NSG 533 Opioid Quiz Study Guide- Advanced Pharmacology
Practice Questions & Answers
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 converting a client from morphine to hydromorphone. Which
statement reflects the correct equianalgesic ratio?
A) 1 mg hydromorphone = 1 mg morphine
B) 1 mg hydromorphone = 5 mg morphine
C) 1 mg hydromorphone = 10 mg morphine
D) 1 mg hydromorphone = 2 mg morphine
Rationale: Hydromorphone is approximately 5 times more potent than morphine;
therefore, 1 mg of hydromorphone is roughly equianalgesic to 5 mg of morphine.
2. A nurse is teaching about fentanyl transdermal patch disposal. Which action is
correct?
A) Flush down the toilet
B) Throw in regular trash
C) Fold adhesive side together and dispose in a sharps container
D) Burn the patch
Rationale: Used fentanyl patches should be folded adhesive side together and disposed of
in a secure sharps container to prevent accidental exposure, especially to children and
pets.
,3. A client on methadone reports palpitations. Which ECG finding is concerning?
A) Prolonged QT interval
B) Shortened QT interval
C) ST elevation
D) U waves
Rationale: Methadone can prolong the QT interval, increasing the risk of torsades de
pointes; monitor ECG in at-risk clients.
4. A nurse is assessing a client for opioid-induced immunosuppression. Which
finding is expected?
A) Increased WBC count
B) Increased susceptibility to infections
C) Hyperglycemia
D) Hypertension
Rationale: Opioids can suppress immune function, increasing the risk of infections.
5. A client on long-term opioids reports decreased libido. Which is the likely
cause?
A) Opioid-induced hyperalgesia
B) Opioid-induced adrenal insufficiency
C) Opioid-induced hypogonadism
D) Opioid-induced hyperthyroidism
Rationale: Opioids suppress gonadotropin-releasing hormone, leading to hypogonadism
and decreased libido.
6. A nurse is teaching about opioid-induced constipation prophylaxis. Which
medication is a peripherally acting mu-opioid receptor antagonist?
A) Docusate
B) Methylnaltrexone
,C) Bisacodyl
D) Loperamide
Rationale: Methylnaltrexone is a peripherally acting mu-opioid receptor antagonist used
for opioid-induced constipation when other laxatives fail.
7. A client on PCA morphine is found unresponsive with a respiratory rate of 6.
What is the priority action?
A) Administer naloxone
B) Stimulate the client and call for help
C) Call a code
D) Document the event
Rationale: The first action is to stimulate the client and call for help, then administer
naloxone as prescribed.
8. A nurse is teaching about opioid use in breastfeeding. Which opioid is generally
considered safe?
A) Codeine
B) Morphine
C) Methadone
D) Fentanyl
Rationale: Morphine is considered safe for breastfeeding; codeine is contraindicated due to
risk of infant respiratory depression.
9. A client on opioids reports insomnia. Which intervention is appropriate?
A) Increase opioid dose
B) Add a benzodiazepine
C) Sleep hygiene measures
D) Administer naloxone
, Rationale: Opioids can disrupt sleep; sleep hygiene and non-pharmacologic measures are
first-line.
10. A nurse is assessing a client for opioid withdrawal. Which finding is expected?
A) Pinpoint pupils
B) Bradycardia
C) Diarrhea
D) Respiratory depression
Rationale: Opioid withdrawal causes diarrhea, sweating, agitation, and dilated pupils.
11. A client on high-dose opioids develops myoclonus. Which action is
appropriate?
A) Increase opioid dose
B) Rotate to a different opioid
C) Administer naloxone
D) Add a benzodiazepine
Rationale: Myoclonus can be a sign of opioid neurotoxicity; opioid rotation may help.
12. A nurse is teaching about opioid-induced hyperalgesia. Which statement is
correct?
A) It is the same as tolerance
B) It is a paradoxical increase in pain
C) It requires higher opioid doses
D) It is a sign of addiction
Rationale: Opioid-induced hyperalgesia is a paradoxical increase in pain sensitivity with
opioid use.
