Nokea
A nurse must be careful when administering opioid antagonists to clients taking which of the following?
- A. Codeine for cough
- B. Zolpidem for sleep
- C. Oxycodone for analgesia
- D. Naproxen for analgesia
- E. Diphenoxylate for diarrhea
Correct Answer: A,C,E
Rationale: Opioid antagonists may prevent the action or intended use of opioids like codeine for cough, oxycodone for analgesia, or diphenoxylate for diarrhea, so administration of opioid antagonists in clients taking these medications must be monitored carefully.
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Prior to the administration of an opioid antagonist, which of the following would be most important for the nurse to obtain?
- A. Blood pressure
- B. Blood glucose
- C. Pulse
- D. Pain assessment
- E. Respiratory rate
Correct Answer: A,C,E
Rationale: Prior to the administration of an opioid antagonist, the nurse must obtain the client's blood pressure, pulse, and respiratory rate.
A client is prescribed naloxone for the treatment of postoperative acute respiratory depression after a kidney transplant. The nurse explains the drug to the family, describing its action as which of the following?
- A. Naloxone stops internal bleeding.
- B. Naloxone restores respiratory function.
- C. Naloxone restores reflexes of limbs.
- D. Naloxone helps the client overcome pain.
Correct Answer: B
Rationale: The nurse should explain that naloxone restores respiratory function within 1 to 2 minutes after administration. Naloxone neither stops internal bleeding nor restores limb reflexes. Naloxone also does not overcome pain.
A nurse would expect to administer naloxone cautiously to which client?
- A. A client who is pregnant
- B. A client with cardiovascular disease
- C. A client with an alcohol dependency
- D. A client with an opioid dependency
- E. A client with chronic obstructive pulmonary disease
Correct Answer: A,B,D
Rationale: Opioid antagonists like naloxone (Narcan) should be used cautiously in those who are pregnant or lactating, in infants of opioid-dependent mothers, and in clients with an opioid dependency or cardiovascular disease.
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 an example?
- A. Naproxen
- B. Nalbuphine
- C. Naloxone
- D. Nevirapine
Correct Answer: C
Rationale: Naloxone is an opioid antagonist. Naproxen is an NSAID. Nalbuphine is an opioid agonist-antagonist. Nevirapine is an antiretroviral agent.
A client who has been receiving naloxone suddenly starts grimacing and moaning, moving his arms back and forth across his body, and drawing his legs up to his abdomen. Prior to administration the client was sleepy and calm. Assessment reveals that his respiratory rate is 18 breaths per minute. Which nursing diagnosis would most likely apply?
- A. Acute Pain
- B. Impaired Spontaneous Ventilation
- C. Deficient Knowledge
- D. Ineffective Coping
Correct Answer: A
Rationale: The client is exhibiting nonverbal indicators of acute pain, which can result after naloxone reverses the opioid's effects. The client's respiratory rate is 18 breaths per minute, so impaired spontaneous ventilation is not appropriate.