front 1 The ______ theory proposes tissue injury activates _________ and causes the release of chemical mediators. | back 1 Gate, Nociceptors |
front 2 Opioids such as morphine activate the same receptors as ________ to reduce pain. | back 2 Endorphins |
front 3 Nonsteroidal antiinflammatories drugs (NSAID's) control pain at the periphery level by blocking pain sensitizing chemicals and interfering with the product of _____________. | back 3 Prostaglandins |
front 4 As a result of unrelieved pain, a client may develop glucose intolerance and _____________ respiratory rate, heart rate, blood pressure, and stress response. | back 4 increased |
front 5 What is the level of stimulus needed to create a painful sensation? A. Pain threshold B. Pain tolerance C. neuropathic pain D. endorphins E. Analgesics F. Nociceptors | back 5 A. Pain threshold |
front 6 What is a neurohormone that naturally suppress pain conduction? A. Pain threshold B. Pain tolerance C. neuropathic pain D. endorphins E. Analgesics F. Nociceptors | back 6 D. endorphins |
front 7 What is pain due to disease or injure of the peripheral nervous system or central nervous system? A. Pain threshold B. Pain tolerance C. neuropathic pain D. endorphins E. Analgesics F. Nociceptors | back 7 C. Neuropathic Pain |
front 8 What is the amount of pain a person can endure without interfering with normal functioning? A. Pain threshold B. Pain tolerance C. neuropathic pain D. endorphins E. Analgesics F. Nociceptors | back 8 B. Pain tolerance |
front 9 Opioids act primarily on the _____________ and nonopioid analgesics act on the ____________________ at the pain receptor sites. | back 9 Central nervous system , Peripheral nervous system |
front 10 In addition to suppressing pain, Opioids also suppress ___________ and ____________. | back 10 respiration and coughing |
front 11 Opioids are contraindicated for use in clients with ____________ , ______________ , ____________ , and _____________ . | back 11 head injuries, respiratory depression, shock, hypotension |
front 12 The client taking meperidine reports blurred vision. The nurse knows that this is a(n) _______________ and would report this to the _________________ . | back 12 side effect , health care provider |
front 13 Pentazocine, an opioid agonist-antagonist, is classified as a schedule ____ drug. | back 13 IV |
front 14 What type of pain originates from smooth muscle and organs? A. Superficial pain B. Vascular pain C. Somatic pain D. Visceral pain | back 14 D. Visceral pain |
front 15 What type of pain originates in skeletal muscle, ligaments, and joints? A. Superficial pain B. Vascular pain C. Somatic pain D. Visceral pain | back 15 C. Somatic pain |
front 16 What type of pain originates on the surface areas such as skin and mucous membranes? A. Superficial pain B. Vascular pain C. Somatic pain D. Visceral pain | back 16 A. Superficial pain |
front 17 What kind of pain contributes to headaches or migraines? A. Cancer pain B. Vascular pain C. Somatic pain D. Visceral pain | back 17 B. Vascular pain |
front 18 What type of pain occurs from pressure on nerves and organs? A. Cancer pain B. Vascular pain C. Somatic pain D. Visceral pain | back 18 A. Cancer Pain |
front 19 Which drug effect is considered a major side effect of meperidine? A. Decreased Blood pressure B. Decreased pule rate C. increased respiration D. increased urine output | back 19 A. Decreased blood pressure |
front 20 Which assessment finding is an indication of opioid overdose? A. Dilated pupils B. increased urinary output C. pinpoint pupils D. Diarrhea | back 20 C. Pinpoint pupils |
front 21 Which nursing assessment would be least important when monitoring a client who is receiving hydromorphone? A. Bowel sounds B. Fluid intake C. pain scale D. vital signs | back 21 B. Fluid intake |
