Nursing practice questions with comprehensive rationales
NurseDive Free Nursing Practice Question
A nurse is caring for a patient who is receiving epidural analgesia with buprenorphine (Buprenex). Which assessment finding would indicate that an adverse effect may be occurring?
A. Respiratory rate: 10 breaths/min
This indicates that the patient may be experiencing respiratory depression, which is a serious adverse effect of buprenorphine and other opioids. Respiratory depression can lead to hypoxia, brain damage, or death if not treated promptly. The normal respiratory rate for adults is 12 to 20 breaths/min.
B. Blood pressure: 110/70 mm Hg
This is wrong because this is within the normal range for adults, which is 90/60 to 120/80 mm Hg.Buprenorphine can cause hypotension as a side effect, but this is not evident in this case.
C. Heart rate: 72 beats/min
This is wrong because this is also within the normal range for adults, which is 60 to 100 beats/min.Buprenorphine can cause bradycardia as a side effect, but this is not evident in this case.
D. Temperature: 37°C.
This is wrong because this is the normal body temperature for humans.Buprenorphine can cause hyperthermia as a side effect, but this is not evident in this case.
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Full Explanation
The correct answer is choice A) Respiratory rate: 10 breaths/min. This indicates that the patient may be experiencing respiratory depression, which is a serious adverse effect of buprenorphine and other opioids.
Respiratory depression can lead to hypoxia, brain damage, or death if not treated promptly.
The normal respiratory rate for adults is 12 to 20 breaths/min.
Choice B) Blood pressure: 110/70 mm Hg is wrong because this is within the normal range for adults, which is 90/60 to 120/80 mm Hg. Buprenorphine can cause hypotension as a side effect, but this is not evident in this case.
Choice C) Heart rate: 72 beats/min is wrong because this is also within the normal range for adults, which is 60 to 100 beats/min. Buprenorphine can cause bradycardia as a side effect, but this is not evident in this case.
Choice D) Temperature: 37°C is wrong because this is the normal body temperature for humans. Buprenorphine can cause hyperthermia as a side effect, but this is not evident in this case.
Similar Questions
A patient who is addicted to heroin is admitted to the hospital for treatment of an infection. The patient is prescribed methadone (Dolophine) as part of a detoxification program. What is the rationale for using methadone in this patient?
A. Methadone prevents withdrawal symptoms and reduces cravings for heroin.
This is wrong because methadone does not prevent withdrawal symptoms, but rather reduces them.
B. Methadone blocks the euphoric effects of heroin and discourages its use.
Methadone blocks the euphoric effects of heroin and discourages its use.Methadone is a synthetic opioid analgesic that produces a cross-tolerance to other narcotics, thereby preventing the user from feeling the high of heroin.Methadone also reduces the withdrawal symptoms and cravings for heroin.
C. Methadone stimulates opioid receptors and enhances natural pain relief.
This is wrong because methadone does not stimulate opioid receptors, but rather occupies them and blocks their activation by heroin.
D. Methadone reverses the respiratory depression caused by heroin overdose.
This is wrong because methadone does not reverse the respiratory depression caused by heroin overdose, but rather carries a risk of overdose itself.
Full Explanation
The correct answer is choice B. Methadone blocks the euphoric effects of heroin and discourages its use. Methadone is a synthetic opioid analgesic that produces a cross-tolerance to other narcotics, thereby preventing the user from feeling the high of heroin. Methadone also reduces withdrawal symptoms and cravings for heroin.
Choice A is wrong because methadone does not prevent withdrawal symptoms, but rather reduces them.
Choice C is wrong because methadone does not stimulate opioid receptors, but rather occupies them and blocks their activation by heroin.
Choice D is wrong because methadone does not reverse the respiratory depression caused by heroin overdose, but rather carries a risk of overdose itself.
A patient who has chronic low back pain is prescribed oxycodone (OxyContin) for long-term use.
Which of the following interventions should the nurse implement to prevent complications from this medication? (Select all that apply.)
A. Monitor the patient’s vital signs regularly.
This is wrong because monitoring vital signs regularly is not specific to oxycodone use, but rather a general nursing intervention for any patient with chronic pain.
