NSG 533 Opioid Quiz Study Guide- Advanced Pharmacology
Practice Questions & Answers 3 Versions
This specialized clinical test-preparation guide features targeted practice questions,
verified answers, and detailed therapeutic rationales designed explicitly for the NSG 533
Opioid Quiz. It provides comprehensive graduate-level coverage of opioid
pharmacology, including mu-receptor agonism, adverse effect mitigation, equianalgesic
dosing conversions, and strict opioid rotation protocols. Advanced practice nursing
students will master substance use disorder criteria, safety monitoring parameters, and
prescriptive compliance regulations required to pass their proctored clinical
assessments.
1. A nurse is calculating an equianalgesic dose for a client being switched from
morphine to fentanyl. Which conversion ratio is correct?
A) 1 mg IV morphine = 1 mcg IV fentanyl
B) 1 mg IV morphine = 10 mcg IV fentanyl
C) 1 mg IV morphine = 100 mcg IV fentanyl
D) 1 mg IV morphine = 0.1 mcg IV fentanyl
Rationale: The equianalgesic ratio for IV morphine to IV fentanyl is approximately 1 mg
morphine to 10 mcg fentanyl (100:1 ratio).
2. A nurse is converting a client from oral oxycodone to oral morphine. Which
equianalgesic ratio is correct?
A) 1 mg oxycodone = 1 mg morphine
B) 1 mg oxycodone = 1.5 mg morphine
C) 1 mg oxycodone = 3 mg morphine
D) 1 mg oxycodone = 5 mg morphine
Rationale: The equianalgesic ratio for oral oxycodone to oral morphine is approximately
1:1.5 (1 mg oxycodone ≈ 1.5 mg morphine).
3. A client on methadone is being rotated to morphine. Which statement about
methadone conversion is correct?
A) Methadone conversion is linear and predictable
,B) Methadone conversion is nonlinear and requires careful titration
C) Methadone is equianalgesic to morphine at all doses
D) Methadone should never be rotated
Rationale: Methadone has a nonlinear conversion ratio that increases with higher doses,
requiring careful titration and specialist guidance.
4. A nurse is teaching about codeine metabolism. Which CYP enzyme is
responsible for converting codeine to morphine?
A) CYP1A2
B) CYP2D6
C) CYP3A4
D) CYP2C9
Rationale: Codeine is metabolized by CYP2D6 to morphine; genetic variations affect
analgesic efficacy and toxicity risk.
5. A client on fentanyl is prescribed a CYP3A4 inhibitor. Which effect should the
nurse monitor for?
A) Decreased fentanyl effect
B) Increased fentanyl toxicity
C) No change in fentanyl effect
D) Increased fentanyl clearance
Rationale: CYP3A4 inhibitors decrease fentanyl metabolism, leading to increased fentanyl
levels and risk of toxicity.
6. A nurse is teaching about opioid interactions with benzodiazepines. Which
effect should the nurse include?
A) Decreased sedation
B) Increased risk of respiratory depression
,C) Increased analgesia
D) Decreased constipation
Rationale: Combining opioids with benzodiazepines significantly increases the risk of
respiratory depression and overdose.
7. A client on tramadol is prescribed an SSRI. Which adverse effect should the
nurse monitor for?
A) Decreased tramadol effect
B) Serotonin syndrome
C) Hypertension
D) Bradycardia
Rationale: Tramadol and SSRIs both increase serotonin, increasing the risk of serotonin
syndrome.
8. A nurse is assessing a client on opioids. Which finding indicates miosis?
A) Dilated pupils
B) Constricted pupils
C) Unequal pupils
D) Fixed pupils
Rationale: Opioids cause miosis (pinpoint pupils) due to stimulation of the oculomotor
nerve.
9. A client on opioids develops hypotension. Which mechanism is responsible?
A) Increased cardiac output
B) Histamine release and vasodilation
C) Increased sympathetic tone
D) Increased blood volume
Rationale: Opioids can cause histamine release and vasodilation, leading to hypotension.
, 10. A nurse is assessing a client on opioids. Which finding indicates bradycardia?
A) Heart rate 100 beats/min
B) Heart rate 50 beats/min
C) Heart rate 80 beats/min
D) Heart rate 120 beats/min
Rationale: Opioids can cause bradycardia through increased vagal tone.
11. A client on opioids reports nausea. Which mechanism is responsible?
A) Direct GI irritation
B) Stimulation of the chemoreceptor trigger zone
C) Increased gastric motility
D) Decreased gastric acid
Rationale: Opioids stimulate the chemoreceptor trigger zone in the brain, causing nausea
and vomiting.
12. A nurse is teaching about opioid-induced pruritus. Which mechanism is
responsible?
A) Direct opioid receptor activation
B) Histamine release
C) Serotonin release
D) Acetylcholine release
Rationale: Opioid-induced pruritus is primarily caused by histamine release from mast
cells.
13. A client on opioids develops urinary retention. Which mechanism is
responsible?
