NURS 4301 Exam 3 Multimodal Interventions for Pain
Management Learning Objectives Questions With Complete
Solutions
Antidote for acetaminophen overdose Correct Answer N-
acetylcysteine, activated charcoal
Calculate morphine milligram equivalent (MME) dosage from
prescription information and interpret the results Correct
Answer identify patients at risk of overdose and death with too
high of doses (≥50 MME/day, avoid ≥90 MME/day); determine
total daily amount of each opioid taken → convert to MMEs by
multiplying the dose by its conversion factor → add them
together
Compare and contrast the benefits and limitations of continuous
versus intermittent schedules of analgesic delivery Correct
Answer continuous prevents pain from occurring in between
doses that would make it harder to control and need to take more
to reduce level again; continuous is easier to overdose; least
effective is nurse driven PRN
Describe mixed opioid agonist-antagonists in terms of their
mechanism of action and indications Correct Answer bind as
agonists on kappa receptors and as weak antagonists or partial
agonists on mu receptors; produce less respiratory depression
than drugs acting only at mu receptors; produce analgesia when
administered alone; limited clinical application in pain
management due to analgesic ceiling, precipitation of
withdrawal for dependence on mu agonist drugs, and blocking
effects of other drugs
, Describe opioid agonists in terms of their mechanism of action
and indications Correct Answer bind as agonists to mu and
kappa receptors; produce analgesia, euphoria, respiratory
depression, physical dependence, constipation
Describe opioid antagonists in terms of their mechanism of
action and indications Correct Answer bind as antagonists to
mu and kappa receptors; reversal of respiratory and CNS
depression caused by overdose of opioid agonist; may treat
opioid-induced constipation
Describe the contraindications for acetaminophen Correct
Answer concurrent alcohol use at high doses may cause liver
and kidney damage; warfarin; vaccines; undernourished; liver
disease
Describe the contraindications for aspirin Correct Answer
peptic ulcer disease, bleeding disorders (due to irreversible
inhibition of COX, so body needs to make more COX),
hypersensitivity; use in pregnancy and children with influenza or
chicken pox requires extreme caution
Describe the contraindications for nonsteroidal anti-
inflammatory drugs (NSAIDs) Correct Answer peptic ulcer
disease; 65+; concurrent use of corticosteroids or anticoagulants;
pregnancy; concurrent use of lithium; increased risk for GI
bleeding with concurrent use of SSRIs
Describe the contraindications in the delivery of opioids through
a patient-controlled analgesia (PCA) device Correct Answer
Management Learning Objectives Questions With Complete
Solutions
Antidote for acetaminophen overdose Correct Answer N-
acetylcysteine, activated charcoal
Calculate morphine milligram equivalent (MME) dosage from
prescription information and interpret the results Correct
Answer identify patients at risk of overdose and death with too
high of doses (≥50 MME/day, avoid ≥90 MME/day); determine
total daily amount of each opioid taken → convert to MMEs by
multiplying the dose by its conversion factor → add them
together
Compare and contrast the benefits and limitations of continuous
versus intermittent schedules of analgesic delivery Correct
Answer continuous prevents pain from occurring in between
doses that would make it harder to control and need to take more
to reduce level again; continuous is easier to overdose; least
effective is nurse driven PRN
Describe mixed opioid agonist-antagonists in terms of their
mechanism of action and indications Correct Answer bind as
agonists on kappa receptors and as weak antagonists or partial
agonists on mu receptors; produce less respiratory depression
than drugs acting only at mu receptors; produce analgesia when
administered alone; limited clinical application in pain
management due to analgesic ceiling, precipitation of
withdrawal for dependence on mu agonist drugs, and blocking
effects of other drugs
, Describe opioid agonists in terms of their mechanism of action
and indications Correct Answer bind as agonists to mu and
kappa receptors; produce analgesia, euphoria, respiratory
depression, physical dependence, constipation
Describe opioid antagonists in terms of their mechanism of
action and indications Correct Answer bind as antagonists to
mu and kappa receptors; reversal of respiratory and CNS
depression caused by overdose of opioid agonist; may treat
opioid-induced constipation
Describe the contraindications for acetaminophen Correct
Answer concurrent alcohol use at high doses may cause liver
and kidney damage; warfarin; vaccines; undernourished; liver
disease
Describe the contraindications for aspirin Correct Answer
peptic ulcer disease, bleeding disorders (due to irreversible
inhibition of COX, so body needs to make more COX),
hypersensitivity; use in pregnancy and children with influenza or
chicken pox requires extreme caution
Describe the contraindications for nonsteroidal anti-
inflammatory drugs (NSAIDs) Correct Answer peptic ulcer
disease; 65+; concurrent use of corticosteroids or anticoagulants;
pregnancy; concurrent use of lithium; increased risk for GI
bleeding with concurrent use of SSRIs
Describe the contraindications in the delivery of opioids through
a patient-controlled analgesia (PCA) device Correct Answer
