A. Administer morphine as prescribed.
B. Obtain a prescription for a vasoconstrictor.
C. Give half the prescribed amount of morphine.
D. Withhold morphine until the blood pressure stabilizes.

Answer 17

D. Withhold morphine until the blood pressure stabilizes.

Question 18

Which response to morphine would need to be reported immediately to the health care provider?
A. Nausea
B. Headache
C. Drowsiness
D. Bradycardia

Answer 18

D. Bradycardia

Question 19

A client, admitted to the cardiac care unit with a myocardial infarction, complains of chest pain. Which intervention will be most effective in relieving the client’s pain?
A. Nitroglycerin sublingually
B. Oxygen per nasal cannula
C. Lidocaine hydrochloride 50-mg intravenous (IV) bolus
D. Morphine sulfate 2 mg IV

Answer 19

D. Morphine sulfate 2 mg IV

Question 20

The nurse is caring for a client hospitalized with a myocardial infarction. Which analgesic is the medication of choice for this client?
A. Ketorolac
B. Meperidine
C. Flurazepam
D. Morphine sulfate

Answer 20

D. Morphine sulfate

Question 21

A client with a myocardial infarction is admitted to the cardiac intensive care unit. Which pain relief medication would the nurse expect to find on the plan of care for this client?
A. Morphine
B. Diazepam
C. Midazolam
D. Oxycodone

Answer 21

A. Morphine

Question 22

A client in the coronary care unit develops ‘viselike’ chest pain radiating to the neck. Assessment reveals a blood pressure of 124/64 mm Hg, an irregular apical pulse of 64 beats per minute, and diaphoresis. Cardiac monitoring is instituted, and morphine sulfate 4 mg intravenous (IV) push stat is prescribed. Which intervention is the priority nursing care for this client?
A. Relief of pain
B. Client teaching
C. Cardiac monitoring
D. Maintenance of bed rest

Answer 22

A. Relief of pain

Question 23

Morphine has been prescribed for a client in a hospice home care program. Which information will the nurse provide regarding this pain management regimen?
A. Medication addiction is a concern with this medication.
B. Request the medication before the pain becomes severe.
C. Dosages of the medication will be given automatically at regular intervals around the clock.
D. Intermittent administration of the medication is possible after an intermittent lock is inserted.

Answer 23

C. Dosages of the medication will be given automatically at regular intervals around the clock.

Question 23

A health care provider prescribes morphine for a client being treated for myocardial infarction. Which physiological response will occur if the client experiences the intended therapeutic effect of morphine? A. Increased respiratory rate B. Decreased workload of the heart C. Dilation of coronary arteries D. Diminished metabolites within the ischemic heart muscle

Answer 23

B. Decreased workload of the heart

Question 24

*The nurse is caring for an 81-year-old client with colorectal cancer. Previously, the client's pain was managed with acetaminophen with codeine. However, the client is now experiencing frequent, severe pain and intravenous morphine has been prescribed. What should the nurse recognize about this order? A. Inappropriate due to the potential of respiratory depression B. Inappropriate and demonstrates lack of knowledge related to pain control C. Appropriate despite the risk of diarrhea and abdominal upset D. Appropriate pain management and should be available around the clock

Answer 24

D. Appropriate pain management and should be available around the clock

Question 25

The nurse is caring for a client who is actively dying and has been receiving high doses of opioid analgesics. The client has become unresponsive to verbal stimuli. What action should the nurse take? A. Stop giving the analgesic B. Give an extra dose of the analgesic C. Decrease the analgesic dosage by half D. Continue the analgesic at the current dose

Answer 25

D. Continue the analgesic at the current dose

Question 26

A hospice client who has severe pain asks for another dose of oxycodone/morphine/opioid. Which consideration is the nurse’s primary concern when responding to the client’s request? A. Prevent addiction. B. Determine why the medication is needed. C. Provide alternative comfort measures. D. Reduce the client’s pain.

Answer 26

D. Reduce the client’s pain.

Question 27

An adolescent client has orders for morphine sulfate for severe pain and acetaminophen-codeine compound for moderate pain after a spinal fusion. The pain assessment reveals the client is rigid and crying in pain. Which information would influence the nurse’s choice of analgesic? A. One dose of morphine may be given, but the drug should be restricted thereafter because it is addictive. B. Adolescents tend to exaggerate their discomfort, particularly when they are immobilized by surgery or injury. C. Spinal fusion causes considerable pain during the early postoperative days, and morphine is the more effective analgesic. D. The acetaminophen-codeine compound is preferred because morphine can cause respiratory depression or respiratory arrest.

Answer 27

C. Spinal fusion causes considerable pain during the early postoperative days, and morphine is the more effective analgesic.

Question 28

Which medication would the nurse anticipate will be prescribed to relieve anxiety and apprehension in a client with pulmonary edema? A. Morphine B. Phenobarbital C. Hydroxyzine D. Chloral hydrate

Answer 28

A. Morphine

Question 29

Which medications should the nurse caution the client about taking while receiving an opioid analgesic? A. Antacids. B. Benzodiazepines. C. Antihypertensives. D. Oral antidiabetics.

