Lilley pharm test bank ch 10
A patient was diagnosed with pancreatic cancer last month, and has complained of a dull ache
in the abdomen for the past 4 months. This pain has been gradually increasing, and the pain
relievers taken at home are no longer effective. What type of pain is the patient experiencing?
a. Acute pain
b. Chronic pain
c. Somatic pain
d. Neuropathic pain - ANS ANS: B
Chronic pain is associated with cancer and is characterized by slow onset, long duration, and
dull, persistent aching. The patient's symptoms are not characteristics of acute pain, somatic
pain, or neuropathic pain.
A 16-year-old field hockey player fell and twisted her ankle during a game. The nurse will expect
to administer which type of analgesic?
a. Synthetic opioid, such as meperidine (Demerol)
b. Opium alkaloid, such as morphine sulfate
c. Opioid antagonist, such as naloxone HCL (Narcan)
d. Nonopioid analgesics, such as indomethacin (Indocin) - ANS ANS: D
Somatic pain, which originates from skeletal muscles, ligaments, and joints, usually responds to
nonopioid analgesics such as nonsteroidal anti-inflammatory drugs (NSAIDs). The other options
are not the best choices for somatic pain.
A patient had abdominal surgery this morning. The patient is groggy but complaining of severe
pain around the incision. What is the most important assessment data to consider before the
nurse administers a dose of morphine sulfate to the patient?
a. The patient's pulse rate
b. The patient's respiratory rate
c. The appearance of the incision
d. The date of the patient's last bowel movement - ANS ANS: B
One of the most serious adverse effects of opioids is respiratory depression. The nurse must
assess the patient's respiratory rate before administering an opioid. The other options are
incorrect.
A 78-year-old patient is in the recovery room after having a lengthy surgery on his hip. As he is
gradually awakening, he requests pain medication. Within 10 minutes after receiving a dose of
morphine sulfate, he is very lethargic and his respirations are shallow, with a rate of 7
breaths/minute. The nurse prepares for which priority action at this time?
a. Assessment of the patient's pain level
b. Immediate intubation and artificial ventilation
c. Administration of naloxone (Narcan)
d. Close observation of signs of opioid tolerance - ANS ANS: C
, Naloxone, an opioid-reversal agent, is used to reverse the effects of acute opioid overdose and
is the drug of choice for reversal of opioid-induced respiratory depression. This situation is
describing an opioid overdose, not opioid tolerance. Intubation and artificial ventilation are not
appropriate because the patient is still breathing at 7 breaths/min. It would be inappropriate to
assess the patient's level of pain.
A patient will be discharged with a 1-week supply of an opioid analgesic for pain management
after abdominal surgery. The nurse will include which information in the teaching plan?
a. How to prevent dehydration due to diarrhea
b. The importance of taking the drug only when the pain becomes severe
c. How to prevent constipation
d. The importance of taking the drug on an empty stomach - ANS ANS: C
Gastrointestinal (GI) adverse effects, such as nausea, vomiting, and constipation, are the most
common adverse effects associated with opioid analgesics. Physical dependence usually
occurs in patients undergoing long-term treatment. Diarrhea is not an effect of opioid analgesics.
Taking the dose with food may help minimize GI upset.
A patient has been treated for lung cancer for 3 years. Over the past few months, the patient
has noticed that the opioid analgesic is not helping as much as it had previously and more
medication is needed for the same pain relief. The nurse is aware that this patient is
experiencing which of these?
a. Opioid addiction
b. Opioid tolerance
c. Opioid toxicity
d. Opioid abstinence syndrome - ANS ANS: B
Opioid tolerance is a common physiologic result of long-term opioid use. Patients with opioid
tolerance require larger doses of the opioid agent to maintain the same level of analgesia. This
situation does not describe toxicity (overdose), addiction, or abstinence syndrome (withdrawal).
A 38-year-old man has come into the urgent care center with severe hip pain after falling from a
ladder at work. He says he has taken several pain pills over the past few hours but cannot
remember how many he has taken. He hands the nurse an empty bottle of acetaminophen
(Tylenol). The nurse is aware that the most serious toxic effect of acute acetaminophen
overdose is which condition?
a. Tachycardia
b. Central nervous system depression
c. Hepatic necrosis
d. Nephropathy - ANS ANS: C
Hepatic necrosis is the most serious acute toxic effect of an acute overdose of acetaminophen.
The other options are incorrect.
