Nokea
A patient is to receive acetylcysteine as part of the treatment for an acetaminophen overdose. Which action by the nurse is appropriate when giving this medication?
- A. Giving the medication undiluted for full effect
- B. Avoiding the use of a straw when giving this medication
- C. Disguising the flavor with soda or flavored water
- D. Preparing to give this medication via a nebulizer
Correct Answer: C
Rationale: Acetylcysteine has the flavor of rotten eggs and so is better tolerated if it is diluted and disguised by mixing with a drink such as cola or flavored water to help increase its palatability. The use of a straw helps to minimize contact with the mucous membranes of the mouth and is recommended. The nebulizer form of this medication is used for certain types of pneumonia, not for acetaminophen overdose.
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The opioid Vicodin (acetaminophen/hydrocodone) is prescribed for a patient who has had surgery. The nurse informs the patient that which common adverse effects can occur with this medication?
- A. Diarrhea
- B. Constipation
- C. Lightheadedness
- D. Nervousness
- E. Urinary retention
- F. Itching
Correct Answer: B,C,E,F
Rationale: Constipation (not diarrhea), lightheadedness (not nervousness), urinary retention, and itching are some of the common adverse effects that the patient may experience while taking opioids such as Vicodin.
A 16-year-old field hockey player fell and twisted her ankle during a game. The nurse will expect to administer which type of analgesic?
- A. Synthetic opioid, such as meperidine
- B. Opium alkaloid, such as morphine sulfate
- C. Opioid antagonist, such as naloxone HCL
- D. Nonopioid analgesics, such as indomethacin
Correct Answer: D
Rationale: Somatic pain, which originates from skeletal muscles, ligaments, and joints, usually responds to nonopioid analgesics such as nonsteroidal anti-inflammatory drugs (NSAIDs). The other options are not the best choices for somatic pain.
A patient is receiving gabapentin (Neurontin), an anticonvulsant, but has no history of seizures. The nurse expects that the patient is receiving this drug for which condition?
- A. Inflammation pain
- B. Pain associated with peripheral neuropathy
- C. Depression associated with chronic pain
- D. Prevention of seizures
Correct Answer: B
Rationale: Anticonvulsants are often used as adjuvants for treatment of neuropathic pain to enhance analgesic efficacy. The other indications listed are not correct.
A patient is suffering from tendonitis of the knee. The nurse is reviewing the patient's medication administration record and recognizes that which adjuvant medication is most appropriate for this type of pain?
- A. Antidepressant
- B. Anticonvulsant
- C. Corticosteroid
- D. Local anesthesia
Correct Answer: C
Rationale: Corticosteroids have an anti-inflammatory effect, which may help to reduce pain. The other medications do not have anti-inflammatory properties.
A patient was diagnosed with pancreatic cancer last month, and has complained of a dull ache in the abdomen for the past 4 months. This pain has been gradually increasing, and the pain relievers taken at home are no longer effective. What type of pain is the patient experiencing?
- A. Acute pain
- B. Chronic pain
- C. Somatic pain
- D. Neuropathic pain
Correct Answer: B
Rationale: Chronic pain is associated with cancer and is characterized by slow onset, long duration, and dull, persistent aching. The patient's symptoms are not characteristics of acute pain, somatic pain, or neuropathic pain.