front 22 Which information will the nurse include in a teaching plan for a client who is being discharged home after knee surgery with a prescription for an opioid? Select all that appy A. Dietary restriction while taking hydrocordone B. Instruction not to exceed recommended dosage C. Instructions not to use alcohol or central nervous system depressants while taking hydrocodone D. Instructions on how to prevent constipation E. Side effect to report | back 22 B. Instruction not to exceed recommended dosage C. Instructions not to use alcohol or central nervous system depressants while taking hydrocodone D. Instructions on how to prevent constipation E. Side effect to report |
front 23 The client is brought to the emergency department with a reported overdose of morphine. Which drug will the nurse anticipate be prescribed? A. Butorphanol B. Naloxone C. Flumazenil D. Pentazocine | back 23 B. Naloxone |
front 24 Mixed opioid agonist-antagonists were developed in hopes of decreasing which problem? A. Chronic pain B. opioid abuse C. renal failure D. respiratory depression | back 24 B. Opioid abuse |
front 25 The client abruptly stopped taking an opioid after taking it for 8 weeks for a mild back injury sustained at work. Which time frame would the nurse anticipate withdrawal symptoms attributable to physical dependence to begin? A. 6-12 hours B. 24-48 hours C. 48- 72 hours D. 72- 96 hours | back 25 B. 24-48 hours |
front 26 An 8 year old child is seen in the ER with a broken arm. Which intervention would the nurse do to be more successful in treating pain in an 8 year old child? Select all that apply A. assume the child is hurt and administer pain drug B. Discuss the child's typical responses with the caregiver C. Utilize only non pharmacological pain control D. Use a pain scale appropriate for children E. Utilize developmentally appropriate communication technique | back 26 B. Discuss the child's typical responses with the caregiver D. Use a pain scale appropriate for children E. Utilize developmentally appropriate communication technique |
front 27 A client will be discharged home with a prescription for an opioid with acetaminophen. Which drug, when taken with an opioid will the nurse question? A. Ampicillin B. Cholestyramine C. Furosemide D. Propranolol | back 27 B. Cholestyramine Cholestyramine will decrease the effectiveness of acetaminophen. An alternative nonopioid would be an option |
front 28 The nurse is concerned that a client is experiencing side effects of opioid agonist-antagonists. Which assessment would be priority for the nurse to monitor? A. Constipation B. Dysuria C. Hypertension D. Respiratory depression | back 28 D. Respiratory depression |
front 29 A client 4-hours postoperative is requesting morphine for the third time for pain rated an 8 on the numeric pain scale. The vital signs include temperature 97.5 F, heart rate 88 beats/min, respiratory rate of 12 breaths per min, blood pressure 104/60, and oxygen saturation 98% on room air. Assuming that a dose of the drug is due, which action would be best for the nurse to take? A. Administer the dose and contact the HCP about the respiratory rate B. Administer the dose and contact HCP about inadequate pain control C. Hold the dose and contact the HCP regarding the respiratory rate. D. Hold the dose and contact the HCP about inadequate pain control | back 29 B. Administer the dose and contact HCP about inadequate pain control The nurse would hold the dose is the respiratory rate is below 10 breaths per minute |
front 30 The older adult client has a fentanyl patch 75 mcg for chronic pain. Which statement is correct regarding this drug for the older adult? A. This patient should not have fentanyl patch for chronic pain B. The dose may be too low C. The dose may be too high for this patient D. The dose is appropriate | back 30 C. The dose may be too high for this patient |
front 31 A client was prescribed oral ketorolac for postoperative pain. Which time frame indicates the maximum length of time this drug can be taken? A. 24 hours B. 3 days C. 5 days D. 2 weeks | back 31 C. 5 days |
front 32 Which drugs would be appropriate for pain management for a client who sustained multiple abrasions to both knees after falling off a bicycle? Select all that apply A. Acetaminophen B. Aspirin C. Hydrocodone D. Ibuprofen E. Morphine | back 32 A. Acetaminophen B. Aspirin D. Ibuprofen |
