NRS 3015 Medical Surgical Nursing I.
Final Exam Questions and Answers
Rank these opioids in order of strength: Codeine, Fentanyl, Morphine, Dilaudid - answer
Fentanyl, Dilaudid, Morphine, Codeine
What is the most important assessment the nurse completes before administering an
opioid agonist?
a.) hepatic labs
b.) respiratory rate
c.) bowel sounds
d.) pulse oximetry - answerRespiratory Rate
Side effects of opioid agonists: (SATA)
a.) diminished cough reflex
b.) pruritis
c.) constipation
d.) increased fall risk - answerA, B, C, D
The patient is ordered Acet/Hydromorph 325mg/5mg, the floor stocks Acet/Hydromorph
500mg/5mg. What should the nurse do?
a.) call the provider and ask for an order change
b.) call the pharmacy and request the lesser concentration
c.) administer the stocked dose - this is an acceptable substitution - answercall the
pharmacy and request a lesser concentration
How fast can we push an opioid agonist intravenously?
a.) over 1-2 minutes
b.) over 3-5 minutes
c.) over 10-15 minutes
d.) opioids should not be pushed IV - answerover 3-5 minutes
Which patient should NOT receive an IVP opioid agonist?
a.) a 65-year old woman with a history of ovarian cancer and COPD
b.) a 24-year old male s/p appendectomy ambulating in the hall with a PTA
c.) a 44-year old male s/p surgical resection of the bowel with a history of SUD
,d.) a 68-year old male with s/p prostatectomy and a pulse ox of 94% - answera 24-year
old male s/p appendectomy ambulating in the hall with a PTA
Opioid agonists should be given on a PRN basis and not scheduled.
True or False - answerBoth-ish, there's not enough information here to answer this
question
Why would we schedule opioid agonists for a patient's pain? (SATA)
a.) the patient will be participating in therapy or other painful activity
b.) the patient has had a major injury or surgery and pain is expected
c.) the nurse needs to schedule their care of their assignment` - answerA, B
How can we best assess pain in a non-verbal patient? (SATA)
a.) use a visual report aid that the patient can point to
b.) ask the patient to hold up fingers (1-10) related to pain level
c.) use the FACES scale to have them indicate which one best matches the pain
d.) the nurse can match the patient's appearance to the FACES pain scale - answerA,
B, C
A 2 day s/p knee replacement patient receiving opioids has N/V. What should the nurse
do first?
a.) hold the opioid medication at next dose
b.) palpate the abdomen
c.) auscultate the abdomen
d.) administer Zofran 4mg, IVP - answerauscultate the abdomen
A patient with a 24-hour history of flank pain, N/V has orders: 2mg Dilaudid, UA, strain
urine, and Zofran. What do you do first?
a.) give Zofran
b.) give Dilaudid
c.) do the UA
d.) strain the urine - answerGive Dilaudid
A 70-year old patient is ordered Norco 500/5 q6h and Tylenol 650 q8h. Is this safe?
a.) absolutely not
b.) yep, no worries here
c.) can I see some hepatic labs first?
d.) call the pharmacist - answerabsolutely not
What is the purpose of a surgical drain
,a.) stop bleeding
b.) prevent accumulation of excess fluid
c.) prevent infection
d.) provide sterile irrigation - answerprevent accumulation of excess fluid
Is a penrose an active drain?
True or False - answerFalse
What type of drain is a Jackson-Pratt?
Active or Passive - answerActive
The separation of a surgical incision or rupture of a would closure is called:
a.) eviseration
b.) dehiscence
c.) slough
d.) laceration - answerdehiscence
The following findings could indicate a post-operative ileus: (SATA)
a.) fever
b.) absent bowel sounds
c.) absent flatus
d.) abdominal distension - answerB, C, D
The acronym VTE means:
a.) vein to emboli
b.) venous thromboembolism
c.) variable thrombi
d.) vein tenderness - answervenous thromboembolism
This route of Heparin administration is used for VTE prophylaxis:
a.) IM
b.) SubQ
c.) PO
d.) IV - answerSubQ
Which patient is MOST at risk for developing VTE?
a.) 45-year old with hyperlipidemia & diabetes
b.) 70-year old with severe anxiety
, c.) 25-year old with IV drug dependency
d.) 60-year old day 1 post-op knee replacement - answer60-year old 1 day post-op knee
replacement
Etomidate (Amidate)
a.) anticholinergic
b.) adrenergic agonist, inotropic
c.) hynotic, anesthesia induction agent
d.) antiplatelet - answerhynotic, anesthesia induction agent
Why does Fentanyl cause hypotension?
a.) vasoconstriction
b.) vasodilation
c.) dizziness
d.) bradycardia - answervasodilation
Atropine
a.) speeds up the heart
b.) slows down the heart
c.) stops the heart
d.) increases contractility of the heart - answerspeeds up the heart
Atropine is classified as a/an
a.) anticholinergic
b.) parasympatholitic
c.) both a & b
d.) neither a or b - answerboth a & b
Atropine can be used post-operative to decrease N/V
True or False - answerTrue
Midazolam is an ___ and a ___ ___
a.) anticholinergic, muscle relaxer
b.) anxiolytic, muscle relaxer - answeranxiolytic, muscle relaxer
Midazolam is in the following drug family:
a.) opioid
b.) NSAID
c.) benzodiazepine
Final Exam Questions and Answers
Rank these opioids in order of strength: Codeine, Fentanyl, Morphine, Dilaudid - answer
Fentanyl, Dilaudid, Morphine, Codeine
What is the most important assessment the nurse completes before administering an
opioid agonist?
a.) hepatic labs
b.) respiratory rate
c.) bowel sounds
d.) pulse oximetry - answerRespiratory Rate
Side effects of opioid agonists: (SATA)
a.) diminished cough reflex
b.) pruritis
c.) constipation
d.) increased fall risk - answerA, B, C, D
The patient is ordered Acet/Hydromorph 325mg/5mg, the floor stocks Acet/Hydromorph
500mg/5mg. What should the nurse do?
a.) call the provider and ask for an order change
b.) call the pharmacy and request the lesser concentration
c.) administer the stocked dose - this is an acceptable substitution - answercall the
pharmacy and request a lesser concentration
How fast can we push an opioid agonist intravenously?
a.) over 1-2 minutes
b.) over 3-5 minutes
c.) over 10-15 minutes
d.) opioids should not be pushed IV - answerover 3-5 minutes
Which patient should NOT receive an IVP opioid agonist?
a.) a 65-year old woman with a history of ovarian cancer and COPD
b.) a 24-year old male s/p appendectomy ambulating in the hall with a PTA
c.) a 44-year old male s/p surgical resection of the bowel with a history of SUD
,d.) a 68-year old male with s/p prostatectomy and a pulse ox of 94% - answera 24-year
old male s/p appendectomy ambulating in the hall with a PTA
Opioid agonists should be given on a PRN basis and not scheduled.
True or False - answerBoth-ish, there's not enough information here to answer this
question
Why would we schedule opioid agonists for a patient's pain? (SATA)
a.) the patient will be participating in therapy or other painful activity
b.) the patient has had a major injury or surgery and pain is expected
c.) the nurse needs to schedule their care of their assignment` - answerA, B
How can we best assess pain in a non-verbal patient? (SATA)
a.) use a visual report aid that the patient can point to
b.) ask the patient to hold up fingers (1-10) related to pain level
c.) use the FACES scale to have them indicate which one best matches the pain
d.) the nurse can match the patient's appearance to the FACES pain scale - answerA,
B, C
A 2 day s/p knee replacement patient receiving opioids has N/V. What should the nurse
do first?
a.) hold the opioid medication at next dose
b.) palpate the abdomen
c.) auscultate the abdomen
d.) administer Zofran 4mg, IVP - answerauscultate the abdomen
A patient with a 24-hour history of flank pain, N/V has orders: 2mg Dilaudid, UA, strain
urine, and Zofran. What do you do first?
a.) give Zofran
b.) give Dilaudid
c.) do the UA
d.) strain the urine - answerGive Dilaudid
A 70-year old patient is ordered Norco 500/5 q6h and Tylenol 650 q8h. Is this safe?
a.) absolutely not
b.) yep, no worries here
c.) can I see some hepatic labs first?
d.) call the pharmacist - answerabsolutely not
What is the purpose of a surgical drain
,a.) stop bleeding
b.) prevent accumulation of excess fluid
c.) prevent infection
d.) provide sterile irrigation - answerprevent accumulation of excess fluid
Is a penrose an active drain?
True or False - answerFalse
What type of drain is a Jackson-Pratt?
Active or Passive - answerActive
The separation of a surgical incision or rupture of a would closure is called:
a.) eviseration
b.) dehiscence
c.) slough
d.) laceration - answerdehiscence
The following findings could indicate a post-operative ileus: (SATA)
a.) fever
b.) absent bowel sounds
c.) absent flatus
d.) abdominal distension - answerB, C, D
The acronym VTE means:
a.) vein to emboli
b.) venous thromboembolism
c.) variable thrombi
d.) vein tenderness - answervenous thromboembolism
This route of Heparin administration is used for VTE prophylaxis:
a.) IM
b.) SubQ
c.) PO
d.) IV - answerSubQ
Which patient is MOST at risk for developing VTE?
a.) 45-year old with hyperlipidemia & diabetes
b.) 70-year old with severe anxiety
, c.) 25-year old with IV drug dependency
d.) 60-year old day 1 post-op knee replacement - answer60-year old 1 day post-op knee
replacement
Etomidate (Amidate)
a.) anticholinergic
b.) adrenergic agonist, inotropic
c.) hynotic, anesthesia induction agent
d.) antiplatelet - answerhynotic, anesthesia induction agent
Why does Fentanyl cause hypotension?
a.) vasoconstriction
b.) vasodilation
c.) dizziness
d.) bradycardia - answervasodilation
Atropine
a.) speeds up the heart
b.) slows down the heart
c.) stops the heart
d.) increases contractility of the heart - answerspeeds up the heart
Atropine is classified as a/an
a.) anticholinergic
b.) parasympatholitic
c.) both a & b
d.) neither a or b - answerboth a & b
Atropine can be used post-operative to decrease N/V
True or False - answerTrue
Midazolam is an ___ and a ___ ___
a.) anticholinergic, muscle relaxer
b.) anxiolytic, muscle relaxer - answeranxiolytic, muscle relaxer
Midazolam is in the following drug family:
a.) opioid
b.) NSAID
c.) benzodiazepine
