Nursing practice questions with comprehensive rationales
NurseDive Free Nursing Practice Question
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.
This question is an excerpt from Nurse Dive's nursing test bank - More questions on this topics. Take the full exam now
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.
Similar Questions
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.
(Select all that apply) A patient with postoperative pain is prescribed hydroxyzine as an adjuvant analgesic. The nurse should teach the patient about which of the following benefits of this medication.
A. It can decrease anxiety related to pain.
Hydroxyzine is an antihistamine that hasantiemeticandsedativeeffects that are thought to be mediated by its actions in the brain.It can alsodecrease anxietyrelated to pain by inhibiting the hypothalamic H-1 histamine receptors.Hydroxyzine may also have apotentiatingeffect on other analgesics, although the evidence for this is not conclusive.
B. It can prevent nausea and vomiting related to pain.
Hydroxyzine is an antihistamine that hasantiemeticandsedativeeffects that are thought to be mediated by its actions in the brain.It can alsodecrease anxietyrelated to pain by inhibiting the hypothalamic H-1 histamine receptors.Hydroxyzine may also have apotentiatingeffect on other analgesics, although the evidence for this is not conclusive.
C. It can reduce inflammation and swelling related to pain.
This is wrong because hydroxyzine does not have any anti-inflammatory properties.It is a competitive antagonist of histamine H1-receptors, not a cyclooxygenase inhibitor.
D. It can promote sleep and rest related to pain.
Hydroxyzine is an antihistamine that hasantiemeticandsedativeeffects that are thought to be mediated by its actions in the brain.It can alsodecrease anxietyrelated to pain by inhibiting the hypothalamic H-1 histamine receptors.Hydroxyzine may also have apotentiatingeffect on other analgesics, although the evidence for this is not conclusive.
E. It can enhance the effect of other analgesics related to pain.
Hydroxyzine is an antihistamine that hasantiemeticandsedativeeffects that are thought to be mediated by its actions in the brain.It can alsodecrease anxietyrelated to pain by inhibiting the hypothalamic H-1 histamine receptors.Hydroxyzine may also have apotentiatingeffect on other analgesics, although the evidence for this is not conclusive.
Full Explanation
The correct answer is choice A, B, D, and E. Hydroxyzine is an antihistamine that has antiemetic and sedative effects that are thought to be mediated by its actions in the brain. It can also decrease anxiety related to pain by inhibiting the hypothalamic H-1 histamine receptors. Hydroxyzine may also have a potentiating effect on other analgesics, although the evidence for this is not conclusive.
Choice C is wrong because hydroxyzine does not have any anti-inflammatory properties. It is a competitive antagonist of histamine H1-receptors, not a cyclooxygenase inhibitor.
The nurse is preparing to administer morphine sulfate, an opioid analgesic, to a client who reports pain at level 8 on a scale of 0 to 10. Which action should the nurse take first?
A. Assess the client’s respiratory rate.
This is wrong because assessing the client’s respiratory rate is not the first action the nurse should take. Although morphine sulfate can cause respiratory depression, which is a serious side effect that needs to be monitored, the nurse should first ensure that the client is not allergic to the medication.
B. Check the client’s allergy history.
This is because morphine sulfate is a medication that can cause severe allergic reactions in some people, such as anaphylaxis, which can be life-threatening. Therefore, the nurse should always check the client’s allergy history before administering any medication, especially opioids.
C. Review the client’s medication record.
This is wrong because reviewing the client’s medication record is not the first action the nurse should take. Although morphine sulfate can interact with other medications, such as sedatives, antidepressants, or alcohol, which can increase the risk of respiratory depression or overdose, the nurse should first ensure that the client is not allergic to the medication.
D. Verify the dosage with another nurse.
This is wrong because verifying the dosage with another nurse is not the first action the nurse should take. Although morphine sulfate is a high-alert medication that requires double-checking to prevent medication errors, the nurse should first ensure that the client is not allergic to the medication.
Full Explanation
The correct answer is choice B. Check the client’s allergy history.
This is because morphine sulfate is a medication that can cause severe allergic reactions in some people, such as anaphylaxis, which can be life-threatening.
Therefore, the nurse should always check the client’s allergy history before administering any medication, especially opioids.
Choice A is wrong because assessing the client’s respiratory rate is not the first action the nurse should take.
Although morphine sulfate can cause respiratory depression, which is a serious side effect that needs to be monitored, the nurse should first ensure that the client is not allergic to the medication.
Choice C is wrong because reviewing the client’s medication record is not the first action the nurse should take.
Although morphine sulfate can interact with other medications, such as sedatives, antidepressants, or alcohol, which can increase the risk of respiratory depression or overdose, the nurse should first ensure that the client is not allergic to the medication.
Choice D is wrong because verifying the dosage with another nurse is not the first action the nurse should take.
Although morphine sulfate is a high-alert medication that requires double-checking to prevent medication errors, the nurse should first ensure that the client is not allergic to the medication.