front 33 Which statement describes the pathophysiology of pain? A. Chemical mediators sensitize the pain receptors B. Nociceptive pain signals are transmitted through efferent fibers C. Pain signals begin at the central nervous system and end at the periphery D. Chemical mediators such as glucose and sodium are released upon tissue injury | back 33 A. Chemical mediators sensitize the pain receptors |
front 34 Which medication is a non steroidal anti-inflammatory analgesic? A. Diflunisal B. Ketorolac C. Celecoxib D. Acetaminophen | back 34 A. Diflunisal |
front 35 Which drug may cause tinnitus as a side effect? A. Aspirin B. Tramadol C. Indomethacin D. Acetaminophen | back 35 A. Aspirin Aspirin is associated with tennitus and vertigo. Tramadol causes nausea, vomiting, constipation, dizziness, and headache. Indomethacin causes gastric distress. Overdose of acetaminophen causes hepatotoxicity. pg 297 |
front 36 Which characteristic feature is indicative of cluster headaches? A. pain is pulsatile B. more common in women C. headache preceded by an aura D. pain is usually located around the eyes | back 36 D. Pain is usually located around the eyes |
front 37 Which condition is a contraindication for the administration of opioid analgesic? A. Gout B. Diabetes C. Skin Disease D. Status Asthmaticus | back 37 D. Status asthmaticus Respiratory insufficiency, renal or hepatic disorders, hypovolemia, urinary retention, sleep apnea, IOP, CNS or respiratory depression |
front 38 Which food or dietary supplement would the nurse identify as potentially causing increased sedation with opioid therapy? select all that apply A. Kava B. Valerian C. Bananas D. Grapefruit E. St. Johns Wort | back 38 A. Kava, B. Valerian, E. St. Johns Wort |
front 39 A patient with migraine headaches who is on selective serotonin reuptake inhibitor therapy is prescribed sumatriptan. Which possible complication would the nurse anticipate in the patient? A. Vasospasm B. Hypertension C. Serotonin Syndrome D. Central Nervous system depression | back 39 C. Serotonin syndrome Sumatriptan is contraindicated in patient receiving SSRI because of the risk for serotonin syndrome. 307-308 |
front 40 The nurse is teaching a student nurse about medication that are contraindicated when caring for patients with head injuries. Which medication identified by the student indicates an understanding of the teaching? A. Ketorolac B. Nalbuphie C. Methylprednisolone D. Acetaminophen | back 40 B. Nalbuphine Narcotics depress respiration, resulting in carbon dioxide retention and increased ICP. |
front 41 Which sign or symptom is indicative of salicylate toxicity? select all that apply A. Vertigo B. Anorexia C. Nausea D. Tinnitus E. Diarrhea F. Hyperventilation | back 41 Vertigo, tinnitus, Hyperventilation |
front 42 Which medication would the nurse anticipate administering to a patient admitted for treatment of an opioid addiction? A. Morphine B. Naloxone C. Methadone D. Meperidine | back 42 C. Methadone pg. 301 |
front 43 Which drug is an opioid agonist-antagonist? Select all that apply A. Butorphanol B. Fentanyl C. Tapentadol D. Nalbuphine E. Buprenorphine | back 43 A. Butorphanol, D. Nalbuphine, E. Buprenorphine |
front 44 Which lab level would the nurse monitor for in a patient who is receiving acetaminophen therapy? Select all that apply A. uric acid level B. Bilirubin C. Creatinine D. Alkaline phosphatase (ALP) E. Alanine Aminotransferase (ALT) | back 44 B. Bilirubin, D. Alkaline phosphatase, E. Alanine aminotransferase OD of Acetaminophen may cause liver damage, resulting in hepatotoxicity |
front 45 Which medication class includes adjuvant analgesic medications? Select all A. Corticosteroids B. Anticonvulsants C. Antidepressants D. Antidysrhythmics E. local anesthetics | back 45 All of them ABCDE Adjuvant analgesic meds are those that are used to potentiate the action of opioid or nonopijoid analgesics. |
front 46 Which adverse effect is associated with excessive doses of acetaminophen is likely to be found in a patient? Select all that apply A. Nausea B. Vomiting C. Blurred vision D. Hepatotoxicity E. Hearing impairment | back 46 A. Nausea, B. Vomiting, D.. Hepatotoxicity Life treating Hepatotoxicity, renal failure, hypokalemia, rhabdomyolysis, anemia, agranulocytosis, neutropenia, thrombocytopenia |
