Nokea
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.
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Which of the following would alert the nurse to suspect that a client is experiencing intermediate manifestations of abstinence syndrome?
- A. Rhinorrhea
- B. Increased blood pressure
- C. Tachycardia
- D. Mydriasis
- E. Miosis
Correct Answer: C,D
Rationale: Intermediate symptoms of abstinence syndrome include mydriasis, tachycardia, twitching, tremor, restlessness, irritability, anxiety, and anorexia.
A nurse should be aware of contraindications to the use of opioids to help decrease the likelihood of adverse reactions. The nurse understands that opioids would be contraindicated in which client?
- A. A client with acute bronchial asthma
- B. A client with an acute myocardial infarction
- C. A client with a head injury
- D. A client with grand mal seizures
- E. A client with mild renal impairment
Correct Answer: A,C,D
Rationale: The use of opioids is contraindicated in clients with acute bronchial asthma, emphysema, upper airway obstruction, head injury, increased intracranial pressure, convulsive disorders, severe renal or hepatic dysfunction, and acute ulcerative colitis.
A nurse is caring for a client who is prescribed an opioid analgesic by her primary health care provider. Which assessment finding would lead the nurse to suspect that the client is experiencing an adverse reaction?
- A. Decreased intracranial pressure
- B. Increased breathing rate
- C. Tachycardia
- D. Urinary frequency
Correct Answer: C
Rationale: The nurse should monitor the client for tachycardia, increased intracranial pressure, depressed breathing rate, and urinary retention as possible adverse reactions.
A nurse is assessing a client receiving an opioid as treatment for diarrhea. The nurse would notify the primary health care provider immediately if which of the following occur?
- A. Constipation
- B. Blood noted in the stool
- C. Worsening of diarrhea
- D. Report of severe abdominal pain
- E. Diarrhea unrelieved
Correct Answer: B,C,D,E
Rationale: A nurse monitoring a client taking an opioid for diarrhea should notify the physician immediately if diarrhea is not relieved or becomes worse, if the client has severe abdominal pain, or if blood in the stool is noted.
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.