A 57-year-old woman being treated for end-stage breast cancer has been using a transdermal
opioid analgesic as part of the management of pain. Lately, she has been experiencing
A patient was diagnosed with pancreatic cancer last month, and has complained of a dull ache
in the abdomen for the past 4 months. This pain has been gradually increasing, and the pain
relievers taken at home are no longer effective. What type of pain is the patient experiencing?
a. Acute pain
b. Chronic pain
c. Somatic pain
d. Neuropathic pain - ANS ANS: B
Chronic pain is associated with cancer and is characterized by slow onset, long duration, and
dull, persistent aching. The patient's symptoms are not characteristics of acute pain, somatic
pain, or neuropathic pain.
A 16-year-old field hockey player fell and twisted her ankle during a game. The nurse will expect
to administer which type of analgesic?
a. Synthetic opioid, such as meperidine (Demerol)
b. Opium alkaloid, such as morphine sulfate
c. Opioid antagonist, such as naloxone HCL (Narcan)
d. Nonopioid analgesics, such as indomethacin (Indocin) - ANS ANS: D
Somatic pain, which originates from skeletal muscles, ligaments, and joints, usually responds to
nonopioid analgesics such as nonsteroidal anti-inflammatory drugs (NSAIDs). The other options
are not the best choices for somatic pain.
A patient had abdominal surgery this morning. The patient is groggy but complaining of severe
pain around the incision. What is the most important assessment data to consider before the
nurse administers a dose of morphine sulfate to the patient?
a. The patient's pulse rate
b. The patient's respiratory rate
c. The appearance of the incision
d. The date of the patient's last bowel movement - ANS ANS: B
One of the most serious adverse effects of opioids is respiratory depression. The nurse must
assess the patient's respiratory rate before administering an opioid. The other options are
incorrect.
A 78-year-old patient is in the recovery room after having a lengthy surgery on his hip. As he is
gradually awakening, he requests pain medication. Within 10 minutes after receiving a dose of
morphine sulfate, he is very lethargic and his respirations are shallow, with a rate of 7
breaths/minute. The nurse prepares for which priority action at this time?
a. Assessment of the patient's pain level
b. Immediate intubation and artificial ventilation
c. Administration of naloxone (Narcan)
d. Close observation of signs of opioid tolerance - ANS ANS: C
, Naloxone, an opioid-reversal agent, is used to reverse the effects of acute opioid overdose and
is the drug of choice for reversal of opioid-induced respiratory depression. This situation is
describing an opioid overdose, not opioid tolerance. Intubation and artificial ventilation are not
appropriate because the patient is still breathing at 7 breaths/min. It would be inappropriate to
assess the patient's level of pain.
A patient will be discharged with a 1-week supply of an opioid analgesic for pain management
after abdominal surgery. The nurse will include which information in the teaching plan?
a. How to prevent dehydration due to diarrhea
b. The importance of taking the drug only when the pain becomes severe
c. How to prevent constipation
d. The importance of taking the drug on an empty stomach - ANS ANS: C
Gastrointestinal (GI) adverse effects, such as nausea, vomiting, and constipation, are the most
common adverse effects associated with opioid analgesics. Physical dependence usually
occurs in patients undergoing long-term treatment. Diarrhea is not an effect of opioid analgesics.
Taking the dose with food may help minimize GI upset.
A patient has been treated for lung cancer for 3 years. Over the past few months, the patient
has noticed that the opioid analgesic is not helping as much as it had previously and more
medication is needed for the same pain relief. The nurse is aware that this patient is
experiencing which of these?
a. Opioid addiction
b. Opioid tolerance
c. Opioid toxicity
d. Opioid abstinence syndrome - ANS ANS: B
Opioid tolerance is a common physiologic result of long-term opioid use. Patients with opioid
tolerance require larger doses of the opioid agent to maintain the same level of analgesia. This
situation does not describe toxicity (overdose), addiction, or abstinence syndrome (withdrawal).
A 38-year-old man has come into the urgent care center with severe hip pain after falling from a
ladder at work. He says he has taken several pain pills over the past few hours but cannot
remember how many he has taken. He hands the nurse an empty bottle of acetaminophen
(Tylenol). The nurse is aware that the most serious toxic effect of acute acetaminophen
overdose is which condition?
a. Tachycardia
b. Central nervous system depression
c. Hepatic necrosis
d. Nephropathy - ANS ANS: C
Hepatic necrosis is the most serious acute toxic effect of an acute overdose of acetaminophen.
The other options are incorrect.
A 57-year-old woman being treated for end-stage breast cancer has been using a transdermal
opioid analgesic as part of the management of pain. Lately, she has been experiencing