front 47 Which phrase describes an adjuvant analgesic? A. only used with opioid analgesics B. Used when opioid analgesics are ineffective C. Potentiates the action of an analgesic medication D. Increases the likelihood of adverse reactions when used with analgesics | back 47 C. Potentiates the action of an analgesic medication pg. 304 |
front 48 While admitting a patient for treatment of an acetaminophen overdose, the nurse would anticipate the administration of which medication to prevent toxicity? A. Vitamin K B. Naloxone C. Acetylcysteine D. Methylprednisolone | back 48 C. Acetylcysteine is the antidote for acetaminophen overdose. Loading dose followed by doses every 4 hours for 17 more doses. Vitamin K is antidote for Warfarin overdose and toxicity. Naloxone is used to reverse an opioid overdose or opioid induced respiratory depression. Methylprednisolone is a glucocorticoid that is used as an antiimflammatory. |
front 49 Which narcotic is the drug of choice for pain relief during childbirth? A. Meperidine B. Hydromorphone C. morphine sulfate D. Oxycodone Hydrochloride | back 49 A. Meperidine It does not diminish uterine contraction and causes less neonatal respiratory depression. |
front 50 Which condition is a contraindication for the administration of acetaminophen? A. Anemia B. Asthma C. joint pain D. liver disease | back 50 D. liver disease Acetaminophen is safe for anemia, asthma, and joint pain. pg. 297 |
front 51 Which drug can be used as an adjunct to psychosocial treatments for alcoholism? A. Meperidine B. Tapentadol C. Polyethylene glycol D. Naltrexone hydrochloride | back 51 D. Naltrexone Hydrochloride pg. 306 |
front 52 When teaching a patient about the administration of a fentanyl transdermal patch, which frequency would the nurse include for changing the patch? A. When pain recurs B. Every 24 hours C. Every 72 hours D. once a week | back 52 C. every 72 hours pg. 301 |
front 53 Which medication would the nurse administer for severe postoperative pain? A. Acetaminophen B. Acetylsalicylic acid C. Meperidine D. Fentanyl | back 53 C. Meperidine 75 mg intramuscular pg 300 |
front 54 Which condition would the nurse expect to see in a patient who ingested 14 grams of acetaminophen? A. Renal failure B. Kidney stones C. Acute hepatotoxicity D. Metabolic alkalosis | back 54 C. Acute hepatotoxicity Pg 296 |
front 55 Which assessment is most important for the nurse to monitor in a patient receiving an opioid analgesic? A. Heart rate B. Mental status C. Blood Pressure D. Respiratory Rate | back 55 D. Respiratory rate P 300 |
front 56 When developing a plan of care for a postoperative patient receiving morphine sulfate which patient problem would be the highest priority? A. Acute pain related to tissue injury and inflammation B. Risk for falls related to drowsiness and changes in mental status C. Risk for impaired gas exchange related to respiratory depression D. Risk for constipation related to decreased gastrointestinal motility | back 56 C. Risk for impaired gas exchange related to respiratory depression ABC.'s. Airway Breathing Circulation. p. 300 |
front 57 A patient admitted to the hospital with a diagnosis pf pneumonia asks the nurse why am I receiving codeine? I am not in pain. Which effect of codeine would the nurse include in responding to the patient? A. Antitussive B. Expectorant C. immunostimulant D. immunosuppressant | back 57 A. Antitussive pg. 301 |
front 58 Which trigger of migraine headaches would the nurse include when teaching a patient about the administration of sumatriptan for treatment of migraine headaches? Select all that apply A. Red wine B. Chocolate C. Aspartame D. Sleep deprivation E. Monosodium Glutamate | back 58 All of them |
front 59 When assessing a patient for adverse effects of morphine sulfate, which finding would the nurse expect? A. Diarrhea B. insomnia C. Drowsiness D. increased Bowel sounds | back 59 C. Drowsiness |
