A nurse is caring for a client who has an acute exacerbation of chronic pain. Which of the following medications should the nurse anticipate administering for the client?
Acetaminophen
Naloxone
Zolpidem
Fentanyl
The Correct Answer is D
Rationale:
A. Acetaminophen is a non-opioid analgesic used for mild to moderate pain or as an adjunct in multimodal pain management. It works centrally to reduce pain and fever but does not have strong anti-inflammatory or opioid-level analgesic effects. In an acute exacerbation of chronic pain, acetaminophen alone is often insufficient because the pain intensity is typically moderate to severe. It may be used alongside stronger medications but not as primary therapy in this scenario.
B. Naloxone is an opioid antagonist, meaning it reverses the effects of opioids by competitively binding to opioid receptors. It is used in cases of opioid overdose, respiratory depression, or opioid toxicity. Administering naloxone would rapidly reverse analgesia and significantly increase the client’s pain, making it inappropriate for pain management.
C. Zolpidem is a sedative-hypnotic medication used for short-term treatment of insomnia. It acts on the central nervous system to promote sleep but has no analgesic properties. It does not treat pain and would not be appropriate for managing an acute pain flare.
D. Fentanyl is a high-potency synthetic opioid analgesic used for severe acute pain, breakthrough pain, and chronic pain exacerbations, especially in clients who may already be opioid-tolerant. It works by binding strongly to mu-opioid receptors in the brain and spinal cord, altering pain perception and emotional response to pain. It has a rapid onset and short duration of action, making it useful for acute pain episodes. In this scenario, where a client has an acute worsening of chronic pain, fentanyl is an appropriate medication to provide effective and immediate pain relief.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Rationale:
A. A red tag indicates a client who requires immediate life-saving intervention and has life-threatening injuries but a high chance of survival with prompt treatment (e.g., airway obstruction, severe hemorrhage, shock). A closed forearm fracture does not meet criteria for immediate intervention.
B. A black tag is assigned to clients who are deceased or expected to die because their injuries are not survivable with available resources. A closed fracture of the forearm is not life-threatening.
C. A yellow tag indicates delayed treatment for serious but not immediately life-threatening injuries. Examples include open fractures or multiple fractures requiring surgical repair. A simple closed forearm fracture without neurovascular compromise is typically not categorized as delayed priority in mass casualty triage.
D. A green tag indicates “minor” injuries—clients who are stable and can wait for treatment. A closed fracture of the forearm is generally stable, non-life-threatening, and does not compromise airway, breathing, or circulation, making it appropriate for the “walking wounded” category.
Correct Answer is B
Explanation
Rationale:
A. While understanding the origin of a conflict may be useful in later analysis, focusing primarily on how the conflict occurred during negotiation can lead to blame, defensiveness, and decreased collaboration. Effective negotiation emphasizes present concerns and mutual resolution rather than assigning fault.
B. Effective negotiation requires active listening, empathy, and understanding the perspectives, needs, and concerns of all parties involved. By acknowledging both sides of the overtime conflict, the charge nurse can facilitate open communication, reduce tension, and promote a collaborative solution that supports fairness and teamwork.
C. Personalizing conflict shifts focus to individual blame or emotions rather than the issue itself. This approach increases defensiveness, escalates tension, and interferes with productive negotiation. Professional conflict resolution requires objectivity and focus on the problem, not the individuals.
D. Pre-determining solutions before hearing all perspectives limits open discussion and can bias the negotiation process. Effective negotiation involves exploring options collaboratively after understanding all viewpoints, not imposing solutions prematurely.
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