A nurse is providing an in-service on the complications of overdosing on morphine, such as the opioid toxicity triad. Which of the following signs and symptoms should the nurse include in her in-service about opioid toxicity triad?
Coma, respiratory alkalosis, and regular pupils.
Pinpoint pupils, respiratory depression, and coma.
Pinpoint pupils, hypertension, and constipation.
Constipation, pupillary dilation, and hypotension.
The Correct Answer is B
A. Coma, respiratory alkalosis, and regular pupils: These are not indicative of opioid toxicity. Opioid toxicity typically leads to respiratory depression and constricted pupils.
B. Pinpoint pupils, respiratory depression, and coma: This is the classic triad of opioid toxicity. Pinpoint pupils, respiratory depression, and coma are hallmark signs.
C. Pinpoint pupils, hypertension, and constipation: Hypertension is not a typical feature of opioid overdose; hypotension is more common.
D. Constipation, pupillary dilation, and hypotension: Constipation is common with opioids but pupillary dilation and hypotension are not part of the typical toxicity triad.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. Respiratory depression is a hallmark sign of opioid toxicity. A rate of 7 breaths per minute indicates severe respiratory depression, which can be life-threatening and requires immediate intervention with naloxone.
B. Anxiety is not typically associated with opioid toxicity, but rather may be a sign of withdrawal or other conditions.
C. Fever is not a sign of opioid toxicity. It may be a sign of infection or other medical issues.
D. Hypertension is not typical of opioid toxicity; opioids usually cause hypotension, not hypertension.
Correct Answer is B
Explanation
A. Insomnia is not a serious adverse effect of ethinyl estradiol and drospirenone (Yasmin). Common side effects may include nausea or headaches, but insomnia is not a red flag.
B. This could indicate deep vein thrombosis (DVT), a serious complication associated with hormonal contraceptives like Yasmin. The nurse should educate the patient to report these symptoms immediately.
C. Sedation is not a common or serious adverse effect of Yasmin. Side effects are more commonly related to gastrointestinal or cardiovascular systems.
D. Indigestion is not typically associated with a serious complication of Yasmin. Some mild gastrointestinal discomfort may occur, but it is not a major concern unless it is severe.
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