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STUVIA 2024/2025Chapter 25: Analgesics
A postoperative patient has a history of opioid abuse. Which analgesic medication will the nurse
expect the provider to order for this patient?
a. Buprenorphine (Buprenex)
b. Butorphanol tartrate (Stadol)
c. Naloxone (Narcan)
d. Pentazocine (Talwin) - ✔✔ANS: A
Buprenorphine is an opioid agonist-antagonist analgesic and was developed to help decrease opioid
abuse. Butorphanol and pentazocine are also in this class, but reports say that they cause
dependence. Naloxone is an opioid antagonist and is given to reverse the effects of opioids if toxicity
occurs.
An adolescent female has dysmenorrhea associated with heavy menstrual periods. The patient's
provider has recommended ibuprofen (Motrin). When teaching this patient about this drug, the nurse
will tell her that ibuprofen:
a. may decrease the effectiveness of oral contraceptive pills.
b. may increase bleeding during her period.
c. should be taken on an empty stomach to increase absorption.
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d. will decrease the duration of her periods. - ✔✔ANS: B
When nonsteroidal anti-inflammatory drugs (NSAIDs) are used to treat dysmenorrhea, excess
bleeding may occur during the first 2 days of a period. NSAIDs do not decrease the effect of OCPs.
NSAIDs are irritating to the stomach, so patients should take it with food or a full glass of water.
NSAIDs will not decrease the duration of periods.
One hour after receiving intravenous morphine sulfate, a patient reports generalized itching. The
nurse assesses the patient and notes clear breath sounds, no rash, respirations of 14 breaths per
minute, a heart rate of 68 beats per minute, and a blood pressure of 110/70 mm Hg. Which action will
the nurse take?
a. Administer naloxone to reverse opiate overdose.
b. Have resuscitation equipment available at the bedside.
c. Prepare an epinephrine injection in case of an anaphylactic reaction.
d. Reassure the patient that this is a common side effect of this drug. - ✔✔ANS: D
Pruritus is a common opioid side effect and can be managed with diphenhydramine. Patients
developing anaphylaxis will have urticaria and hypotension, and these patients will need epinephrine
and resuscitation. Respiratory depression is a sign of morphine overdose, which will require
naloxone.
stuvia
, STUVIA 2024/2025
The emergency department nurse is caring for a patient who has received morphine sulfate for
severe pain following an injury. The nurse performs a drug history and learns that the patient takes St.
John's wort for symptoms of depression. The nurse will observe this patient closely for an increase in
which opioid adverse effect?
a. Constipation
b. Pruritus
c. Respiratory depression
d. Sedation - ✔✔ANS: D
St. John's wort can increase the sedative effects of opioids. It does not enhance other side effects.
The nurse administers nalbuphine (Nubain) to a patient who is experiencing severe pain. Which
statement by the patient indicates a need for further teaching about this drug?
a. "I may experience unusual dreams while taking this medication."
b. "I may need to use a laxative when taking this drug."
c. "I should ask for assistance when I get out of bed."
d. "I should expect to have more frequent urination." - ✔✔ANS: D
A common side effect of opioid agents is urinary retention. Patients should notify the nurse if they
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cannot void. Side effects may include unusual dreams, constipation, and dizziness.
The nurse assesses an older patient 60 minutes after administering 4 mg of intravenous morphine
sulfate (MS) for postoperative pain. The patient's analgesia order is for 2 to 5 mg of MS IV every 2
hours. The nurse notes that the patient is lying very still. The patient's heart rate is 96 beats per
minute, respiratory rate is 14 breaths per minute, and blood pressure is 140/90 mm Hg. When asked
to rate the level of pain, the patient replies "just a 5." The nurse will perform which action?
a. Give 3 mg of MS at the next dose.
b. Give 5 mg of MS at the next dose.
c. Request an order for an oral opioid to give now.
d. Request an order for acetaminophen to give now. - ✔✔ANS: B
Older patients often minimize pain when asked, so the nurse should evaluate nonverbal cues to pain
such as elevated heart rate and blood pressure and the fact that the patient is lying very still. The
nurse should increase the dose the next time the pain medication is given.
The nurse assumes care of a patient in the post-anesthesia care unit (PACU). The patient had
abdominal surgery and is receiving intravenous morphine sulfate for pain. The patient is asleep and
has not voided since prior to surgery. The nurse assesses a respiratory rate of 10 breaths per minute
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