Nokea
A 57-year-old woman being treated for end-stage breast cancer has been using a transdermal opioid analgesic as part of the management of pain. Lately, she has been experiencing breakthrough pain. The nurse expects this type of pain to be managed by which of these interventions?
- A. Administering NSAIDs
- B. Administering an immediate-release opioid
- C. Changing the opioid route to the rectal route
- D. Making no changes to the current therapy
Correct Answer: B
Rationale: If a patient is taking long-acting opioid analgesics, breakthrough pain must be treated with an immediate-release dosage form that is given between scheduled doses of the long-acting opioid. The other options are not appropriate actions.
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A 16-year-old field hockey player fell and twisted her ankle during a game. The nurse will expect to administer which type of analgesic?
- A. Synthetic opioid, such as meperidine
- B. Opium alkaloid, such as morphine sulfate
- C. Opioid antagonist, such as naloxone HCL
- D. Nonopioid analgesics, such as indomethacin
Correct Answer: D
Rationale: Somatic pain, which originates from skeletal muscles, ligaments, and joints, usually responds to nonopioid analgesics such as nonsteroidal anti-inflammatory drugs (NSAIDs). The other options are not the best choices for somatic pain.
A patient was diagnosed with pancreatic cancer last month, and has complained of a dull ache in the abdomen for the past 4 months. This pain has been gradually increasing, and the pain relievers taken at home are no longer effective. What type of pain is the patient experiencing?
- A. Acute pain
- B. Chronic pain
- C. Somatic pain
- D. Neuropathic pain
Correct Answer: B
Rationale: Chronic pain is associated with cancer and is characterized by slow onset, long duration, and dull, persistent aching. The patient's symptoms are not characteristics of acute pain, somatic pain, or neuropathic pain.
A patient had abdominal surgery this morning. The patient is groggy but complaining of severe pain around the incision. What is the most important assessment data to consider before the nurse administers a dose of morphine sulfate to the patient?
- A. The patient's pulse rate
- B. The patient's respiratory rate
- C. The appearance of the incision
- D. The date of the patient's last bowel movement
Correct Answer: B
Rationale: One of the most serious adverse effects of opioids is respiratory depression. The nurse must assess the patient's respiratory rate before administering an opioid. The other options are incorrect.
A patient is suffering from tendonitis of the knee. The nurse is reviewing the patient's medication administration record and recognizes that which adjuvant medication is most appropriate for this type of pain?
- A. Antidepressant
- B. Anticonvulsant
- C. Corticosteroid
- D. Local anesthesia
Correct Answer: C
Rationale: Corticosteroids have an anti-inflammatory effect, which may help to reduce pain. The other medications do not have anti-inflammatory properties.
A patient arrives at the urgent care center complaining of leg pain after a fall when rock climbing. The radiographs show no broken bones, but he has a large bruise on his thigh. The patient says he drives a truck and does not want to take anything strong because he needs to stay awake. Which statement by the nurse is most appropriate?
- A. It would be best for you not to take anything if you are planning to drive your truck.
- B. We will discuss with your doctor about taking an opioid because that would work best for your pain.
- C. You can take acetaminophen, also known as Tylenol, for pain, but no more than 1000 mg per day.
- D. You can take acetaminophen, also known as Tylenol, for pain, but no more than 3000 mg/day.
Correct Answer: D
Rationale: Acetaminophen is indicated for mild-to-moderate pain and does not cause drowsiness, as an opioid would. Currently, the maximum daily amount of acetaminophen is 3000 mg/day. The 1000 mg amount per day is too low. Telling the patient not to take any pain medications is incorrect.