A patient is ready for discharge home from a lengthy hospital stay after a motor vehicle accident. The patient suffered multiple fractures and required large doses of morphine for several weeks. The nurse preparing the patient for discharge notes that the patient requests the maximum dose of the oral opioid analgesic at the exact intervals it is prescribed. The nurse is correct to suspect what has occurred?
Drug tolerance
Compulsive drug seeking
Cross-tolerance
Physical dependence
The Correct Answer is A
A. Drug tolerance: Tolerance occurs when the body adapts to a drug, requiring higher or maximum doses to achieve the same therapeutic effect. The patient’s consistent request for the maximum prescribed dose at regular intervals reflects the body’s reduced response after prolonged opioid use.
B. Compulsive drug seeking: Compulsive drug-seeking behavior is characteristic of addiction, in which a patient prioritizes drug use despite harm. In this case, the patient is using opioids as prescribed without out-of-control behavior.
C. Cross-tolerance: Cross-tolerance occurs when tolerance to one drug confers tolerance to another drug in the same or related class. While opioids can cause cross-tolerance, the scenario only highlights reduced effectiveness of the prescribed opioid, not cross-reaction.
D. Physical dependence: While possible after prolonged opioid use, the key finding here is the need for higher dosing at exact intervals, which points more specifically to tolerance rather than dependence.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A. Hypothermia: Diarrhea usually causes fluid and electrolyte loss but does not directly result in hypothermia. More commonly, dehydration and electrolyte imbalances occur, while temperature changes are related to infection or other systemic causes.
B. Rigid abdomen: A rigid abdomen is often associated with peritonitis or acute abdominal emergencies, not uncomplicated diarrhea. Diarrhea generally causes cramping, urgency, and loose stools without producing abdominal rigidity.
C. Decreased bowel sounds: Diarrhea is caused by increased intestinal motility, so bowel sounds are typically hyperactive rather than decreased. Hypoactive or absent bowel sounds are seen more often with conditions like ileus or severe hypokalemia.
D. Dehydration: Persistent diarrhea leads to significant fluid and electrolyte loss, resulting in dehydration. Expected findings include dry mucous membranes, poor skin turgor, hypotension, and concentrated urine output.
Correct Answer is A
Explanation
This is the dorsalis pedis pulse located on the dorsum of the foot along the extensor hallucis longus tendon.
B. This is the posterior tibial located behind and slightly below the medial malleolus on the inner aspect of the ankle.
C. This is the popliteal artery pulse found behind the knee in the popliteal fossa. It assesses circulation above the tibia, not posterior tibial.
D. This is the femoral pulse found in the groin (inguinal area), useful for assessing central circulation, but not posterior tibial.
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