Nclex Examination Chapter 28: Opioid (Narcotic) Analgesics, Opioid Antagonist, and Nonopioid Centrally Acting Analgesics.

The nurse recognizes that the primary indication for the administration of morphine is to do what? A. Relieve pain B. Reduce anxiety C. Treat left ventricular failure D. Decrease level of consciousness - ANSWER-A. Relieve pain The principal indication for morphine is relief of moderate to severe pain. The drug can relieve postoperative pain, the chronic pain of cancer, and pain associated with labor and delivery. In addition, morphine can be used to relieve pain of myocardial infarction and dyspnea associated with left ventricular failure and pulmonary edema. Morphine may also be administered before surgery for sedation and reduction of anxiety. In preparing an inservice about opioids, the nurse includes which problem as the most serious adverse effect? A. Suppressed cardiac automaticity B. Respiratory depression C. Profound sedation D. Hyperthermia - ANSWER-B. Respiratory depression Respiratory depression is the most serious adverse effect of the opioids. At equianalgesic doses, all of the pure opioid agonists depress respiration to the same extent. Death following overdose is almost always a result of respiratory arrest. The nurse correlates orthostatic hypotension resulting from opioid administration with which cause? A. Decreased heart rate B. Impaired contractility C. Dilation of peripheral veins D. Elevated circulating catecholamines - ANSWER-C. Dilation of peripheral veins Morphine-like drugs lower blood pressure by blunting the baroreceptor reflex and by dilating peripheral arterioles and veins. Peripheral vasodilation results primarily from morphine-induced release of histamine. Hypotension is mild in the recumbent patient but can be substantial when the patient stands up