Nursing practice questions with comprehensive rationales
NurseDive Free Nursing Practice Question
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.
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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.
Similar Questions
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.
A patient with cancer-related bone pain is receiving etidronate as an adjuvant analgesic. The nurse should monitor the patient for which of the following laboratory values?
A. Serum calcium
Etidronate is a bisphosphonate that inhibits bone resorption and reduces the risk of skeletal complications in patients with cancer-related bone pain.However, it can also cause hypocalcemia (low serum calcium levels) as a side effect, which can lead to muscle spasms, numbness, tingling, seizures, and cardiac arrhythmias. Therefore, the nurse should monitor the patient’s serum calcium levels regularly and supplement with calcium and vitamin D if needed.
B. Serum potassium
This is wrong because etidronate does not affect potassium levels.Potassium is mainly regulated by the kidneys and can be altered by renal impairment, dehydration, acid-base imbalance, or medications such as diuretics or potassium-sparing agents.
C. Serum creatinine
This is wrong because etidronate does not affect creatinine levels. Creatinine is a waste product of muscle metabolism that is excreted by the kidneys.It reflects the glomerular filtration rate (GFR) and can be elevated in renal dysfunction or dehydration.
D. Serum albumin
This is wrong because etidronate does not affect albumin levels. Albumin is a protein that is synthesized by the liver and helps maintain fluid balance and transport substances in the blood.It can be decreased in liver disease, malnutrition, inflammation, or protein-losing conditions.
Full Explanation
The correct answer is choice A. Serum calcium. Etidronate is a bisphosphonate that inhibits bone resorption and reduces the risk of skeletal complications in patients with cancer-related bone pain. However, it can also cause hypocalcemia (low serum calcium levels) as a side effect, which can lead to muscle spasms, numbness, tingling, seizures, and cardiac arrhythmias.
Therefore, the nurse should monitor the patient’s serum calcium levels regularly and supplement with calcium and vitamin D if needed.
Choice B. Serum potassium is wrong because etidronate does not affect potassium levels. Potassium is mainly regulated by the kidneys and can be altered by renal impairment, dehydration, acid-base imbalance, or medications such as diuretics or potassium-sparing agents.
Choice C. Serum creatinine is wrong because etidronate does not affect creatinine levels.
Creatinine is a waste product of muscle metabolism that is excreted by the kidneys. It reflects the glomerular filtration rate (GFR) and can be elevated in renal dysfunction or dehydration.
Choice D. Serum albumin is wrong because etidronate does not affect albumin levels.
Albumin is a protein that is synthesized by the liver and helps maintain fluid balance and transport substances in the blood. It can be decreased in liver disease, malnutrition, inflammation, or protein-losing conditions.