Chapter 28: Opioid (Narcotic) Analgesics, Opioid Antagonists, and Nonopioid Cen-trally Acting Analgesics

Chapter 28: Opioid (Narcotic) Analgesics, Opioid Antagonists, and Nonopioid Centrally Acting Analgesics

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

1. An elderly patient weighing 119 pounds reports having back pain for 3 months and taking only nonsteroidal anti-inflammatory agents to alleviate the pain. The nurse anticipates the administration of which medication to address the patient’s chronic pain?

a.	Fentanyl (Duragesic) 25 mcg
b.	Hydrocodone (Vicodin) 60 mg
c.	Tramadol (Ultram) 50 mg
d.	Morphine sulfate 10 mg

 

 

ANS:   A

Duragesic would be used to address the patient’s chronic pain, and the dose is appropriate for the patient’s weight and age.

Hydrocodone is indicated for acute moderate to severe pain, not for the chronic pain reported by this patient.

Ultram is indicated for short-term therapy for acute pain.

Morphine sulfate is indicated for acute moderate to severe pain and would not be used for chronic pain; nor would it be used in an elderly patient because of its respiratory depressive effect.

 

DIF:    Cognitive Level: Application             REF:    p. 268

TOP:    Nursing Process: Planning

MSC:   NCLEX Client Needs Category: Physiological Integrity: Pharmacological and Parenteral Therapies

 

2. A patient has been experiencing severe chronic pain for 2 months. The nurse anticipates that the prescriber will order which medication, which would have a more consistent effect for the patient’s chronic pain?

a.	Meperidine (Demerol) via patient-controlled analgesia pump
b.	Morphine (morphine sulfate) given intravenously
c.	Fentanyl (Duragesic) transdermal patch
d.	Hydromorphone hydrochloride (Dilaudid) orally

 

 

ANS:   C

Fentanyl’s half-life is very long; with transdermal application, levels remain steady for 24 to 48 hours.

Demerol is not a long-acting formula because of its short half-life, and it would not be used for chronic pain.

Morphine has a very short half-life and would not be used for chronic pain.

Hydromorphone given orally is not a long-acting formulation and would not be used to manage chronic pain.

 

DIF:    Cognitive Level: Application             REF:    pp. 268 | pp. 270

TOP:    Nursing Process: Planning

MSC:   NCLEX Client Needs Category: Physiological Integrity: Pharmacological and Parenteral Therapies

 

3. A student nurse is presenting a teaching section for the class on opiates. The student is comparing the potencies of morphine sulfate and fentanyl (Duragesic). Which of the following statements by the student should be included in her teaching session?

a.	Morphine sulfate elicits a greater response at a smaller dose.
b.	Morphine sulfate and fentanyl have about equal potency, depending on the route of administration.
c.	Potency indicates a higher dose and stronger response.
d.	Fentanyl is more potent than morphine sulfate

 

 

ANS:   D

Fentanyl is much more potent than morphine, as evidenced by its dosing in micrograms rather than milligrams.

Morphine does not elicit a greater response at a smaller dose than fentanyl.

Morphine and fentanyl do not have equal potency; fentanyl is much more potent.

Potency is defined as providing a stronger response at a smaller dosage.

 

DIF:    Cognitive Level: Analysis                  REF:    pp. 268

TOP:    Nursing Process: Evaluation

MSC:   NCLEX Client Needs Category: Physiological Integrity: Pharmacological and Parenteral Therapies