CH 10 NCLEX Prep

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A patient needs to switch analgesic drugs secondary to an adverse reaction to the current treatment regimen. The patient is concerned that the new prescription will not provide optimal pain control. The nurse’s response is based on knowledge that doses of analgesics are determined using an equianalgesic table with which drug prototype?



The nurse is caring for a patient with opioid addiction. The nurse anticipates that the patient will be prescribed which medication?

Methadone (Dolophine)


While admitting a patient for treatment of an acetaminophen (Tylenol) overdose, the nurse prepares to administer which medication to prevent toxicity?

Acetylcysteine (Mucomyst)


A patient prescribed massage therapy for musculoskeletal pain asks the nurse, “How is rubbing my muscles going to make the pain go away?” What is the nurse’s best response?

“Massaging muscles activates large sensory nerve fibers that send signals to the spinal cord to close the gate, thus blocking painful stimuli from reaching the brain.”


When assessing for the MOST serious adverse effect to an opioid analgesic, what does the nurse monitor for in this patient?

Respiratory rate


Which medication is used to treat a patient with severe adverse effects of a narcotic analgesic?

Naloxone (Narcan)


A patient with a diagnosis of pneumonia asks the nurse, “Why am I receiving codeine when I have no pain?” The nurse’s response is based on knowledge that codeine also has what effect?

Cough suppressant


In monitoring a patient for adverse effects related to morphine sulfate (MS Contin), the nurse assesses for stimulation of which area in the central nervous system (CNS)?

The chemoreceptor trigger zone


The nurse is preparing to administer an intravenous injection of morphine to a patient. The nurse assesses a respiratory rate of 10 breaths/min. Which action should the nurse perform?

Withhold the medication and notify the health care provider.


A patient receiving narcotic analgesics for chronic pain can minimize the GI side effects by:

increasing fluid and fiber in the diet.


A patient is prescribed an opioid analgesic for chronic pain. Which information should the nurse discuss with the patient to minimize the GI adverse effects?

Increase fluid intake and fiber in the diet.


The nurse teaches a patient prescribed the fentanyl (Duragesic) transdermal delivery system to change the patch at what interval?

Every 72 hours


The nurse plans pharmacologic management for a patient with pain. The nurse should administer the pain medication based on what dosage schedule?

Pain relief is best obtained by administering analgesics around the clock.


In developing a plan of care for a patient receiving morphine sulfate (MS Contin), which nursing diagnosis has the highest priority?

Impaired gas exchange related to respiratory depression


When assessing a patient for adverse effects related to morphine sulfate (MS Contin), which clinical findings is the nurse MOST likely to find? (Select all that apply.)


Inability to void