A nurse is assessing a client who has a history of prescription drug abuse. Which of the following findings is a possible indicator of opioid misuse?

Correct answer: a) Constricted pupils

Rationale: Opioids are central nervous system depressants that can cause miosis (constricted pupils), respiratory depression, bradycardia, hypotension, and sedation.

Incorrect choices:
b) Tachycardia: This is a sign of sympathetic stimulation, which can be caused by stimulants, withdrawal, or anxiety.
c) Hypertension: This is also a sign of sympathetic stimulation, which can be caused by stimulants, withdrawal, or anxiety.
d) Agitation: This is a sign of psychological distress, which can be caused by stimulants, withdrawal, or anxiety.

Correct answer: a) Assess the client's pain level and quality

Rationale: The first action the nurse should take when using the nursing process is to assess the client's condition. By assessing the client's pain level and quality, the nurse can determine the possible causes of their inadequate pain relief and plan appropriate interventions.

Incorrect choices:
b) Educate the client about the dangers of opioid overdose: This is an important action, but not the first one. The nurse should first assess the client's pain before providing education.
c) Refer the client to a pain management specialist: This may be a helpful action, but not the first one. The nurse should first assess the client's pain and collaborate with the prescriber before making referrals.
d) Notify the prescriber about the client's medication misuse: This is an essential action, but not the first one. The nurse should first assess the client's pain and communicate their findings to the prescriber.