The drug nalbuphine is an agonist-antagonist (partial agonist). The nurse understands that which is a characteristic of partial agonists?
- A. They have anti-inflammatory effects.
- B. They are given to reverse the effects of opiates.
- C. They have a higher potency than agonists.
- D. They have a lower dependency potential than agonists.
Correct Answer: D
Rationale: Partial agonists such as nalbuphine are similar to the opioid agonists in terms of their therapeutic indications; however, they have a lower risk of misuse and addiction. They do not have anti-inflammatory effects, nor are they given to reverse the effects of opiates. They do not have a higher potency than agonists.
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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 78-year-old patient is in the recovery room after having a lengthy surgery on his hip. As he is gradually awakening, he requests pain medication. Within 10 minutes after receiving a dose of morphine sulfate, he is very lethargic and his respirations are shallow, with a rate of 7 breaths/minute. The nurse prepares for which priority action at this time?
- A. Assessment of the patient's pain level
- B. Immediate intubation and artificial ventilation
- C. Administration of naloxone (Narcan)
- D. Close observation of signs of opioid tolerance
Correct Answer: C
Rationale: Naloxone is an opioid antagonist used to reverse the effects of opioid overdose, such as respiratory depression. The patient's symptoms of lethargy and shallow respirations at 7 breaths/minute indicate a potential opioid overdose, making naloxone administration the priority action. The other options are not appropriate in this urgent situation.
A patient had abdominal surgery this morning. The patient is groggy but complaining of severe pain around the incision. What is the most important assessment data to consider before the nurse administers a dose of morphine sulfate to the patient?
- A. The patient's pulse rate
- B. The patient's respiratory rate
- C. The appearance of the incision
- D. The date of the patient's last bowel movement
Correct Answer: B
Rationale: One of the most serious adverse effects of opioids is respiratory depression. The nurse must assess the patient's respiratory rate before administering an opioid. The other options are incorrect.
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.
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.
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