NURS 3320 EVALUATION EXAM 2025 QUESTIONS WITH
SOLUTIONS RATED A+
✔✔Opiods- what will you monitor? - ✔✔Respiratory Status:
Tis may last longer than the analgesic effect and nalaxone and resuscitative equipment
should be nearby
Pain relief
BP: hypotension
HR: bradycardia
Other Adverse Reactions: Constipation, urinary retention
Tolerance and Dependence: the first sign is usually a shortened duration of drug
effectiveness
✔✔Mixed Opioid Agonist-Antagonists - ✔✔Some opioid analgesics have agonist and
antagonist properties. The agonist component relieves pain while the antagonist
decreases risks of toxicity and dependence; thus reducing the risk for respiratory
depression and drug abuse
Prototypes:
pentazocine hydrochloride
butorphanol tartrate (Stadol)
✔✔Butorphanol (Stadol) - ✔✔Mixed agonist-antagonist analgesic resulting in good
analgesia but with less respiratory depression, nausea, and vomiting compared with
opioid agonist analgesics.
✔✔What will occur if mixed agonist-antagonists are administered to a patient already
taking narcotics? - ✔✔Initiation of withdrawal symptoms:
Tremors
Agitation
N&V
✔✔What are the 4 side effects of narcotic medications? - ✔✔Respiratory depression
CNS depression
N&V
Constipation
✔✔Opioid Educaton - ✔✔Be care walking and getting up from bed
Avoid hazardous activities
No alcohol
,Increase fiber in diet and use a stool softener to prevent constipation
Breathe deeply, cough, and change position every 2 hours
Report continued pain
✔✔Nursing Implications for Opioids - ✔✔The goal is to relieve moderate to severe pain
while causing minimal respiratory depression, constipation, urinary retention and other
adverse effects
Obtain Baseline data: pain, VS, identify high risk pt's
Administer as ordered
Evaluate therapeutic effects (1 hour after administration)
Minimize adverse effects and interactions
✔✔Non-Opioid Analgesics - ✔✔These meds target and block the chemical substances
released by the brain (particularly prostaglandin) in response to injury.
Used to control mild to moderate pain and/or fever
✔✔Non-Opioid Analgesic Prototypes - ✔✔Acetaminophen (Tylenol)
NSAIDS:
Meloxicam (Mobic)
Naproxen (Aleve, Midol)
Radiopharmaceuticals:
Strontium-89 Chloride (Metastron)
Herbals
Salicylates: Aspirin
✔✔Non-Opioids What to Know - ✔✔Nice to Know:
Analgesia for mild to moderate pain
NSAIDS - pain relief, suppression of inflammation, and reduction of fever
Acetaminophen - analgesia but lacks anti-inflammatory
Good to Know:
Strontium-89 chloride is a radiopharmaceutical is given intravenously to help relieve the
bone pain associated with some cancers.
Really Important to Know:
Acetaminophen is found in more than 600 (!) over-the-counter drugs. Educate your
clients to read labels and reinforce the recommended maximum daily dose is 4000 mg.
✔✔Salicylates (Aspirin) - ✔✔Used to control pain, reduce fever, reduce inflammation
, One salicylate, Aspirin, inhibits platelet aggregation (thus prevents clotting) and as a
result can enhance blood flow during an MI and prevent an event such as a recurrent MI
✔✔Adverse Effects of Salicylates - ✔✔Most Common:
•Gastric distress (give with food, milk or a large glass of water to reduce GI reactions)
•N&V
•Bleeding tendencies
Other:
Hearing loss, diarrhea, thirst, tinnitus, confusion, dizziness, impaired vision,
hyperventilation, Reye's syndrome (when given to children w the chickenpox or flulike
symptoms)
✔✔When do you withhold Aspirin and notify provider - ✔✔Bleeding
Salicylism (salicylate poisoning characterized by tinnitus or hearing loss)
Adverse GI reactions
Stop aspirin 5-7 days before elective surgery is ordered.
✔✔Salicylate Poisoning - ✔✔Fever
Tinnitus
N&V
Lethargy/Excitability
Hyperventilation leading to respiratory alkalosis
When severe:
Metabolic Acidosis
Seizures
Toxic Level for a 30lb child: 12 adult aspirin; or 48 baby aspirin
✔✔Acetaminophen - ✔✔Drug of choice for fever or flulike symptoms
Be aware that high doses or unsupervised long-term use can cause liver damage
(excessive alcohol use increases risk)
Liver toxicity increased with: phenytoin, barbiturates, carbamezapine, rifampin, and
isoniazid are combined with acetaminophen
Monitor for hepatic damage (N&V, diarrhea, abdominal pain)
Antidote: Acetylcysteine
✔✔What drugs cannot be combined with acetaminophen due to risk of hepatotoxicity? -
✔✔Phenytoin
Barbiturates
Carbamezapine
Rifampin
Isoniazid
SOLUTIONS RATED A+
✔✔Opiods- what will you monitor? - ✔✔Respiratory Status:
Tis may last longer than the analgesic effect and nalaxone and resuscitative equipment
should be nearby
Pain relief
BP: hypotension
HR: bradycardia
Other Adverse Reactions: Constipation, urinary retention
Tolerance and Dependence: the first sign is usually a shortened duration of drug
effectiveness
✔✔Mixed Opioid Agonist-Antagonists - ✔✔Some opioid analgesics have agonist and
antagonist properties. The agonist component relieves pain while the antagonist
decreases risks of toxicity and dependence; thus reducing the risk for respiratory
depression and drug abuse
Prototypes:
pentazocine hydrochloride
butorphanol tartrate (Stadol)
✔✔Butorphanol (Stadol) - ✔✔Mixed agonist-antagonist analgesic resulting in good
analgesia but with less respiratory depression, nausea, and vomiting compared with
opioid agonist analgesics.
✔✔What will occur if mixed agonist-antagonists are administered to a patient already
taking narcotics? - ✔✔Initiation of withdrawal symptoms:
Tremors
Agitation
N&V
✔✔What are the 4 side effects of narcotic medications? - ✔✔Respiratory depression
CNS depression
N&V
Constipation
✔✔Opioid Educaton - ✔✔Be care walking and getting up from bed
Avoid hazardous activities
No alcohol
,Increase fiber in diet and use a stool softener to prevent constipation
Breathe deeply, cough, and change position every 2 hours
Report continued pain
✔✔Nursing Implications for Opioids - ✔✔The goal is to relieve moderate to severe pain
while causing minimal respiratory depression, constipation, urinary retention and other
adverse effects
Obtain Baseline data: pain, VS, identify high risk pt's
Administer as ordered
Evaluate therapeutic effects (1 hour after administration)
Minimize adverse effects and interactions
✔✔Non-Opioid Analgesics - ✔✔These meds target and block the chemical substances
released by the brain (particularly prostaglandin) in response to injury.
Used to control mild to moderate pain and/or fever
✔✔Non-Opioid Analgesic Prototypes - ✔✔Acetaminophen (Tylenol)
NSAIDS:
Meloxicam (Mobic)
Naproxen (Aleve, Midol)
Radiopharmaceuticals:
Strontium-89 Chloride (Metastron)
Herbals
Salicylates: Aspirin
✔✔Non-Opioids What to Know - ✔✔Nice to Know:
Analgesia for mild to moderate pain
NSAIDS - pain relief, suppression of inflammation, and reduction of fever
Acetaminophen - analgesia but lacks anti-inflammatory
Good to Know:
Strontium-89 chloride is a radiopharmaceutical is given intravenously to help relieve the
bone pain associated with some cancers.
Really Important to Know:
Acetaminophen is found in more than 600 (!) over-the-counter drugs. Educate your
clients to read labels and reinforce the recommended maximum daily dose is 4000 mg.
✔✔Salicylates (Aspirin) - ✔✔Used to control pain, reduce fever, reduce inflammation
, One salicylate, Aspirin, inhibits platelet aggregation (thus prevents clotting) and as a
result can enhance blood flow during an MI and prevent an event such as a recurrent MI
✔✔Adverse Effects of Salicylates - ✔✔Most Common:
•Gastric distress (give with food, milk or a large glass of water to reduce GI reactions)
•N&V
•Bleeding tendencies
Other:
Hearing loss, diarrhea, thirst, tinnitus, confusion, dizziness, impaired vision,
hyperventilation, Reye's syndrome (when given to children w the chickenpox or flulike
symptoms)
✔✔When do you withhold Aspirin and notify provider - ✔✔Bleeding
Salicylism (salicylate poisoning characterized by tinnitus or hearing loss)
Adverse GI reactions
Stop aspirin 5-7 days before elective surgery is ordered.
✔✔Salicylate Poisoning - ✔✔Fever
Tinnitus
N&V
Lethargy/Excitability
Hyperventilation leading to respiratory alkalosis
When severe:
Metabolic Acidosis
Seizures
Toxic Level for a 30lb child: 12 adult aspirin; or 48 baby aspirin
✔✔Acetaminophen - ✔✔Drug of choice for fever or flulike symptoms
Be aware that high doses or unsupervised long-term use can cause liver damage
(excessive alcohol use increases risk)
Liver toxicity increased with: phenytoin, barbiturates, carbamezapine, rifampin, and
isoniazid are combined with acetaminophen
Monitor for hepatic damage (N&V, diarrhea, abdominal pain)
Antidote: Acetylcysteine
✔✔What drugs cannot be combined with acetaminophen due to risk of hepatotoxicity? -
✔✔Phenytoin
Barbiturates
Carbamezapine
Rifampin
Isoniazid
