Chapter 26: Narcotics, Narcotic Antagonists and Antimigraine Agents, prepU (GRADED A) Questions and Answers REF, Karch, A. M., Focus on Nursing Pharmacology, 8th ed | 100% VERIFIED.

CHAPTER 26 Narcotics Question 1 See full question36s Report this Question When describing the onset of action of naloxone, the nurse would explain that the drug achieves its effect in which amou nt of time? You Selected: 1 to 2 minutes Correct response: 1 to 2 minutes Explanation: Naloxone is capable of restoring respiratory function within 1 to 2 minutes of administration. The shorter the time to restoring respiration the less time the client has to depend on manual or mechanical ventilation and the better the outcome for the client. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 26: Narcotics, Narcotic Antagonists and Antimigraine Agents, Prototype Summary: Naloxone, p. 454. Chapter 26: Narcotics, Narcotic Antagonists and Antimigraine Agents - Page 454 Add a Note Question 2 See full question3m 31s Report this Question Which conditions would occur due to the administration of an opioid antagonist in a client who is physically dependent on opioids? You Selected: withdrawal symptoms Correct response: withdrawal symptoms Explanation: Opioid antagonists produce withdrawal symptoms in clients who are physically dependent on opioids. Drowsiness, hypotension, and insomnia do not occur in opioid-dependent clients who are administered opioid antagonists. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 26: Narcotics, Narcotic Antagonists and Antimigraine Agents, Box 32.4, p. 449. Chapter 26: Narcotics, Narcotic Antagonists and Antimigraine Agents - Page 449 Add a Note Question 3 See full question37s Report this Question A hospice patient has been ordered morphine (Roxanol) 5 mg every 2 hours. Roxanol contains 10 mg/mL. How many mL will be administered? You Selected: 0.5 mL Correct response: 0.5 mL Explanation: 5 mg/X=10 mg/mL. The calculation results in .5 mL. The administration of 0.25, 1, or 2 mL is incorrect. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 26: Narcotics, Narcotic Antagonists and Antimigraine Agents, Table 26.1 Drugs in Focus: Narcotics (continued ), p. 446. Chapter 26: Narcotics, Narcotic Antagonists and Antimigraine Agents - Page 446 Add a Note Question 4 See full question1m 1s Report this Question A 40-year-old male client with arthritis of the knee joint has been prescribed an analgesic to relieve the pain. Which medication is a narcotic analgesic? You Selected: Morphine Correct response: Morphine Explanation: Morphine is a narcotic analgesic. Aspirin, ibuprofen, and celecoxib are nonnarcotic analgesics. Aspirin is classified as a salicylate and ibuprofen as a nonsteroidal anti-inflammatory drug (NSAID). Celecoxib is a newer NSAID that acts by inhibiting the cyclo-oxygenase–2 (COX-2) enzyme. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 26: Narcotics, Narcotic Antagonists and Antimigraine Agents, Narcotic Agonists–Antagonists, p. 450. Chapter 26: Narcotics, Narcotic Antagonists and Antimigraine Agents - Page 450 Add a Note Question 5 See full question2m 53s Report this Question The nurse is caring for a patient who is suffering from postoperative pain. The physician orders 2.5 mg of morphine IV q2h. Morphine is supplied in 10 mg/mL vials. How many mL will the nurse administer in each dose? You Selected: 0.25 mL Correct response: 0.25 mL Explanation: Since 1 mL contains 10 mg of morphine, the nurse will administer 0.25 mL to deliver 2.5 mg of morphine (2.5 mg ÷ 10 mg/mL = 0.25 mL) Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 26: Narcotics, Narcotic Antagonists and Antimigraine Agents, Table 26.1 Drugs in Focus: Narcotics (continued ), p. 446. Chapter 26: Narcotics, Narcotic Antagonists and Antimigraine Agents - Page 446 Add a Note Question 6 See full question4m 11s Report this Question Morphine, an opioid agonist, is administered for both acute and chronic pain. Along with the administered dosage, what determines the patient's response to morphine? You Selected: The route of administration Correct response: The route of administration Explanation: Patient response to morphine depends on the route of administration and the dosage. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 26: Narcotics, Narcotic Antagonists and Antimigraine Agents, Box 26.3, p. 448. Chapter 26: Narcotics, Narcotic Antagonists and Antimigraine Agents - Page 448 Add a Note Question 7 See full question28s Report this Question The nurse enters the client's room to see how the client's pain level is because PRN demerol can be given. The client is sitting up in bed laughing and visiting with family. The client states that the pain is a "10" on a pain scale of 0 to 10. What is the best response by the nurse? You Selected: Administer the pain medication as ordered. Correct response: Administer the pain medication as ordered. Explanation: Pain is what the client says it is. If the client states pain is a "10" and is requesting medication, the nurse should medicate as per orders. The client laughing and visiting may be a method of coping with the pain. The nurse should demonstrate a nonjudgmental attitude to build a trusting relationship. The nurse cannot alter the dosage of medication without consulting the health care provider. