Nokea
A nurse has administered an opioid to a client. Which of the following would the nurse do if the client shows a decrease in respirations?
- A. Monitor and encourage the client to cough and breathe deeply every 2 hours.
- B. Instruct the client to restrict his consumption of liquids.
- C. Instruct the client to take complete bed rest.
- D. Instruct the client to avoid any kind of exercise.
Correct Answer: A
Rationale: The nurse should encourage the client to cough and breathe deeply every 2 hours if the client shows a decrease in respirations after the administration of opioid analgesics. The nurse need not instruct the client to restrict his consumption of liquids to help him cope with the effects of an ineffective breathing pattern.
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A client is receiving an opioid analgesic following abdominal surgery. The client has been out of bed to the chair and is encouraged to ambulate with assistance. The nurse is also encouraging the client to increase his fluids. He reports that his appetite is good and he has been finishing most of his meals. His bowel sounds are active but he is having difficulty passing stools. A laxative is ordered. Which nursing diagnosis would be most appropriate?
- A. Imbalanced Nutrition: Less Than Body Requirements
- B. Constipation
- C. Risk for Injury
- D. Deficient Knowledge
Correct Answer: B
Rationale: The client is most likely experiencing constipation from the opioid therapy as well as from the lack of ambulation and activity. The client is eating, so imbalanced nutrition is not necessarily a problem.
A client is receiving drugs through a PCA infusion pump. When teaching the client about this therapy, which of the following would the nurse include?
- A. Pain relief should occur 1 hour after pushing the control button.
- B. The control button and the button to call the nurse are the same.
- C. The control button activates administration of the drug.
- D. The machine delivers the drug every time the control button is used.
Correct Answer: C
Rationale: The nurse should inform the client that the control button activates administration of the drug. Pain relief occurs shortly after, and not an hour after, pushing the button.
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.
After teaching a group of nursing students about opioids, the instructor determines that additional teaching is needed when the students identify which of the following as a natural opioid?
- A. Meperidine
- B. Morphine
- C. Codeine
- D. Opium
Correct Answer: A
Rationale: Meperidine is a synthetic opioid. Natural opioids include morphine sulfate, codeine, opium alkaloids, and tincture of opium.
A nurse is reviewing the differences between opioid agonists and opioid agonist-antagonists. The nurse correctly identifies which of the following as an opioid agonist-antagonist?
- A. Alfentanil (Alfenta)
- B. Buprenorphine (Buprenex)
- C. Meperidine (Demerol)
- D. Nalbuphine (Nubain)
- E. Pentazocine (Talwin)
Correct Answer: B,D,E
Rationale: Opioid agonist-antagonists include buprenorphine, butorphanol, nalbuphine, and pentazocine.