A) Increased bladder contractility
Practice Questions & Answers 3 Versions
This specialized clinical test-preparation guide features targeted practice questions,
verified answers, and detailed therapeutic rationales designed explicitly for the NSG 533
Opioid Quiz. It provides comprehensive graduate-level coverage of opioid
pharmacology, including mu-receptor agonism, adverse effect mitigation, equianalgesic
dosing conversions, and strict opioid rotation protocols. Advanced practice nursing
students will master substance use disorder criteria, safety monitoring parameters, and
prescriptive compliance regulations required to pass their proctored clinical
assessments.
1. A nurse is calculating an equianalgesic dose for a client being switched from
morphine to fentanyl. Which conversion ratio is correct?
A) 1 mg IV morphine = 1 mcg IV fentanyl
B) 1 mg IV morphine = 10 mcg IV fentanyl
C) 1 mg IV morphine = 100 mcg IV fentanyl
D) 1 mg IV morphine = 0.1 mcg IV fentanyl
Rationale: The equianalgesic ratio for IV morphine to IV fentanyl is approximately 1 mg
morphine to 10 mcg fentanyl (100:1 ratio).
2. A nurse is converting a client from oral oxycodone to oral morphine. Which
equianalgesic ratio is correct?
A) 1 mg oxycodone = 1 mg morphine
B) 1 mg oxycodone = 1.5 mg morphine
C) 1 mg oxycodone = 3 mg morphine
D) 1 mg oxycodone = 5 mg morphine
Rationale: The equianalgesic ratio for oral oxycodone to oral morphine is approximately
1:1.5 (1 mg oxycodone ≈ 1.5 mg morphine).
3. A client on methadone is being rotated to morphine. Which statement about
methadone conversion is correct?
A) Methadone conversion is linear and predictable
,B) Methadone conversion is nonlinear and requires careful titration
C) Methadone is equianalgesic to morphine at all doses
D) Methadone should never be rotated
Rationale: Methadone has a nonlinear conversion ratio that increases with higher doses,
requiring careful titration and specialist guidance.
4. A nurse is teaching about codeine metabolism. Which CYP enzyme is
responsible for converting codeine to morphine?
A) CYP1A2
B) CYP2D6
C) CYP3A4
D) CYP2C9
Rationale: Codeine is metabolized by CYP2D6 to morphine; genetic variations affect
analgesic efficacy and toxicity risk.
5. A client on fentanyl is prescribed a CYP3A4 inhibitor. Which effect should the
nurse monitor for?
A) Decreased fentanyl effect
B) Increased fentanyl toxicity
C) No change in fentanyl effect
D) Increased fentanyl clearance
Rationale: CYP3A4 inhibitors decrease fentanyl metabolism, leading to increased fentanyl
levels and risk of toxicity.
6. A nurse is teaching about opioid interactions with benzodiazepines. Which
effect should the nurse include?
A) Decreased sedation
B) Increased risk of respiratory depression
,C) Increased analgesia
D) Decreased constipation
Rationale: Combining opioids with benzodiazepines significantly increases the risk of
respiratory depression and overdose.
7. A client on tramadol is prescribed an SSRI. Which adverse effect should the
nurse monitor for?
A) Decreased tramadol effect
B) Serotonin syndrome
C) Hypertension
D) Bradycardia
Rationale: Tramadol and SSRIs both increase serotonin, increasing the risk of serotonin
syndrome.
8. A nurse is assessing a client on opioids. Which finding indicates miosis?
A) Dilated pupils
B) Constricted pupils
C) Unequal pupils
D) Fixed pupils
Rationale: Opioids cause miosis (pinpoint pupils) due to stimulation of the oculomotor
nerve.
9. A client on opioids develops hypotension. Which mechanism is responsible?
A) Increased cardiac output
B) Histamine release and vasodilation
C) Increased sympathetic tone
D) Increased blood volume
Rationale: Opioids can cause histamine release and vasodilation, leading to hypotension.
, 10. A nurse is assessing a client on opioids. Which finding indicates bradycardia?
A) Heart rate 100 beats/min
B) Heart rate 50 beats/min
C) Heart rate 80 beats/min
D) Heart rate 120 beats/min
Rationale: Opioids can cause bradycardia through increased vagal tone.
11. A client on opioids reports nausea. Which mechanism is responsible?
A) Direct GI irritation
B) Stimulation of the chemoreceptor trigger zone
C) Increased gastric motility
D) Decreased gastric acid
Rationale: Opioids stimulate the chemoreceptor trigger zone in the brain, causing nausea
and vomiting.
12. A nurse is teaching about opioid-induced pruritus. Which mechanism is
responsible?
A) Direct opioid receptor activation
B) Histamine release
C) Serotonin release
D) Acetylcholine release
Rationale: Opioid-induced pruritus is primarily caused by histamine release from mast
cells.
13. A client on opioids develops urinary retention. Which mechanism is
responsible?
A) Increased bladder contractility