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 26: Narcotics, Narcotic Antagonists and Antimigraine Agents, Pain Management, p. 444. Chapter 26: Narcotics, Narcotic Antagonists and Antimigraine Agents - Page 444 Add a Note Question 8 See full question1m 19s Report this Question Which medications are opioids for which naloxone may be given to counter the effects? You Selected: Meperidine Correct response: Meperidine Explanation: Meperidine is an opioid medication for which naloxone is an opioid antagonist, and for which naloxone counters the effects. Acetaminophen is not an opioid medication and naloxone would have no effect on a client receiving this medication. Ibuprofen and naproxen are nonsteroidal anti-inflammatory drugs, and naloxone would have no effect on a client receiving these medications. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 26: Narcotics, Narcotic Antagonists and Antimigraine Agents, Box 26.1, p. 445. Chapter 26: Narcotics, Narcotic Antagonists and Antimigraine Agents - Page 445 Add a Note Question 9 See full question1m 26s Report this Question A client's family asks why the nurse has placed suction equipment in the room immediately after administering a dose of naloxone. Which explanation by the nurse is correct? You Selected: Abrupt reversal of opioid-induced respiratory depression may cause vomiting. Correct response: Abrupt reversal of opioid-induced respiratory depression may cause vomiting. Explanation: It is important to keep suction equipment readily available because abrupt reversal of opioid-induced respiratory depression may cause vomiting. None of the other rationales provided is a valid reason for adding suction equipment to the room of a client who requires a dose of naloxone. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 26: Narcotics, Narcotic Antagonists and Antimigraine Agents, Adverse Effects, p. 448. Chapter 26: Narcotics, Narcotic Antagonists and Antimigraine Agents - Page 448 Add a Note Question 10 See full question1m 33s Report this Question A client who is receiving morphine reports nausea after every dose of medication. What is the nurse’s best response to this client? You Selected: “This is a common side effect of the medication. I will try to make sure you have something to eat when you take the morphine.” Correct response: “This is a common side effect of the medication. I will try to make sure you have something to eat when you take the morphine.” Explanation: Nausea is a common side effect of morphine. Giving it with food helps to reduce the occurrence of the problem. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 26: Narcotics, Narcotic Antagonists and Antimigraine Agents, Prototype Summary: Morphine, p. 449. Chapter 26: Narcotics, Narcotic Antagonists and Antimigraine Agents - Page 449 Add a Note Question 11 See full question9s Report this Question A client is to receive a narcotic that will be applied transdermally. The nurse identifies this as which agent? You Selected: Fentanyl Correct response: Fentanyl Explanation: Fentanyl is available as a transdermal patch. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 26: Narcotics, Narcotic Antagonists and Antimigraine Agents, Table 26.1 Drugs in Focus: Narcotics, p. 445. Chapter 26: Narcotics, Narcotic Antagonists and Antimigraine Agents - Page 445 Add a Note Question 12 See full question14s Report this Question A nurse is assessing a client’s pain level. Which would be the most appropriate method? You Selected: Have the client rate it on a scale of 1 to 10. Correct response: Have the client rate it on a scale of 1 to 10. Explanation: The most appropriate method for assessing pain is to have the client rate his pain by using some type of scale. This provides objective evidence of the severity of the pain and provides a basis for comparison later on. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 26: Narcotics, Narcotic Antagonists and Antimigraine Agents, Pain Management, p. 444. Chapter 26: Narcotics, Narcotic Antagonists and Antimigraine Agents - Page 444 Add a Note Question 13 See full question40s Report this Question The nurse is giving instructions to a client who has just been prescribed sumatriptan for the treatment of migraine headaches. The client will be instructed to take this medication at what time? You Selected: At the onset of migraine symptoms Correct response: At the onset of migraine symptoms Explanation: Sumatriptan should be taken at the onset of migraine symptoms. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 26: Narcotics, Narcotic Antagonists and Antimigraine Agents, Prototype Summary: Sumatriptan, p. 460. Chapter 26: Narcotics, Narcotic Antagonists and Antimigraine Agents - Page 460 Add a Note Question 14 See full question51s Report this Question A client is to receive naltrexone. The nurse would expect to administer this drug by which route? You Selected: Oral Correct response: Oral Explanation: Naltrexone is administered orally. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 26: Narcotics, Narcotic Antagonists and Antimigraine Agents, Pharmacokinetics, p. 454. Chapter 26: Narcotics, Narcotic Antagonists and Antimigraine Agents - Page 454 Add a Note Question 15 See full question6m 32s Report this Question Which information presented in the client’s history should prompt the nurse to discourage a client from self-medicating with an over-the-counter (OTC) acetaminophen, aspirin, and caffeine combination drug? You Selected: The client has a diagnosis of liver cirrhosis. Correct response: The client has a diagnosis of liver cirrhosis. Explanation: Clients diagnosed with hepatic impairment should not receive this combination agent on an ongoing basis. They may not metabolize acetaminophen in this combined medication effectively, leading to hepatotoxicity. Lack of previous adherence, cigarette smoking, and the presence of skin ulcers do not necessarily contraindicate the use of this drug. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 26: Narcotics, Narcotic Antagonists and Antimigraine Agents. Add a Note Question 16 See full question50s Report this Question In order to maximize therapeutic benefit while reducing the risk of adverse effects of sumatriptan, the nurse should encourage the client to implement which intervention? You Selected: Take the medication as soon as the earliest symptoms of migraine are sensed. Correct response: Take the medication as soon as the earliest symptoms of migraine are sensed. Explanation: It is important to administer sumatriptan at the onset of migraine symptoms. The drug is not taken on a daily, scheduled basis and is not used as a preventative treatment. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 26: Narcotics, Narcotic Antagonists and Antimigraine Agents, Box 11.3 Focus on Herbal and Alternative Therapies, p. 174. Chapter 26: Narcotics, Narcotic Antagonists and Antimigraine Agents - Page 174 Add a Note Question 17 See full question1m 2s Report this Question Naproxen has been prescribed to a client whose increasingly severe migraines are interfering with work performance and family life. When providing health education to this client, the nurse should instruct the client to consider what intervention? You Selected: Take the pills with meals to minimize stomach upset. Correct response: Take the pills with meals to minimize stomach upset. Explanation: Naproxen should be taken on a full stomach. The pills should not be crushed. Constipation is not a noted adverse effect, and regular blood work is not warranted. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 52: Drug Therapy for Migraines and other Headaches, Box 11.3 Focus on Herbal and Alternative Therapies, p. 174. Chapter 26: Narcotics, Narcotic Antagonists and Antimigraine Agents - Page 174 Add a Note Question 18 See full question2m 13s Report this Question A group of nursing students are reviewing information about the different classifications of opioids. The students demonstrate understanding of the information when they identify which as an opioid agonist? Select all that apply. You Selected: fentanyl oxycodone hydromorphone Correct response: hydromorphone fentanyl oxycodone Explanation: Hydromorphone, fentanyl, and oxycodone are opioid agonists. Buprenorphine and pentazocine are agonist-antagonists. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 26: Narcotics, Narcotic Antagonists and Antimigraine Agents, Contraindications and Cautions, p. 448. Chapter 26: Narcotics, Narcotic Antagonists and Antimigraine Agents - Page 448 Add a Note Question 19 See full question25s Report this Question Which client would the nurse identify as being opioid naive? You Selected: one who does not routinely take opioids Correct response: one who does not routinely take opioids Explanation: Opioid-naive clients are defined as those who do not use opioids or infrequently use them. Those who routinely take and are physically or psychologically dependent on opioids are not considered opioid naive. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 26: Narcotics, Narcotic Antagonists and Antimigraine Agents. Add a Note Question 20 Report this Question The client is to take almotriptan 6.25 mg orally for a migraine. Almotriptan is sent to the unit from the pharmacy in 12.5-mg tablets. The nurse will administer how many tablet(s)? Your Response: 0.5 Correct response: 0.5 Explanation: 6.25/12.5 = 0.5 or 1/2 tablet Question 1 See full question57s Report this Question The nurse observes that a new client’s medication regimen includes sumatriptan. What assessment should the nurse prioritize? You Selected: Assessing the client for respiratory depression Correct response: Assessing the client for migraine pain Explanation: Sumatriptan is indicated for the treatment of acute migraine and cluster headaches. As such, the nurse should assess the client for indications of this health problem, more so than respiratory status or blood pressure. Narcotic withdrawal syndrome is unrelated. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 26: Narcotics, Narcotic Antagonists and Antimigraine Agents, Therapeutic Actions and Indications, p. 458. Chapter 26: Narcotics, Narcotic Antagonists and Antimigraine Agents - Page 458 Add a Note Question 2 See full question1m 37s Report this Question A client has been administered an opioid. What effect should the client be regularly assessed for? You Selected: level of consciousness (LOC) Correct response: level of consciousness (LOC) Explanation: Opioids will produce decreased LOC. Oliguria is not a result of the administration of an opioid. Edema is not a result of the administration of an opioid. Tachycardia is not a result of the administration of an opioid. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 26: Narcotics, Narcotic Antagonists and Antimigraine Agents, Pain Receptors, pp. 443-444. Chapter 26: Narcotics, Narcotic Antagonists and Antimigraine Agents - Page 443-444 Add a Note Question 3 See full question3m 14s Report this Question A nurse has entered a client's room at the beginning of a shift to quickly assess the clent's airway, breathing, circulation, and consciousness. The nurse observes that the client is wincing, stating, “ Oh, I am in so much pain right now.” What initial question should the nurse ask this client? You Selected: "Where exactly are you hurting?" Correct response: "Where exactly are you hurting?" Explanation: To begin the pain assessment, first determine the location of the pain. Location gives possible clues to the source of the pain and can help identify whether the pain is acute or of a more chronic nature. Questions about preferred treatments and the timing of the pain are appropriate and important, but it is normally necessary to first ascertain the location of the client's pain. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 26: Narcotics, Narcotic Antagonists and Antimigraine Agents, Pain, p. 442. Chapter 26: Narcotics, Narcotic Antagonists and Antimigraine Agents - Page 442 Add a Note Question 4 See full question18s Report this Question The nurse knows that, of the following clients, who is least likely to be prescribed transdermal fentanyl? You Selected: A woman 85 years of age Correct response: A woman 85 years of age Explanation: The transdermal route of medication administration is dependent upon the amount of subcutaneous tissue present for medication distribution. Subcutaneous tissue is reduced as a result of the aging process. Therefore, the client 85 years of age would be least likely to be prescribed a transdermal medication. The clients 25, 35 and 50 years of age would have adequate subcutaneous tissue for medication distribution. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 26: Narcotics, Narcotic Antagonists and Antimigraine Agents, Narcotic Agonists, p. 445. Chapter 26: Narcotics, Narcotic Antagonists and Antimigraine Agents - Page 445 Add a Note Question 5 See full question1m 13s Report this Question The health care provider has ordered 0.2 mg naloxone to be administered intramuscularly stat. The pharmacy has available naloxone 0.4 mg/mL. How much naloxone will the nurse administer to the client? Your Response: 0.5 Correct response: 0.5 Explanation: If there is 0.4 mg in 1 mL and the nurse wishes to give 0.2 mg, then the nurse should withdraw 1/2 of 1 mL or 0.5 mL. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 26: Narcotics, Narcotic Antagonists and Antimigraine Agents, Table 26.1 Drugs in Focus: Narcotics, p. 447. Chapter 26: Narcotics, Narcotic Antagonists and Antimigraine Agents - Page 447 Add a Note Question 6 See full question6m 42s Report this Question Which instruction would the nurse include for a client who is prescribed extended release oxycodone? You Selected: Take the tablet as a whole tablet at one time. Correct response: Take the tablet as a whole tablet at one time. Explanation: Extended-release preparations should be taken as a whole tablet—not cut, crushed, or chewed. Doing so with oxycodone would allow release of the entire drug dose at one time instead of the gradual release over time, as would be appropriate with an extended-release form. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 26: Narcotics, Narcotic Antagonists and Antimigraine Agents, Contraindications and Cautions, p. 448. Chapter 26: Narcotics, Narcotic Antagonists and Antimigraine Agents - Page 448 Add a Note Question 7 See full question58s Report this Question The client's care plan specifies the use of preemptive analgesia. This approach to pain control will involve what nursing intervention? You Selected: simultaneous use of analgesics from different drug classes Correct response: simultaneous use of analgesics from different drug classes Explanation: Preemptive analgesia is used to reduce postsurgical pain by simultaneously administering medications from different drug classes to suppress pain by blocking multiple pain pathways. It is not synonymous with PCA and does not require alternation between opioid agonists and antagonists nor is it necessarily more frequent or requires higher medication dosage. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 26: Narcotics, Narcotic Antagonists and Antimigraine Agents. Add a Note Question 8 See full question35s Report this Question An elderly client experiencing recurrent tension headaches reports taking an over-the-counter (OTC) combination of acetaminophen, aspirin, and caffeine several times a week. The nurse should recognize that this combination medication may be contraindicated if the client has a history of what medical condition? You Selected: gastrointestinal (GI) bleeding Correct response: gastrointestinal (GI) bleeding Explanation: Aspirin is normally contraindicated in clients who have had a history of GI bleeding. The other listed health problems do not contraindicate the use of combination acetaminophen, aspirin, and caffeine. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 26: Narcotics, Narcotic Antagonists and Antimigraine Agents, Antifungal Agents, p. 171. Chapter 26: Narcotics, Narcotic Antagonists and Antimigraine Agents - Page 171 Add a Note Question 9 See full question20s Report this Question A nurse is caring for a client diagnosed with a migraine. The client received acetaminophen-aspirin- caffeine by mouth. Which method should be used to assess for the therapeutic effects of the medication? You Selected: Pain scale Correct response: Pain scale Explanation: Following the administration of the acetaminophen-aspirin-caffeine combination, the client should exhibit diminished pain. The nurse assesses for pain using the pain scale. Vital signs do not always align with the pain the client is experiencing. The Glasgow coma scale assesses neurologic function and not pain. The subjective assessment can accompany the pain scale to determine and document exactly what the client states. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 26: Narcotics, Narcotic Antagonists and Antimigraine Agents, Implementation with Rationale, p. 179. Chapter 26: Narcotics, Narcotic Antagonists and Antimigraine Agents - Page 179 Add a Note Question 10 See full question44s Report this Question What is a priority nursing assessment of a client prescribed oral sumatriptan? You Selected: Vital signs Correct response: Vital signs Explanation: After administration of sumatriptan, the nurse should assess for adverse effects. These include increased blood pressure as well as chest pain, shock, dizziness and vertigo. Urine output and head to toe assessment are not warranted. The Glasgow comas scale is used to determine best neurological function and not migraine pain. Question 1 See full question32s Report this Question A client is prescribed zolmitriptan for migraine headaches. The nurse should instruct the client to administer this drug by which route? You Selected: Oral Correct response: Oral Explanation: Zolmitriptan is administered orally only. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 26: Narcotics, Narcotic Antagonists and Antimigraine Agents, Table 26.2 Drugs in Focus: Antimigraine Agents, p. 457. Chapter 26: Narcotics, Narcotic Antagonists and Antimigraine Agents - Page 457 Add a Note Question 2 See full question23s Report this Question A nurse has just administered an IM injection of meperidine (Demerol) to an elderly client. The priority nursing action for the nurse would be which? You Selected: make sure the side rails are up. Correct response: make sure the side rails are up. Explanation: The priority nursing action will be to make sure that the side rails are up. Meperidine can cause dizziness and sedation, which increase the risk of the client falling. The side rails should be up to remind the client that she should not get out of bed without help. Closing the draperies, checking the temperature of the room, and making sure the client is comfortable creates an environment that will enhance the efficacy of the medication therapy but are not the priority actions. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 26: Narcotics, Narcotic Antagonists and Antimigraine Agents, Box 26.1, p. 445. Chapter 26: Narcotics, Narcotic Antagonists and Antimigraine Agents - Page 445 Add a Note Question 3 See full question1m 42s Report this Question What role does gabapentin play in migraine treatment? You Selected: It relieves acute migraine pain. Correct response: It prevents migraines from occurring. Explanation: Studies have shown that gabapentin is effective in reducing the frequency of migraines. Gabapentin is not an abortive treatment nor does it appear to affect pain or the nature of an aura. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 26: Narcotics, Narcotic Antagonists and Antimigraine Agents, Box 11.3 Focus on Herbal and Alternative Therapies, p. 174. Chapter 26: Narcotics, Narcotic Antagonists and Antimigraine Agents - Page 174 Add a Note Question 4 See full question34s Report this Question Which statement best describes a drug’s characteristic of having no ceiling effect? You Selected: It is a valuable drug to use because dosage can be increased to relieve pain when pain increases or tolerance develops. Correct response: It is a valuable drug to use because dosage can be increased to relieve pain when pain increases or tolerance develops. Explanation: A drug with no ceiling effect is one in which there is no upper limit to the dosage that can be given to clients who have developed tolerance to previous dosages. This characteristic is especially valuable in clients with severe cancer-related pain because drug dosage can be increased and titrated to relieve pain when pain increases or tolerance develops. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 26: Narcotics, Narcotic Antagonists and Antimigraine Agents, Therapeutic Actions and Indications, p. 171. Chapter 26: Narcotics, Narcotic Antagonists and Antimigraine Agents - Page 171 Add a Note Question 5 See full question38s Report this Question How will a client’s impaired renal function affect the pharmacokinetics of morphine? You Selected: The peak drug effect will occur earlier. Correct response: Duration of action will be prolonged. Explanation: Clients with renal impairment should take minimal doses of morphine for the shortest effective time because usual doses may produce profound sedation and a prolonged duration of action. Neither desired effect, onset, nor peak are the concerns. Question 1 See full question15s Report this Question A group of students is reviewing various methods for assessing pain. The students demonstrate understanding of the material when they identify what as the most reliable method? You Selected: Using a pain rating scale Correct response: Using a pain rating scale Explanation: A pain rating scale is the most reliable method because it provides measurable evidence of pain severity. A client’s description of pain is useful, but does not provide objective or quantifiable data over time. Although percussing or palpating provides information, it would increase the client's pain and be inappropriate. Vital sign changes occur for numerous reasons and are not the best indicator of pain in clients who can speak. