Nokea
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.
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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 administering naloxone to a client with respiratory depression, the nurse would expect to see the effects of the drug within which time frame?
- A. 1 to 2 minutes
- B. 3 to 4 minutes
- C. 5 to 6 minutes
- D. 7 to 8 minutes
Correct Answer: A
Rationale: Naloxone is capable of restoring respiratory function within 1 to 2 minutes after administration.
A nurse suspects that a client receiving naloxone is experiencing an adverse reaction when the assessment reveals which of the following?
- A. Bradycardia
- B. Dry, flushed skin
- C. Tremors
- D. Diarrhea
Correct Answer: C
Rationale: Generalized reactions to naloxone include nausea and vomiting, sweating, tachycardia, increased blood pressure, and tremors.
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.
A client is receiving an opioid antagonist. The nurse would closely monitor the client for which of the following?
- A. Cramps
- B. Sweating
- C. Low blood pressure
- D. Skin inflammation
Correct Answer: B
Rationale: The nurse should monitor for sweating when caring for the client since it is one of the adverse reactions of opioid antagonists. Other adverse reactions include nausea, vomiting, tachycardia, increased blood pressure, and tremors. The nurse need not monitor for cramps, low blood pressure, or skin inflammation since these conditions are not known to be caused by opioid antagonists.