front 60 Which statement describes the action of ibuprofen to relieve pain? A. It blocks the action of phospholipase B. It acts in the same way as endorphins C. It reduces the production of leukotrienes D. it block the action of cyclooxyrgenase | back 60 D. It blocks the action of cyclooxygenase Corticosteroids block the action of phosphoipase Opioid analgesics such as morphine and endorphins act on the same receptors Cortisone acts by reducing the production of leukotrienes |
front 61 Which assessment parameter is most important for the nurse to evaluate when determining safe dosing of morphine sulfate for the management of pain in a patient with a terminal cancer diagnosis? A. Sedation level B. Respiratory Rate C. Input and output D. Blood pressure | back 61 B. Respiratory rate morphine may also increase level of sedation, cause urinary retention, and potentiate hypotension. |
front 62 Which action would the nurse take to determine whether sumatriptan is having an adverse effect on a patient being treated for a migraine? A. Assess vital signs B. Ausculate Bowel sounds C. Palpate peripheral pulses D. Ausculate Breath sounds | back 62 A. Assess vital Signs Side effects include hypotension or hypertension, bradycardia or tachycardia. |
front 63 Which actions would the nurse take when a patient with a history of migraine headaches reports, "I'm seeing flashes of light, I have some blind spots, and my hands are tingling"? A. Assess the patient's vital signs B. Administer the patient's naratriptan C. assess the patient's neurologic status D. Notify the health care provider of patient's symptoms | back 63 B. Administer the patient's Naratriptan |
front 64 Which question is a priority for the nurse to ask a patient diagnosed with migraine headaches who is prescribed sumatriptan? A. Do you have a history of diabetes? B. What other medications are you on? C. Have you ever taken Sumatriptan? D. Do you have a history of coronary artery disease? | back 64 D. Do you have a history of coronary artery disease Sumatriptan works to decrease migraine pain by decreasing the arteries in the brain. Sumatriptan could cause the patient to experience a myocardial infarction by constricting the coronary arteries. P 307 |
front 65 Which action would be priority for the nurse to take when noting an elevated blood urea nitrogen and creatinine level in a patient receiving sumatriptan? A. Assess the patient's breath sounds B. Evaluate the patient's diet C. Monitor the patient's intake and output D. Stop the medication and notify the health care provider | back 65 D. Stop the medication and notify the health care provider Life threatening adverse reaction to sumatriptan is renal failure.. |
front 66 Which discharge teaching would the nurse provide to a patient who is taking morphine for postoperative pain? select all that apply A. increase rest periods B. Take a stool softener C. Decrease the medication dosage D. Eat more animal protein and dairy E. Increase fluid intake throughout the day | back 66 B. Take a stool softener E. Increase fluid intake throughout the day |
front 67 A patient receiving morphine has a respiratory rate of 7 breaths per min, and pupils are 1mm and unreactive. Which action would the nurse take? A. call a code B. Call anesthesia C. Administer naloxone D. Initiate rescue breathing | back 67 C. Administer naloxone |
front 68 For which type of pain is a fentanyl transdermal patch best suited? A. Pain after abdominal surgery B. Acute treatment of a migraine headache C. Lower back pain related to lumbar strain D. Severe pai resulting fro cancer metastasis | back 68 D. Severe pain resulting from cancer metastasis |
front 69 The nurse is teaching a student nurse about the benefits of the use of hydromorphone therapy over morphine sulfate. Which benefit identified by the student indicates teaching was effective? Select all that apply A. Hydromorphone has no risk for respiratory depression B. Hydromorphone has a faster onset of action compared with morphine C. Hydromorphone has a greater hypnotic effect compared with morphine. D. Hydromorphone has a shorter duration of action compared with morphine E. The analgesic effect of hydromorphone is 6 times more potent than morphine | back 69 B. D. E. |