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 26: Narcotics, Narcotic Antagonists and Antimigraine Agents, Pain Management, p. 444. Chapter 26: Narcotics, Narcotic Antagonists and Antimigraine Agents - Page 444 Add a Note Question 2 See full question25s Report this Question A patient is suffering from a migraine headache. What is the action of sumatriptan? You Selected: Reducing inflammation in the temporal arteries Correct response: Binding to serotonin to produce vasoconstriction Explanation: Sumatriptan binds to the serotonin receptors in the intracranial blood vessels, resulting in vasoconstriction. Sumatriptan does not bind to phospholipids to diminish anxiety. Sumatriptan does not interrupt the calcium intake in the neuron. Sumatriptan does not reduce inflammation in the temporal arteries. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 26: Narcotics, Narcotic Antagonists and Antimigraine Agents, Migraine Headaches, p. 455. Chapter 26: Narcotics, Narcotic Antagonists and Antimigraine Agents - Page 455 Add a Note Question 3 See full question12s Report this Question The nurse should question the health care provider's IV morphine prescription for which client? You Selected: an 88-year-old female with failure to thrive Correct response: an 88-year-old female with failure to thrive Explanation: Opioid analgesics should be used cautiously in older adults, especially if they are debilitated. Treatment with morphine 1 day after either a mastectomy or an appendectomy is appropriate for pain management. The treatment of pain with morphine is appropriate for a client with a compound fractured femur. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 26: Narcotics, Narcotic Antagonists and Antimigraine Agents, Box 26.1, p. 445. Chapter 26: Narcotics, Narcotic Antagonists and Antimigraine Agents - Page 445 Add a Note Question 4 See full question27s Report this Question An 80-year-old man has been prescribed oxycodone for severe, noncancer, chronic pain. He tells the nurse that he has difficulty swallowing and asks if he can crush the tablet before swallowing. The nurse will advise the client that: You Selected: there is risk of an extremely high dose available all at once if the tablet is crushed. Correct response: there is risk of an extremely high dose available all at once if the tablet is crushed. Explanation: The nurse should caution the client against crushing the tablet before ingesting it. Crushing allows an extremely high dose of the drug to be available all at once, instead of being released slowly over time. Severe adverse effects are possible when it is used in this manner. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 26: Narcotics, Narcotic Antagonists and Antimigraine Agents, Contraindications and Cautions, p. 448. Chapter 26: Narcotics, Narcotic Antagonists and Antimigraine Agents - Page 448 Add a Note Question 5 See full question54s Report this Question A male client is given regular doses of morphine for a period of 6 months. His dosage now needs to be reduced gradually. The health care provider advises the nurse to pay attention to the clinical management of the client's pain to allow proper agonist coverage during the change in drug dosage. Why is the client likely to suffer unnecessary pain and discomfort if proper management is not ensured? You Selected: Physical dependence on the drug Correct response: Physical dependence on the drug Explanation: If morphine use lasts longer than 3 months, then physical dependence will occur. Dependence is characterized by a withdrawal or abstinence syndrome when morphine is discontinued; it represents an exaggerated rebound from its acute effects. Physical dependence is not the same as tolerance or addiction. Tolerance means that the body has become accustomed to the effects of a substance and that the client must use more of it to achieve the desired effect, while addiction involves compulsive use of the drug for a secondary gain, not for pain control. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 26: Narcotics, Narcotic Antagonists and Antimigraine Agents, Narcotic Agonists–Antagonists, p. 450. Chapter 26: Narcotics, Narcotic Antagonists and Antimigraine Agents - Page 450 Add a Note Question 6 See full question13s Report this Question When administering an opioid antagonist drug to a client, the primary goal of the therapy is to provide: You Selected: a return to normal respiratory rate, rhythm, and depth. Correct response: a return to normal respiratory rate, rhythm, and depth. Explanation: The primary reason for administering an opioid antagonist is because the client is experiencing respiratory depression. Therefore, the goal is to improve the client's respiratory rate, rhythm, and depth. None of the other options is part of the drug therapy. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 26: Narcotics, Narcotic Antagonists and Antimigraine Agents, Clinically Important Drug–Drug Interactions, p. 449. Chapter 26: Narcotics, Narcotic Antagonists and Antimigraine Agents - Page 449 Add a Note Question 7 See full question26s Report this Question Both categories of migraine abortive drugs (ergot alkaloids and serotonin agonists) exert powerful vasoconstrictive effects and also have what potential? You Selected: Raise blood pressure Correct response: Raise blood pressure Explanation: Both categories of migraine abortive drugs (e.g., ergot alkaloids and serotonin agonists) exert powerful vasoconstrictive effects and have the potential to raise blood pressure. