A cancer patient asks the nurse what can be given to alleviate severe, chronic pain of several months’ duration. The patient has been taking oxycodone (OxyContin) and states it is no longer effective. The nurse will suggest discussing which medication with the provider?
Pentazocine (Talwin) PO
Hydrocodone (Vicodin) PO
Fentanyl (Duragesic) transdermal patch
Meperidine (Demerol) PO
The Correct Answer is C
Choice A reason: Pentazocine is less effective for severe, chronic pain and has mixed agonist-antagonist effects. Fentanyl is stronger for opioid-tolerant patients, so this is incorrect.
Choice B reason: Hydrocodone is weaker than oxycodone and inadequate for severe, resistant pain. Fentanyl’s potency suits chronic cancer pain, so this is incorrect.
Choice C reason: Fentanyl transdermal is potent, long-acting, and ideal for severe, chronic cancer pain in opioid-tolerant patients. It’s appropriate here, making it the correct choice.
Choice D reason: Meperidine is not recommended for chronic pain due to neurotoxic metabolites. Fentanyl is safer and more effective, so this is incorrect.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A reason: Mannitol, an osmotic diuretic, reduces intracranial pressure by drawing fluid from brain tissue into the bloodstream. This is its primary use in head injuries, making it correct.
Choice B reason: Mannitol is not primarily for peripheral edema; it targets cerebral edema. Furosemide is used for peripheral fluid, so this is incorrect for mannitol’s purpose.
Choice C reason: Mannitol removes fluid, not restores it. extracellular fluid, aiming to reduce brain swelling. Restoring fluid is opposite its effect, so this is incorrect.
Choice D reason: Mannitol increases renal perfusion by promoting diuresis, not reducing it. Its main goal is intracranial pressure reduction, so this is incorrect.
Correct Answer is D
Explanation
Choice A reason: Nighttime awakenings more than twice weekly indicate step 2, requiring maintenance therapy. Step 1 uses albuterol as needed, so this is incorrect.
Choice B reason: Twice-daily glucocorticoids are for step 2 or higher, not step 1, where albuterol is used as needed. This is incorrect for step 1 management.
Choice C reason: LABAs are used in step 3 or higher, not step 1, where albuterol alone is sufficient as needed. This is incorrect for the asthma step.
Choice D reason: At step 1, albuterol is used as a rescue inhaler for acute asthma symptoms. This is the standard approach, making it the correct choice.
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