Nokea
A client with chronic back pain is admitted to a local health care facility for respiratory depression secondary to an inadvertent overdose of his opioid analgesic. The client is to receive naloxone. Which of the following would the nurse include before administering naloxone?
- A. Monitor the client's blood pressure every 5 minutes.
- B. Review the client's allergy history and treatment modalities.
- C. Monitor vital signs every 5 to 15 minutes if the client is responsive.
- D. Monitor respiratory rate and rhythm of the client.
Correct Answer: B
Rationale: Before administering the antagonist, the nurse should review the client's initial health history, allergy history, and treatment modalities. The nurse should also obtain the client's blood pressure, pulse, and respiratory rate and review the record for the drug suspected of causing the symptoms of respiratory depression. All these interventions are part of the preadministration assessment.
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After administering an opioid antagonist, which of the following would be most appropriate for the nurse to do when the client's pain recurs?
- A. Change opioid antagonists.
- B. Review the circumstances that led to the use of the opioid antagonist.
- C. Assess the client's pain level.
- D. Begin to treat the pain again.
- E. Decrease the rate of opioid antagonist administration.
Correct Answer: B,C,D
Rationale: The nurse should assess the client's pain level, review the circumstances that required the use of the antagonist, and begin to treat the pain again. Changing antagonists and decreasing the rate of antagonist administration are inappropriate.
A nursing student is assigned to lead a class discussion on opioid antagonists. Which of the following would the student include as the mechanism by which opioid antagonists reverse the effects of opioid agonists?
- A. Competitive inhibition of the opioid receptor
- B. Direct binding to the opioid agonist
- C. Displacement of the opioid agonist from the opioid receptor
- D. Irreversible inhibition of the opioid receptor
- E. Mutation of the opioid receptor
Correct Answer: A,C
Rationale: Opioid agonists reverse the opioid effects by competing for the opiate receptor site and displacing the opioid drug.
A client is admitted to a local health care facility for alcohol dependence. The nurse knows that the physician is most likely to prescribe which of the following drugs for the client?
- A. Cisapride
- B. Naproxen
- C. Lincosamide
- D. Naltrexone
Correct Answer: D
Rationale: The nurse should administer naltrexone to the client who has alcohol dependence. It is also used to block the effects of suspected opioids if they are being used by the person undergoing treatment for alcohol dependence. Cisapride, naproxen, and lincosamide are not used to treat alcohol dependence.
After teaching a group of nursing students about opioid antagonists, the instructor determines that the teaching was successful when the students identify which of the following as true about these drugs?
- A. An opioid antagonist has greater affinity for opioid receptors than do opioid agonists.
- B. An opioid antagonist has lesser affinity for opioid receptors than do opioid agonists.
- C. An opioid antagonist prevents a response to the opioid by binding to opioid agonists in the bloodstream.
- D. An opioid antagonist prevents a response to the opioid by binding to opioid receptors.
- E. An opioid antagonist potentiates the effect of an opioid.
Correct Answer: A,D
Rationale: An opioid antagonist has a greater affinity for a cell receptor than an opioid agonist, and by binding to the cell receptor, it prevents a response to the opioid agonist.
If time allows, the nurse should review which of the following with the client prior to administering an opioid antagonist?
- A. Initial health history
- B. Allergy history
- C. Bowel history
- D. Family medical history
- E. Current treatment modalities
Correct Answer: A,B,E
Rationale: If time allows, the nurse should review the client's initial health history, allergy history, and current treatment modalities prior to administering an opioid antagonist.