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 26: Narcotics, Narcotic Antagonists and Antimigraine Agents, Therapeutic Actions and Indications, p. 456. Chapter 26: Narcotics, Narcotic Antagonists and Antimigraine Agents - Page 456 Add a Note Question 8 See full question16s Report this Question What action should the nurse take when administering meperidine 75 mg IM every 4 hours to a young adult? You Selected: Give the medication as prescribed. Correct response: Give the medication as prescribed. Explanation: The client should be administered the full dose of medication, which is within dosing recommendations. A client with adequate hepatic and renal function should not receive a lower dose of meperidine without specific instruction from the prescribing care provider. There is no apparent reason to change the route of administration, and such action cannot be implemented without the instruction of the prescribing care provider. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 26: Narcotics, Narcotic Antagonists and Antimigraine Agents, Table 26.1 Drugs in Focus: Narcotics (continued ), p. 446. Chapter 26: Narcotics, Narcotic Antagonists and Antimigraine Agents - Page 446 Add a Note Question 9 See full question22s Report this Question A client is prescribed sumatriptan. Which statement should be included in the teaching plan regarding how the medication works? You Selected: “It produces vascular constriction of cranial blood vessels.” Correct response: “It produces vascular constriction of cranial blood vessels.” Explanation: Sumatriptan binds to the serotonin receptors 5-HT1D, producing vascular constriction of the cranial blood vessels and relieving the pain of a migraine headache. It also relieves the nausea, vomiting, photophobia, and phonophobia that accompany the migraine headache. Sumatriptan does not cause bronchiole constriction or impair the reuptake of norepinephrine. It does not relax smooth muscles of the cardiovascular system. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 26: Narcotics, Narcotic Antagonists and Antimigraine Agents, Triptans, p. 458. Chapter 26: Narcotics, Narcotic Antagonists and Antimigraine Agents - Page 458 Add a Note Question 10 See full question27s Report this Question What beta-adrenergic antagonist is used for migraine prophylaxis? You Selected: propanolol Correct response: propanolol Explanation: The most commonly administered beta-adrenergic blocking agent for migraine headaches is propranolol. Verapamil is a calcium channel blocker. Valproic acid is a carboxylic acid derivative administered to control seizures and prevention of migraine headaches. Topiramate is a sulfamate-substituted monosaccharide agent used as an antiepileptic agent and to limit migraine frequency. Question 1 See full question14s Report this Question What factors affect how the patient will experience and respond to pain? Select all that apply. You Selected: Learned behavior from childhood Cultural expectation about how one should respond to pain Past experience with pain Correct response: Past experience with pain Cultural expectation about how one should respond to pain Learned behavior from childhood Explanation: The experience of pain is personal and subjective; however, how people respond to painful stimuli reflects what they have learned about pain from their families, society, and cultures of origin. Learned messages about pain are indirect, and people react to them subconsciously. These messages include reasons that people experience pain and what are considered appropriate responses to it. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 26: Narcotics, Narcotic Antagonists and Antimigraine Agents, Pain Perception, p. 444. Chapter 26: Narcotics, Narcotic Antagonists and Antimigraine Agents - Page 444 Add a Note Question 2 See full question59s Report this Question After administration of an opioid antagonist, the nurse should perform which action? You Selected: Assess vital signs every five minutes until the client responds. Correct response: Assess vital signs every five minutes until the client responds. Explanation: The client's vital signs should be assessed every five minutes until the client responds to the antagonist, and then every five to 15 minutes once they have responded. Once per hour is too long for vital signs and oxygen saturation assessment. While pain is an important nursing assessment, it is less critical than vital signs after respiratory depression has occurred. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 26: Narcotics, Narcotic Antagonists and Antimigraine Agents, Nursing Considerations for Patients Receiving Narcotic Antagonists, p. 454. Chapter 26: Narcotics, Narcotic Antagonists and Antimigraine Agents - Page 454 Add a Note Question 3 See full question56s Report this Question The nurse has administered a dose of naloxone and the client's respiratory depression improved within five minutes. When the nurse reassessed the client two hours later, the client demonstrates symptoms of respiratory depression. Which action should the nurse perform next? You Selected: Call the provider as another dose of opioid antagonist may be necessary. Correct response: Call the provider as another dose of opioid antagonist may be necessary. Explanation: The effects of some opioids may last longer than the effects of naloxone. A repeat dose of naloxone may be ordered if results obtained from the initial dose are unsatisfactory. Therefore, calling for an order would be an appropriate response. Taking no action in light of respiratory depression, or merely continuing to monitor the client, could lead to deterioration in the client's condition. No medication should be administered without a provider order. