A patient who is taking morphine for pain asks the nurse how a pain medication can also cause constipation. What does the nurse know about morphine?
It binds to different types of receptors in the body
It can cause constipation in toxic doses
It is selective to receptors that regulate more than one body process
It causes only one type of response, and the constipation is coincidental
The Correct Answer is A
Choice A reason: Morphine, an opioid, binds to mu, kappa, and delta receptors in the brain, spinal cord, and gastrointestinal tract. Mu receptors in the gut slow peristalsis, causing constipation, while central receptors relieve pain. This multi-receptor binding explains both therapeutic and side effects, making this the correct choice.
Choice B reason: Constipation from morphine occurs at therapeutic, not just toxic, doses due to mu receptor activation in the gastrointestinal tract, which reduces motility. Toxicity may worsen side effects, but constipation is a common effect at standard doses, making this choice inaccurate for explaining morphine’s mechanism.
Choice C reason: Morphine’s receptors (e.g., mu) regulate multiple processes, but the drug itself isn’t selective to multifunctional receptors. It binds broadly to opioid receptors, causing both analgesia and side effects like constipation. This choice misrepresents morphine’s non-selective binding, making it less accurate than choice A.
Choice D reason: Morphine’s effects, including analgesia and constipation, result from specific receptor binding, not coincidental processes. It activates opioid receptors in the brain for pain relief and in the gut for reduced motility. This choice incorrectly suggests constipation is unrelated to morphine’s pharmacological action, making it incorrect.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A reason: Meperidine, an opioid, crosses the placenta, risking neonatal respiratory depression. Monitoring breathing is critical post-delivery, making this the correct observation for the infant.
Choice B reason: Hypothyroidism is not associated with meperidine exposure. Opioids primarily affect respiration, so this is irrelevant and incorrect for the expected effect.
Choice C reason: Tremors and hyperreflexia are not typical meperidine effects in newborns; respiratory depression is the primary concern. This is incorrect for the nurse’s focus.
Choice D reason: Congenital anomalies result from chronic exposure, not acute labor analgesia. Meperidine’s immediate risk is respiratory, so this is incorrect for monitoring.
Correct Answer is D
Explanation
Choice A reason: To calculate volume, divide the ordered dose (40 mg) by the concentration (20 mg/mL): 40 ÷ 20 = 2 mL. Choice A (5 mL) delivers 100 mg (5 × 20), far exceeding the ordered dose, risking fluid and electrolyte imbalances, making it incorrect for safe administration.
Choice B reason: The correct volume is 40 mg ÷ 20 mg/mL = 2 mL. Choice B (6 mL) delivers 120 mg (6 × 20), significantly overdosing Lasix, which could cause severe dehydration, hypokalemia, or hypotension. This excessive dose is unsafe and incorrect for the prescribed administration.
Choice C reason: Calculating 40 mg ÷ 20 mg/mL yields 2 mL. Choice C (4 mL) delivers 80 mg (4 × 20), doubling the ordered dose. This could lead to excessive diuresis, electrolyte disturbances, or hypotension, making it an incorrect and potentially harmful choice for administration.
Choice D reason: Dividing the ordered dose (40 mg) by the concentration (20 mg/mL) gives 40 ÷ 20 = 2 mL. This volume accurately delivers the prescribed 40 mg of Lasix, ensuring effective diuresis for conditions like edema or heart failure while minimizing risks, making it the correct choice.
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