A young male athlete tells the nurse that he is concerned because his testicles seem to be shrinking. Which question is most important for the nurse to ask this client?

• Pure opioid agonist: Morphine is classified as a pure opioid agonist because it fully binds and activates opioid receptors, particularly mu receptors, producing maximum analgesic effects for moderate to severe pain management.
• Mixed opioid antagonist: Mixed opioid antagonists, like nalbuphine, both activate and block opioid receptors depending on the site. Morphine does not block opioid activity; it purely stimulates, making this choice incorrect.
• Non-opioid analgesic: Non-opioid analgesics, such as acetaminophen and NSAIDs, relieve mild to moderate pain without acting on opioid receptors. Morphine’s mechanism and use are specific to the opioid class.
• Partial opioid agonist: Partial agonists, such as buprenorphine, activate opioid receptors but produce a weaker response compared to pure agonists. Morphine elicits a full receptor response, differentiating it from partial agonists.
• Mu: Mu receptors are the primary opioid receptors activated by morphine, leading to effects such as analgesia, euphoria, respiratory depression, and decreased gastrointestinal motility.
• Beta: Beta receptors are adrenergic receptors involved in cardiovascular responses, not pain modulation. Morphine does not interact with beta receptors.
• Alpha: Alpha receptors are also part of the adrenergic system and regulate vascular tone and blood pressure. Morphine’s action is not through alpha receptor activation.
• Severe pain: Morphine is most commonly used to treat moderate to severe acute or chronic pain, especially postoperative pain, cancer pain, and trauma-related injuries requiring strong opioid therapy.
• Hypertension: Morphine is not indicated for treating hypertension. While it may indirectly lower blood pressure due to vasodilation and reduced sympathetic tone, it is not a therapeutic antihypertensive agent.
• Depression: Morphine is not used for managing depression. Although it can induce feelings of euphoria, its clinical use is strictly for pain relief, not mood disorders.

A. Apply the cream to the area for 2 weeks: Short-term use of topical corticosteroids like betamethasone is appropriate to reduce inflammation and itching. Using it for around 2 weeks helps control symptoms while minimizing the risk of adverse effects like skin thinning or systemic absorption.

B. Limit exposure to direct sunlight: Topical corticosteroids can make the skin more sensitive to UV radiation, increasing the risk of sunburn or irritation. Limiting sun exposure while using betamethasone is a correct precaution and demonstrates good understanding.

C. Use the cream only on intact skin: Betamethasone should be applied only to intact skin because using it on broken or infected areas can increase systemic absorption and raise the risk of side effects. This practice reflects safe and proper medication use.

D. Cover the site with an occlusive dressing: Occlusive dressings significantly increase the absorption of topical steroids, raising the risk of local and systemic side effects like thinning of the skin, adrenal suppression, or infection. Unless specifically directed by the healthcare provider, occlusion should generally be avoided.