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The nurse is assessing a patient who has been admitted to the emergency department for a possible opioid overdose. Which assessment finding is characteristic of an opioid drug overdose?
- A. Dilated pupils
- B. Restlessness
- C. Respiration rate of 6 breaths/min
- D. Heart rate of 55 beats/min
Correct Answer: C
Rationale: The most serious adverse effect of opioid use is CNS depression, which may lead to respiratory depression. Pinpoint pupils, not dilated pupils, are seen. Restlessness and a heart rate of 55 beats/min are not indications of an opioid overdose.
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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.
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.
The nurse is reviewing herbal therapies. Which is a common use of the herb feverfew?
- A. Muscle aches
- B. Menstrual cramps
- C. Joint pain
- D. Incision pain after surgery
Correct Answer: B
Rationale: Feverfew is commonly used for migraine headaches, menstrual problems, arthritis, and fever. Possible adverse effects include muscle stiffness and muscle and joint 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 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.