A nurse is providing patient education to a 55-year-old man who has been prescribed opioids for chronic back pain. Which of the following statements by the nurse is most appropriate when educating the patient about opioid-induced constipation?

"Opioid-induced constipation typically resolves on its own after a few weeks of treatment."

"Avoid physical activity to prevent exacerbating your back pain."

"Start taking stool softeners along with your opioid medication."

"You should wait to see if constipation develops before taking any specific measures."

Answer and Explanation

The Correct Answer is C

A. "Opioid-induced constipation typically resolves on its own after a few weeks of treatment.": This is incorrect. Unlike other opioid side effects such as nausea or sedation, constipation does not typically resolve over time. It often persists and requires proactive management throughout opioid therapy.
B. "Avoid physical activity to prevent exacerbating your back pain.": While activity should be adjusted to the patient’s condition, light physical activity like walking actually helps stimulate bowel function. Complete avoidance of movement can worsen constipation.
C. "Start taking stool softeners along with your opioid medication.": This is the most appropriate advice. Prophylactic use of stool softeners or stimulant laxatives is recommended when initiating opioid therapy, as constipation is a nearly universal side effect due to slowed gastrointestinal motility.
D. "You should wait to see if constipation develops before taking any specific measures.": Waiting for constipation to develop can lead to discomfort and complications like fecal impaction. Preventive strategies should be started as soon as opioid treatment begins.

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Correct Answer is D

Explanation

A. Respiratory arrest and coma: These are late, life-threatening manifestations of local anesthetic systemic toxicity (LAST) that occur after CNS and cardiovascular collapse. Recognizing early signs is critical to preventing progression to this severe stage.
B. Ventricular arrhythmias and cardiac arrest: These are also late signs of LAST, resulting from the anesthetic’s depressant effects on cardiac conduction. By the time these occur, toxicity is advanced and may require immediate resuscitation measures.
C. Hypotension and tachycardia: Although cardiovascular symptoms may eventually develop, they are typically preceded by neurological signs. Early identification and management of CNS symptoms can often prevent progression to cardiovascular compromise.
D. Tinnitus, metallic taste, and perioral numbness: These are classic early signs of LAST and indicate CNS involvement. They often occur within minutes of administration and should prompt immediate intervention to stop drug absorption and initiate supportive care.

A. "Avoid alcohol while taking this medication as it may increase drowsiness." B. "You can abruptly stop taking this medication if you don't notice improvement." C. "Baclofen doesn't cause drowsiness, so you can continue your normal activities without any restrictions." D. "Take this medication only when you experience muscle spasms:"

Correct Answer is A

Explanation

A. "Avoid alcohol while taking this medication as it may increase drowsiness.": Baclofen is a central nervous system depressant and can cause sedation. Alcohol can intensify this effect, increasing the risk of severe drowsiness, dizziness, or respiratory depression.
B. "You can abruptly stop taking this medication if you don't notice improvement.": Abrupt discontinuation of Baclofen can lead to withdrawal symptoms such as hallucinations, seizures, and rebound spasticity. The medication should be tapered under medical supervision.
C. "Baclofen doesn't cause drowsiness, so you can continue your normal activities without any restrictions.": Baclofen often causes drowsiness and dizziness, especially when therapy is initiated. Patients should be cautious with activities requiring alertness, such as driving.
D. "Take this medication only when you experience muscle spasms:": Baclofen is typically taken on a regular schedule to maintain therapeutic levels and control muscle spasms continuously. It is not used on an as-needed basis.

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A nurse is providing patient education to a 55-year-old man who has been prescribed opioids for chronic back pain. Which of the following statements by the nurse is most appropriate when educating the patient about opioid-induced constipation?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is monitoring a patient who recently received a local anesthetic for signs of local anesthetic systemic toxicity (LAST). Which of the following clinical manifestations should the nurse recognize as early signs of LAST?

Correct Answer is D

Explanation

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Correct Answer is A

Explanation

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