Nokea
A client is prescribed a transdermal opioid. After teaching the client and family how to administer this drug, the nurse determines that the teaching was successful when they state which of the following?
- A. The drug should be reapplied every 24 hours.
- B. We should try to apply the patch to about the same site each time.
- C. The site should only be cleaned with water before each application.
- D. A hairy area, like the forearm, is an appropriate place to apply the patch.
Correct Answer: C
Rationale: Only water is used to clean the site because soap and other substances may irritate the skin. The patch is applied for 72 hours and sites should be rotated. Any site that is used should be free of hair.
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A nurse would expect to administer opioid analgesics primarily for the client with which of the following?
- A. Severe acute pain
- B. Mild acute pain
- C. Moderate chronic pain
- D. Mild chronic pain
- E. Opioid dependence
Correct Answer: A,C,E
Rationale: Opioid analgesics are used primarily for the treatment of moderate to severe acute pain and chronic pain and in the treatment and management of opiate dependence.
A client is prescribed oxymorphone. The client is also receiving promethazine. The nurse would carefully monitor which of the following?
- A. Temperature
- B. Blood pressure
- C. Pulse
- D. Respiratory rate
- E. Blood glucose
Correct Answer: B,C,D
Rationale: The nurse should take care to closely monitor a client's blood pressure, pulse, and respiratory rate when oxymorphone is administered with promethazine.
A group of nursing students are reviewing information about epidural pain management with opioid analgesics. The students demonstrate understanding of the information when they identify which of the following as an advantage over other routes of administration?
- A. Longer time to tolerance development
- B. Lower total dose of opioid
- C. Fewer adverse reactions
- D. Greater client comfort
- E. Decreased demand on nursing staff
Correct Answer: B,C,D
Rationale: Epidural administration offers several advantages over other routes of administration for opioid analgesics, including lower total dosages of the drug used, fewer adverse reactions, and greater client comfort.
A nurse is to administer a prescribed opioid to a client. Which of the following conditions should the nurse confirm in the client to ensure that opioid therapy is not contraindicated in this client?
- A. Client does not have acute bronchial asthma.
- B. Client does not have acute diabetic retinopathy.
- C. Client does not have acute pre-existing liver disease.
- D. Client does not have decreased intracranial pressure.
Correct Answer: A
Rationale: Opioid therapy is contraindicated in clients with acute bronchial asthma; therefore, the nurse should confirm that the client does not have this condition before administering opioid therapy. Opioid therapy is not known to be contraindicated in clients with diabetic retinopathy and pre-existing liver disease. Opioid therapy is contraindicated in clients with increased, not decreased, intracranial pressure.
A nurse is administering an opioid analgesic to a client with severe chronic pain. The nurse understands that the rate of tolerance to an opioid analgesics effects varies from client to client. The nurse identifies which of the following as affecting the rate at which tolerance develops?
- A. Body weight
- B. Gender
- C. Dosage
- D. Route of administration
- E. Age
Correct Answer: C,D
Rationale: The rate at which tolerance to an opioid analgesic develops varies according to dosage, the route of administration, and the individual.