Nokea
Which of the following would alert the nurse to suspect that a client is experiencing intermediate manifestations of abstinence syndrome?
- A. Rhinorrhea
- B. Increased blood pressure
- C. Tachycardia
- D. Mydriasis
- E. Miosis
Correct Answer: C,D
Rationale: Intermediate symptoms of abstinence syndrome include mydriasis, tachycardia, twitching, tremor, restlessness, irritability, anxiety, and anorexia.
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A nurse is reviewing the differences between opioid agonists and opioid agonist-antagonists. The nurse correctly identifies which of the following as an opioid agonist-antagonist?
- A. Alfentanil (Alfenta)
- B. Buprenorphine (Buprenex)
- C. Meperidine (Demerol)
- D. Nalbuphine (Nubain)
- E. Pentazocine (Talwin)
Correct Answer: B,D,E
Rationale: Opioid agonist-antagonists include buprenorphine, butorphanol, nalbuphine, and pentazocine.
A client is receiving an opioid analgesic following abdominal surgery. The client has been out of bed to the chair and is encouraged to ambulate with assistance. The nurse is also encouraging the client to increase his fluids. He reports that his appetite is good and he has been finishing most of his meals. His bowel sounds are active but he is having difficulty passing stools. A laxative is ordered. Which nursing diagnosis would be most appropriate?
- A. Imbalanced Nutrition: Less Than Body Requirements
- B. Constipation
- C. Risk for Injury
- D. Deficient Knowledge
Correct Answer: B
Rationale: The client is most likely experiencing constipation from the opioid therapy as well as from the lack of ambulation and activity. The client is eating, so imbalanced nutrition is not necessarily a problem.
A nurse is caring for a client who is prescribed an opioid analgesic by her primary health care provider. Which assessment finding would lead the nurse to suspect that the client is experiencing an adverse reaction?
- A. Decreased intracranial pressure
- B. Increased breathing rate
- C. Tachycardia
- D. Urinary frequency
Correct Answer: C
Rationale: The nurse should monitor the client for tachycardia, increased intracranial pressure, depressed breathing rate, and urinary retention as possible adverse reactions.
A group of nursing students are reviewing information about epidural pain management with opioid analgesics. The students demonstrate understanding of the information when they identify which of the following as an advantage over other routes of administration?
- A. Longer time to tolerance development
- B. Lower total dose of opioid
- C. Fewer adverse reactions
- D. Greater client comfort
- E. Decreased demand on nursing staff
Correct Answer: B,C,D
Rationale: Epidural administration offers several advantages over other routes of administration for opioid analgesics, including lower total dosages of the drug used, fewer adverse reactions, and greater client comfort.
A nurse is caring for a newborn. The newborn's mother is suspected to be opioid dependent. When assessing the newborn, which of the following would alert nurse to the possibility of withdrawal?
- A. Jaundice
- B. Increased respiratory rate
- C. Decreased respiratory rate
- D. Sneezing
- E. Fever
Correct Answer: B,D,E
Rationale: Opiate withdrawal symptoms in a newborn usually appear during the first few days of life and include irritability, excessive crying, yawning, sneezing, increased respiratory rate, tremors, fever, vomiting, and diarrhea.