med surg 2 exam 1 (test bank)

med surg 2 exam 1 (test bank) A patient has been on opioids for 3 months to control pain caused by injuries from a motor vehicle crash. The patient asks about the risk of withdrawal symptoms when the drugs are no longer needed. How should the nurse respond to the patient? - ANS "As long as you taper the drug dose down slowly, you should not experience withdrawal symptoms." The nurse is caring for a patient with lung cancer who has been receiving morphine for 2 weeks and reports the medication is no longer effective. Which is the patient likely experiencing? - ANS Tolerance A patient with chronic pain is on a sustained-release opioid that is ordered every 12 hours. After 6 hours, the patient complains of increasing pain. Which intervention by the nurse is appropriate? - ANS Obtain an order for an immediate-release opioid for breakthrough pain The nurse is preparing to provide opioid medication for a patient's postoperative pain. Which action should the nurse take first? - ANS Determine the respiratory rate. A patient with peripheral neuropathy states, "I don't know why the doctor put me on an antidepressant. I am not depressed!" Which response by the nurse is best? - ANS "Antidepressants are sometimes used to treat nerve pain such as you are experiencing." A patient receiving large doses of opioids is lethargic and difficult to arouse, with a respiratory rate of 6 per minute and constricted pupils. Which medication should the nurse anticipate being prescribed? - ANS Naloxone (Narcan) A physician writes an order to give a saline injection to a patient who has been requesting frequent meperidine (Demerol) shots. Which initial response by the licensed practical nurse (LPN) is best? - ANS Tell the physician about feeling uncomfortable administering saline if the patient thinks it is Demerol. A patient with chronic back pain has a new order for a fentanyl (Duragesic) patch. As the nurse applies the patch, the patient states, "I'm really glad to get that patch on. I am really hurting bad." Which response by the nurse is correct? - ANS "The patch may take a while to work. Would you like a pain shot in the meantime?" The nurse enters a room just as a patient's daughter pushes the button of his IV patient controlled analgesia (PCA) pump. Which response by the nurse is appropriate? - ANS "It is dangerous for anyone but your dad to push the button. Remind him to push it himself if he needs it." The nurse is performing a pain assessment on a newly admitted patient. Which question best assesses the severity of pain? - ANS "Can you please rate your pain on a scale of 0 to 10?" A patient who has just returned from abdominal surgery states, "I learned relaxation exercises, so I won't need any drugs." Which statement about relaxation therapy should the nurse use to guide care for this patient? - ANS Relaxation therapy is an excellent adjunct treatment for pain when used with analgesics The nurse is having difficulty assessing the pain of a mentally impaired patient who has an approximate functional level of a 4-year-old child. Which method should the nurse use to determine the patient's pain level? - ANS Use the FACES scale The nurse is caring for a group of patients. Which patient is experiencing chronic pain? - ANS A patient who fell off a ladder 6 months ago and injured his back The nurse is caring for a patient who is receiving morphine via PCA. Which finding would be of most concern to the nurse? - ANS Respirations 10 breaths/min A patient reports that she has been having bloody stools for the past month. Which medication can the nurse expect to note on the medication history? - ANS Naproxen (Aleve) The nurse is reviewing orders for a patient with diabetic neuropathy. Which medication should the nurse expect to administer? - ANS Carbamazepine (Tegretol) The nurse is caring for a patient who underwent an amputation of the left arm. The patient reports level 9 pain on a 0-to-10 scale. Which action should the nurse take? - ANS Administer 4 mg of morphine intravenously as prescribed The nurse is caring for a patient who was in a motor vehicle accident and has multiple fractures. The patient reports level 9 pain on a 0-to-10 scale. Which route should the nurse use to administer the medication for quickest relief of pain? - ANS IV The nurse is caring for a patient with metastatic cancer. The patient is receiving 4 mg of morphine intravenously every 6 hours as needed and 5 mg hydrocodone/acetaminophen (Lortab) every 6 hours orally as needed for breakthrough pain. The patient reports the medication is effective, but the medication wears off before the dose is due. The nurse notifies the health care provider. Which order should the nurse anticipate? - ANS Changing medications to an around-the-clock schedule The nurse is caring for a group of patients. Which patient is experiencing acute pain? - ANS A patient with a diagnosis of pancreatitis A patient taking hydromorphone for cancer pain is experiencing constipation. What should the nurse teach to help this patient? - AN