Chapter 10: Analgesic Drugs
MULTIPLE CHOICE
1. 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: 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.
DIF: COGNITIVE LEVEL: Understanding (Comprehension) REF: p. 142
TOP: NURSING PROCESS: Assessment
MSC: NCLEX: Physiological Integrity: Basic Care and Comfort
2. An 18-year-old basketball player fell and twisted his 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 analgesic, such as indomethacin (Indocin)
ANS: D
,Somatic pain, which originates from skeletal muscles, ligaments, and joints, usually
responds to nonopioid analgesics such as nonsteroidal antiinflammatory drugs
(NSAIDs). The other options are not the best choices for somatic pain.
DIF: COGNITIVE LEVEL: Applying (Application) REF: p. 143
TOP: NURSING PROCESS: Assessment
MSC: NCLEX: Physiological Integrity: Basic Care and Comfort
3. A patient is recovering from abdominal surgery, which he had this morning. He is
groggy but complaining of severe pain around his incision. What is the most
important assessment data to consider before the nurse administers a dose of morphine
sulfate to the patient?
a. His pulse rate
b. His respiratory rate
c. The appearance of the incision
d. The date of his last bowel movement
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.
DIF: COGNITIVE LEVEL: Applying (Application) REF: p. 150
TOP: NURSING PROCESS: Assessment
MSC: NCLEX: Physiological Integrity: Reduction of Risk Potential
4. 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 per 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: 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 per minute. It would be inappropriate to assess the patient’s
level of pain.
DIF: COGNITIVE LEVEL: Applying (Application) REF: p. 150
TOP: NURSING PROCESS: Implementation
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
5. 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. Importance of taking the drug only when the pain becomes severe
c. How to prevent constipation
d. Importance of taking the drug on an empty stomach
ANS: C
Gastrointestinal 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.
DIF: COGNITIVE LEVEL: Applying (Application) REF: p. 167
TOP: NURSING PROCESS: Implementation
, MSC: NCLEX: Physiological Integrity: Reduction of Risk Potential
6. 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 opioid
a. addiction.
b. tolerance.
c. toxicity.
d. abstinence syndrome.
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).
DIF: COGNITIVE LEVEL: Understanding (Comprehension) REF: p. 144
TOP: NURSING PROCESS: Evaluation
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
7. 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: C
MULTIPLE CHOICE
1. 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: 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.
DIF: COGNITIVE LEVEL: Understanding (Comprehension) REF: p. 142
TOP: NURSING PROCESS: Assessment
MSC: NCLEX: Physiological Integrity: Basic Care and Comfort
2. An 18-year-old basketball player fell and twisted his 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 analgesic, such as indomethacin (Indocin)
ANS: D
,Somatic pain, which originates from skeletal muscles, ligaments, and joints, usually
responds to nonopioid analgesics such as nonsteroidal antiinflammatory drugs
(NSAIDs). The other options are not the best choices for somatic pain.
DIF: COGNITIVE LEVEL: Applying (Application) REF: p. 143
TOP: NURSING PROCESS: Assessment
MSC: NCLEX: Physiological Integrity: Basic Care and Comfort
3. A patient is recovering from abdominal surgery, which he had this morning. He is
groggy but complaining of severe pain around his incision. What is the most
important assessment data to consider before the nurse administers a dose of morphine
sulfate to the patient?
a. His pulse rate
b. His respiratory rate
c. The appearance of the incision
d. The date of his last bowel movement
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.
DIF: COGNITIVE LEVEL: Applying (Application) REF: p. 150
TOP: NURSING PROCESS: Assessment
MSC: NCLEX: Physiological Integrity: Reduction of Risk Potential
4. 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 per 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: 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 per minute. It would be inappropriate to assess the patient’s
level of pain.
DIF: COGNITIVE LEVEL: Applying (Application) REF: p. 150
TOP: NURSING PROCESS: Implementation
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
5. 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. Importance of taking the drug only when the pain becomes severe
c. How to prevent constipation
d. Importance of taking the drug on an empty stomach
ANS: C
Gastrointestinal 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.
DIF: COGNITIVE LEVEL: Applying (Application) REF: p. 167
TOP: NURSING PROCESS: Implementation
, MSC: NCLEX: Physiological Integrity: Reduction of Risk Potential
6. 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 opioid
a. addiction.
b. tolerance.
c. toxicity.
d. abstinence syndrome.
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).
DIF: COGNITIVE LEVEL: Understanding (Comprehension) REF: p. 144
TOP: NURSING PROCESS: Evaluation
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
7. 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: C