B. Encourage fluid intake and high-fiber foods.
Oxycodone (OxyContin) is a potent opioid analgesic that can causeconstipation,drowsiness,nausea,pruritus, andvomitingas common side effects. To prevent constipation, the patient should be encouraged to drink plenty of fluids and eat high-fiber foods.To prevent respiratory depression and sedation, the patient should be advised to avoid alcohol and other CNS depressants while taking oxycodone.
C. Advise the patient to avoid alcohol and other CNS depressants.
Oxycodone (OxyContin) is a potent opioid analgesic that can causeconstipation,drowsiness,nausea,pruritus, andvomitingas common side effects. To prevent constipation, the patient should be encouraged to drink plenty of fluids and eat high-fiber foods.To prevent respiratory depression and sedation, the patient should be advised to avoid alcohol and other CNS depressants while taking oxycodone.
D. Instruct the patient to take acetaminophen (Tylenol) for breakthrough pain.
This is wrong because acetaminophen (Tylenol) can interact with oxycodone and increase the risk of liver damage. The patient should not take any other pain medications without consulting the prescriber.
E. Teach the patient how to use a patient-controlled analgesia (PCA) pump.
This is wrong because a patient-controlled analgesia (PCA) pump is not used for long-term pain management, but rather for acute or postoperative pain.Oxycodone (OxyContin) is formulated as an extended-release tablet that provides sustained pain relief for up to 12 hours.
Full Explanation
The correct answer is choice B and C. Oxycodone (OxyContin) is a potent opioid analgesic that can cause constipation, drowsiness, nausea, pruritus, and vomiting as common side effects.
To prevent constipation, the patient should be encouraged to drink plenty of fluids and eat high-fiber foods. To prevent respiratory depression and sedation, the patient should be advised to avoid alcohol and other CNS depressants while taking oxycodone.
Choice A is wrong because monitoring vital signs regularly is not specific to oxycodone use, but rather a general nursing intervention for any patient with chronic pain.
Choice D is wrong because acetaminophen (Tylenol) can interact with oxycodone and increase the risk of liver damage.
The patient should not take any other pain medications without consulting the prescriber.
Choice E is wrong because a patient-controlled analgesia (PCA) pump is not used for long-term pain management, but rather for acute or postoperative pain. Oxycodone (OxyContin) is formulated as an extended-release tablet that provides sustained pain relief for up to 12 hours.
A patient with chronic back pain is prescribed gabapentin as an adjuvant analgesic. The nurse should instruct the patient to report which of the following adverse effects?
A. Blurred vision
Blurred vision is a common side effect of gabapentin and should be reported to the doctor. Blurred vision can affect the patient’s ability to perform daily activities and may indicate a serious problem with the eyes or the brain.
B. Constipation
That is wrong because constipation is not a common side effect of gabapentin. Constipation can be caused by other factors such as diet, dehydration, or lack of physical activity.
C. Dry mouth
This is wrong because dry mouth is a common side effect of gabapentin and does not usually require medical attention. Dry mouth can be relieved by drinking water, chewing sugar-free gum, or using saliva substitutes.
D. Tinnitus
This is wrong because tinnitus is not a common side effect of gabapentin. Tinnitus is a ringing or buzzing sound in the ears that can be caused by many conditions such as ear infections, hearing loss, or exposure to loud noises.
Full Explanation
The correct answer is choice A. Blurred vision is a common side effect of gabapentin and should be reported to the doctor.
Blurred vision can affect the patient’s ability to perform daily activities and may indicate a serious problem with the eyes or the brain.
Choice B is wrong because constipation is not a common side effect of gabapentin.
Constipation can be caused by other factors such as diet, dehydration, or lack of physical activity.
Choice C is wrong because dry mouth is a common side effect of gabapentin and does not usually require medical attention.
Dry mouth can be relieved by drinking water, chewing sugar-free gum, or using saliva substitutes.
Choice D is wrong because tinnitus is not a common side effect of gabapentin.
Tinnitus is a ringing or buzzing sound in the ears that can be caused by many conditions such as ear infections, hearing loss, or exposure to loud noises.