Chapter 25: Analgesics

Chapter 25: Analgesics

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

MULTIPLE CHOICE

 

1. The nurse is evaluating a patient 2 hours after giving a dose of 30 mg of codeine with acetaminophen for postoperative pain after abdominal surgery. The patient reports a pain level of 7 on a scale of 1 to 10. The nurse notes a heart rate of 110 beats per minute, a respiratory rate of 28 breaths per minute, and a blood pressure of 180/90 mm Hg. Which action will the nurse take?

a.	Administer the next dose of codeine 1 hour early.
b.	Ask the provider if the codeine dose can be increased.
c.	Contact the provider to ask if a dose of ibuprofen may be given now.
d.	Request an order for oxycodone with acetaminophen (Percocet).

 

 

ANS:   D

The patient is showing signs of moderate to severe pain unrelieved by codeine, so the nurse should request a more potent opioid analgesic such as oxycodone. Codeine is effective for mild to moderate pain so will not be effective for this patient even if the dose is increased. The medication should not be given more frequently than every 4 hours. Ibuprofen is used for musculoskeletal pain and not postoperative pain.

 

DIF:    Cognitive Level: Applying (Application)                              REF:    p. 331

TOP:    Nursing Process: Evaluation/Nursing Intervention

MSC:   NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

 

2. The nurse is teaching a female patient who will begin taking 2 tablets of 325 mg acetaminophen every 4 to 6 hours as needed for pain. Which statement by the patient indicates understanding of the teaching?

a.	“I may take acetaminophen up to 6 times daily if needed.”
b.	“I should increase the dose of acetaminophen if I drink caffeinated coffee.”
c.	“If I take oral contraceptive pills, I should use back-up contraception.”
d.	“It is safe to take acetaminophen with any over-the-counter medications.”

 

 

ANS:   A

The maximum daily dose of acetaminophen is 4000 mg. If this patient takes 650 mg/dose 6 times daily, this amount is safe. Taking acetaminophen with caffeine increases the effect of the acetaminophen. Taking acetaminophen with OCPs decreases the effect of the acetaminophen but does not diminish the effect of the OCP. Many over-the-counter medications contain acetaminophen, so patients should be advised to read labels carefully to avoid overdose.

 

DIF:    Cognitive Level: Applying (Application)                              REF:    p. 325

TOP:    Nursing Process: Planning

MSC:   NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

 

3. The parent of a 5-year-old child asks the nurse to recommend an over-the-counter pain medication for the child. Which analgesic will the nurse recommend?

a.	Acetaminophen (Tylenol)
b.	Aspirin (Ecotrin)
c.	Diflunisal (Dolobid)
d.	Ibuprofen (Motrin)

 

 

ANS:   A

Acetaminophen is safe to give to children and does not cause gastrointestinal upset or interfere with platelet aggregation. Aspirin carries an increased risk of Reye’s syndrome in children. Diflunisal (Dolobid) is not available over the counter.

 

DIF:    Cognitive Level: Applying (Application)                              REF:    p. 325

TOP:    Nursing Process: Nursing Intervention: Patient Teaching

MSC:   NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

 

4. The nurse is performing an admission assessment on an adolescent who reports taking extra-strength acetaminophen (Tylenol) regularly to treat daily headaches. The nurse will notify the patient’s provider and discuss an order for

a.	a selective serotonin receptor agonist (SSRA).
b.	hydrocodone with acetaminophen for headache pain.
c.	liver enzyme tests.
d.	serum glucose testing.

 

 

ANS:   C

Large doses or overdoses of acetaminophen can be toxic to hepatic cells, so when large doses are administered over a long period, liver function should be assessed. Daily headaches are not typical of migraine headaches, so SSRA medication is not indicated. Hydrocodone with acetaminophen is not indicated without further evaluation of headaches. Serum glucose is not indicated.

 

DIF:    Cognitive Level: Applying (Application)                              REF:    p. 325

TOP:    Nursing Process: Assessment/Planning

MSC:   NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies