Nokea
A patient with a history of chronic pain has been using an opioid analgesic for 4 months and reports that a larger dose of the pain medication is needed for the same pain relief. The nurse is aware that this patient is experiencing which of these?
- A. Opioid addiction
- B. Opioid tolerance
- C. Opioid toxicity
- D. Opioid abstinence syndrome
Correct Answer: B
Rationale: Opioid tolerance is a common physiologic result of long-term opioid use. Patients with opioid tolerance require larger doses of the opioid agent to maintain the same level of analgesia. This situation does not describe toxicity (overdose), addiction, or abstinence syndrome (withdrawal).
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A patient is to receive methadone 2.5 mg intramuscularly (IM) now. The medication is available in a concentration of 10 mg/mL. Identify how many milliliters of methadone will be drawn up for this dose.
Correct Answer: 0.25 mL
Rationale: 10 mg : 1 mL :: 2.5 mg : x mL; (10 * x) = (1 * 2.5); 10x = 2.5; x = 0.25 mL.
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 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 38-year-old man has come into the urgent care center with severe hip pain after falling from a ladder at work. He says he has taken several pain pills over the past few hours but cannot remember how many he has taken. He hands the nurse an empty bottle of acetaminophen (Tylenol). The nurse is aware that the most serious toxic effect of acute acetaminophen overdose is which condition?
- A. Tachycardia
- B. Central nervous system depression
- C. Hepatic necrosis
- D. Nephropathy
Correct Answer: C
Rationale: Hepatic necrosis is the most serious acute toxic effect of an acute overdose of acetaminophen. The other options are incorrect.
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.