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 26: Narcotics, Narcotic Antagonists and Antimigraine Agents, Prototype Summary: Naloxone, p. 454. Chapter 26: Narcotics, Narcotic Antagonists and Antimigraine Agents - Page 454 Add a Note Question 4 See full question16s Report this Question The nurse has just administered an opioid antagonist to a client who had been experiencing respiratory depression. How soon can the nurse expect to see improvement in the client's respiratory function? You Selected: Within one to five minutes, an effect may be seen. Correct response: Within one to five minutes, an effect may be seen. Explanation: Onset of action is generally rapid and may be seen within one to five minutes. Additional doses may be required to achieve optimal effects. The other answers are incorrect because they are referring to a time later than onset of action, or refer to a conditional onset of action that is untrue. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 26: Narcotics, Narcotic Antagonists and Antimigraine Agents. Add a Note Question 5 See full question1m 24s Report this Question Although naloxone is given to counter opioid medication side effects such as respiratory depression, what additional issues (if any) may result from administration of an opioid antagonist? You Selected: Increase in the client's pain rating Correct response: Increase in the client's pain rating Explanation: An opioid antagonist will counter not only the negative effects of an opioid medication but the beneficial effects of the opioid (such as pain relief) as well, resulting in an increase in the client's pain rating. It would not result in a decrease or lack of change in the pain rating. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 26: Narcotics, Narcotic Antagonists and Antimigraine Agents. Add a Note Question 6 See full question4m 5s Report this Question A female client tells the nurse that the first thing she does when she gets a headache is drink a caffeinated beverage. The nurse is aware that caffeine is known to decrease the pain of migraine headaches by what mechanism? You Selected: Vasoconstriction of blood vessels Correct response: Vasoconstriction of blood vessels Explanation: Caffeine causes vasoconstriction of blood vessels. This helps treat migraine headaches because migraine headaches are caused by vasodilation of cerebral vessels. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 26: Narcotics, Narcotic Antagonists and Antimigraine Agents, Therapeutic Actions and Indications, p. 458. Chapter 26: Narcotics, Narcotic Antagonists and Antimigraine Agents - Page 458 Add a Note Question 7 See full question31s Report this Question A nurse is teaching a client about her prescription for acetaminophen that she will take at home. This medication consists of acetaminophen and what other likely drug that enhances the analgesic effect of acetaminophen? You Selected: codeine Correct response: codeine Explanation: Codeine is often given with acetaminophen for additive analgesic effects. None of the other medications are used in combination with acetaminophen. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 26: Narcotics, Narcotic Antagonists and Antimigraine Agents. Add a Note Question 8 See full question36s Report this Question When diagnostic testing reveals a bone fracture, what type of pain is the client experiencing? You Selected: acute somatic pain Correct response: acute somatic pain Explanation: Sprains and other traumatic injuries are examples of acute somatic pain. Somatic pain results from stimulation of nociceptors in the skin, bone, muscle, and soft tissue. Visceral pain, which is diffuse and not well localized, results when nociceptors are stimulated in abdominal or thoracic organs and their surrounding tissues either from acute or chronic injuries. Neuropathic pain is caused by lesions or physiologic changes that injure peripheral pain receptors, nerves, or the central nervous system. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 26: Narcotics, Narcotic Antagonists and Antimigraine Agents. Add a Note Question 9 See full question1m 19s Report this Question A 60-year-old client tearfully explains to the nurse how her husband downplays her frequent migraines and tells her that she needs to “just push through a headache.” She describes how her migraines have limited her ability to provide childcare for her young grandchildren and explains that she is unable to keep up her garden. The nurse should identify what nursing diagnosis when planning this client’s care? You Selected: ineffective role performance related to migraine headaches Correct response: ineffective role performance related to migraine headaches Explanation: Many nursing diagnoses likely apply to this client's situation, but there is evidence that she grieves her inability to perform a caregiving role for her grandchildren. There is no evidence that the client's health maintenance is inadequate or that she has low self-esteem. Spiritual distress is also not in evidence. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 26: Narcotics, Narcotic Antagonists and Antimigraine Agents, Box 11.3 Focus on Herbal and Alternative Therapies, p. 174. Chapter 26: Narcotics, Narcotic Antagonists and Antimigraine Agents - Page 174 Add a Note Question 10 See full question1m 5s Report this Question A group of nursing students are reviewing information about the different classifications of opioids. The students demonstrate understanding of the information when they identify which as an opioid agonist? Select all that apply. You Selected: oxycodone fentanyl hydromorphone Correct response: hydromorphone fentanyl oxycodone Explanation: Hydromorphone, fentanyl, and oxycodone are opioid agonists. Buprenorphine and pentazocine are agonist-antagonists. Show Less