Practice Questions & Answers
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 converting a client from morphine to hydromorphone. Which
statement reflects the correct equianalgesic ratio?
A) 1 mg hydromorphone = 1 mg morphine
B) 1 mg hydromorphone = 5 mg morphine
C) 1 mg hydromorphone = 10 mg morphine
D) 1 mg hydromorphone = 2 mg morphine
Rationale: Hydromorphone is approximately 5 times more potent than morphine;
therefore, 1 mg of hydromorphone is roughly equianalgesic to 5 mg of morphine.
2. A nurse is teaching about fentanyl transdermal patch disposal. Which action is
correct?
A) Flush down the toilet
B) Throw in regular trash
C) Fold adhesive side together and dispose in a sharps container
D) Burn the patch
Rationale: Used fentanyl patches should be folded adhesive side together and disposed of
in a secure sharps container to prevent accidental exposure, especially to children and
pets.
,3. A client on methadone reports palpitations. Which ECG finding is concerning?
A) Prolonged QT interval
B) Shortened QT interval
C) ST elevation
D) U waves
Rationale: Methadone can prolong the QT interval, increasing the risk of torsades de
pointes; monitor ECG in at-risk clients.
4. A nurse is assessing a client for opioid-induced immunosuppression. Which
finding is expected?
A) Increased WBC count
B) Increased susceptibility to infections
C) Hyperglycemia
D) Hypertension
Rationale: Opioids can suppress immune function, increasing the risk of infections.
5. A client on long-term opioids reports decreased libido. Which is the likely
cause?
A) Opioid-induced hyperalgesia
B) Opioid-induced adrenal insufficiency
C) Opioid-induced hypogonadism
D) Opioid-induced hyperthyroidism
Rationale: Opioids suppress gonadotropin-releasing hormone, leading to hypogonadism
and decreased libido.
6. A nurse is teaching about opioid-induced constipation prophylaxis. Which
medication is a peripherally acting mu-opioid receptor antagonist?
A) Docusate
B) Methylnaltrexone
,C) Bisacodyl
D) Loperamide
Rationale: Methylnaltrexone is a peripherally acting mu-opioid receptor antagonist used
for opioid-induced constipation when other laxatives fail.
7. A client on PCA morphine is found unresponsive with a respiratory rate of 6.
What is the priority action?
A) Administer naloxone
B) Stimulate the client and call for help
C) Call a code
D) Document the event
Rationale: The first action is to stimulate the client and call for help, then administer
naloxone as prescribed.
8. A nurse is teaching about opioid use in breastfeeding. Which opioid is generally
considered safe?
A) Codeine
B) Morphine
C) Methadone
D) Fentanyl
Rationale: Morphine is considered safe for breastfeeding; codeine is contraindicated due to
risk of infant respiratory depression.
9. A client on opioids reports insomnia. Which intervention is appropriate?
A) Increase opioid dose
B) Add a benzodiazepine
C) Sleep hygiene measures
D) Administer naloxone
, Rationale: Opioids can disrupt sleep; sleep hygiene and non-pharmacologic measures are
first-line.
10. A nurse is assessing a client for opioid withdrawal. Which finding is expected?
A) Pinpoint pupils
B) Bradycardia
C) Diarrhea
D) Respiratory depression
Rationale: Opioid withdrawal causes diarrhea, sweating, agitation, and dilated pupils.
11. A client on high-dose opioids develops myoclonus. Which action is
appropriate?
A) Increase opioid dose
B) Rotate to a different opioid
C) Administer naloxone
D) Add a benzodiazepine
Rationale: Myoclonus can be a sign of opioid neurotoxicity; opioid rotation may help.
12. A nurse is teaching about opioid-induced hyperalgesia. Which statement is
correct?
A) It is the same as tolerance
B) It is a paradoxical increase in pain
C) It requires higher opioid doses
D) It is a sign of addiction
Rationale: Opioid-induced hyperalgesia is a paradoxical increase in pain sensitivity with
opioid use.
