Nokea
A nurse is working at a substance abuse clinic. The nurse would expect which of the following to be used in the treatment and management of opioid dependence?
- A. Fentanyl (Duragesic)
- B. Methadone (Dolophine)
- C. Propoxyphene (Darvon)
- D. Levomethadyl (Orlaam)
- E. Oxycodone (OxyContin)
Correct Answer: B,D
Rationale: Levomethadyl and methadone are the two opiates used in the treatment and management of opiate dependence.
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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.
A nurse is assigned to care for a client who has been prescribed an opioid analgesic. Which of the following activities should the nurse perform as part of the preadministration assessment?
- A. Document description of pain and an estimate of when the pain began.
- B. Obtain client's blood pressure and pulse within 5 to 10 minutes.
- C. Monitor the client for symptoms of respiratory depression.
- D. Record each bowel movement and its appearance, color, and consistency.
Correct Answer: A
Rationale: The nurse should document the description of pain and an estimate of when the pain began as part of the preadministration assessment. Obtaining blood pressure and pulse within 5 to 10 minutes, monitoring the client for symptoms of respiratory depression, and recording bowel movements are part of the ongoing assessments conducted by the nurse when caring for the client.
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.
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 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.