Answer 29

B. Benzodiazepines.

Question 30

Which member of the health care team would the nurse ask to serve as a witness when wasting unused morphine? A. Nursing supervisor B. Licensed practical nurse (LPN) or RN C. Client’s health care provider D. Designated nursing assistant

Answer 30

B. Licensed practical nurse (LPN) or RN

Question 31

*A staff nurse is assisting a charge nurse with checking controlled substances at the change of shift. The charge nurse is urgently called to a client’s room and has to leave the medication room. Which action will the staff nurse take? A. Continue performing the check while the charge nurse assists the client B. Leave the medication room to find another nurse to assist with the check C. Stop the check and sign out of the medication dispensing system D. Pause the check until the charge nurse returns to the medication room

Answer 31

C. Stop the check and sign out of the medication dispensing system

Question 32

At which time would the nurse plan to administer morphine 2 mg by mouth every 2 hours as needed to a client who has burns on 55% of the body surface and requires dressing changes? A. 15 minutes before the dressing change B. 60 minutes before the dressing change C. Along with a stool softener each time it is administered D. Only if the client rates pain between 8 and 10 on the pain scale

Answer 32

B. 60 minutes before the dressing change

Question 33

A client is starting celecoxib to treat osteoarthritis. The nurse should instruct the client to watch for and report which of the following adverse effects? A. Black, tarry stools B. Bone pain C. Dry mouth D. Polyuria

Answer 33

A. Black, tarry stools

Question 34

A client with osteoarthritis receives a new prescription for celecoxib (Celebrex) orally for symptom management. The nurse notes the client is allergic to sulfa. Which action is most important for the nurse to implement prior to administering the first dose? A. Review the client's hemoglobin results. B. Notify the healthcare provider. C. Inquire about the reaction to sulfa. D. Record the client's vital signs.

Answer 34

B. Notify the healthcare provider.

Question 35

A client who is receiving medication for an eye disorder reports bleeding in the eye. Which medication will the nurse expect to find in the client’s recent medication history? A. Ketorolac B. Trifluridine C. Natamycin D. Ciprofloxacin

Answer 35

A. Ketorolac

Question 36

An adult client has prescriptions for morphine sulfate 2.5 mg IV every 6 hours and ketorolac (Toradol) 30 mg IV every 6 hours. Which action should the nurse implement? A. Administer both medications according to the prescription. B. Hold the ketorolac to prevent an antagonistic effect. C. Hold the morphine to prevent an additive drug interaction. D. Contact the healthcare provider to clarify the prescription.

Answer 36

A. Administer both medications according to the prescription.

Question 37

A nurse is evaluating a client who takes naproxen for pain associated with osteoarthritis. Which documented statement indicates the expected outcome was met? A. Decreased erythema noted to joints B. Muscle strength 3/5 to lower extremities C. Client observed with steady gait upon ambulation D. Deep tendon reflexes +3

Answer 37

C. Client observed with steady gait upon ambulation

Question 38

*A nurse is caring for a client who is taking naproxen following an exacerbation of rheumatoid arthritis. Which of the following statements by the client requires further discussion by the nurse? A. "I signed up for a swimming class." B. "I've been taking an antacid to help with indigestion." C. "I've lost 2 pounds since my appointment 2 weeks ago." D. "The naproxen is easier to take when I crush it and put it in applesauce."

Answer 38

B. "I've been taking an antacid to help with indigestion."

Question 39

Which medication will the nurse question when it is prescribed for a client with acute pancreatitis? A. Ranitidine B. Cimetidine C. Meperidine D. Promethazine

Answer 39

C. Meperidine

Question 40

The nurse is providing care for a client diagnosed with sickle cell crisis. Which prescribed medication should the nurse clarify with the health care provider? A. Morphine B. Hydromorphone C. Codeine D. Meperidine

Answer 40

D. Meperidine

Question 41

A nurse is teaching a female client who has a new prescription for transdermal sumatriptan to treat migraine headaches. Which of the following instructions should the nurse include? A. "Take this medication daily to prevent headaches." B. "Activate the patch 30 minutes after application." C. "Use contraception while taking this medication." D. "You can bathe with the patch in place."

Answer 41

C. "Use contraception while taking this medication."

Question 42

Which information would the nurse include in the teaching plan for the client who is prescribed sumatriptan for migraine headache? A. It should be administered when headache is at its peak. B. It should be administered by deep intramuscular injection. C. Is contraindicated in people with coronary artery disease. D. Injectable sumatriptan may be administered every 6 hours as needed.

Answer 42

C. Is contraindicated in people with coronary artery disease.

Question 42

The nurse is teaching a client with migraine headaches about almotriptan. Which statement by the client indicates that the teaching was effective? A. "I will wait to take the medication until the pain has become unbearable." B. "I will take the medication as soon as I notice migraine symptoms." C. "If the first dose does not help, I can take two more doses 15 minutes apart." D. "I will take a dose every morning to make sure to prevent an acute attack."

Answer 42

B. "I will take the medication as soon as I notice migraine symptoms."

Question 43

The nurse is teaching a client with migraine headaches about almotriptan. Which statement by the client indicates that the teaching was effective? A. "I will wait to take the medication until the pain has become unbearable." B. "I will take the medication as soon as I notice migraine symptoms." C. "If the first dose does not help, I can take two more doses 15 minutes apart." D. "I will take a dose every morning to make sure to prevent an acute attack."

Answer 43

B. "I will take the medication as soon as I notice migraine symptoms."