For the patient who is taking nalbuphine (Nubain), what should the nurse do? Select all that apply

Monitor any changes in respirations.

Instruct the patient to report bradycardia.

Administer IV nalbuphine undiluted.

Explain to the patient to expect an excessive amount of urine output.

Instruct the patient to avoid alcohol when taking nalbuphine to avoid respiratory depression.

Answer and Explanation

Correct Answer : A,B,C,E

Nalbuphine (Nubain) is an opioid agonist-antagonist used for moderate to severe pain. While effective, it carries opioid-related risks such as respiratory depression and CNS effects, requiring close nursing monitoring and thorough patient teaching.

Rationale for correct answers:
A. Monitor any changes in respirations:
As with other opioids, nalbuphine can depress the respiratory center. Monitoring rate, depth, and pattern is critical, especially after IV administration.

B. Instruct the patient to report bradycardia:
Nalbuphine can slow heart rate. Patients must promptly report dizziness, faintness, or slow pulse to prevent complications.

C. Administer IV nalbuphine undiluted:
This drug may be given undiluted IV, usually slowly over 2 minutes, to reduce adverse effects like hypotension or respiratory depression.

E. Instruct the patient to avoid alcohol when taking nalbuphine to avoid respiratory depression:
Alcohol potentiates CNS and respiratory depression from opioids, so complete avoidance is essential.

Rationale for incorrect answer:
D. Explain to the patient to expect an excessive amount of urine output:
This is false. Nalbuphine does not increase urine output; instead, opioids may cause urinary retention.

Take-home points:

Always monitor respiratory status and heart rate with nalbuphine.
Give IV doses undiluted, administered slowly.
Warn patients about alcohol and CNS depressant interactions.

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Free Nursing Study Resources

Correct Answer is C

Explanation

Acetaminophen is a widely used analgesic and antipyretic. While generally safe, it is primarily metabolized by the liver, and excessive or prolonged use can cause hepatotoxicity. Nurses must assess liver function and consider alternative pain management for patients with significant hepatic impairment.

Rationale for correct answer:

C. A patient admitted with severe hepatitis:
Acetaminophen is contraindicated in patients with active liver disease because it can exacerbate liver injury. Even standard doses may pose a risk in severe hepatic impairment, so an alternate analgesic should be chosen.

Rationale for incorrect answers:

A. A patient with a fever of 103.4°F (39.7°C):
Fever is a standard indication for acetaminophen. It is safe and effective for reducing elevated body temperature.

B. A patient admitted with deep vein thrombosis:
Acetaminophen does not affect coagulation or increase thrombotic risk, making it safe in this context.

D. A patient who had abdominal surgery 1 week earlier:
Postoperative pain is a common indication for acetaminophen. It can be safely used unless there is concurrent liver disease.

Take-home points:

Acetaminophen is hepatotoxic at high doses or in patients with liver disease.
Always review patient history for liver impairment before administration.
Consider alternative analgesics in patients with active hepatitis or severe liver dysfunction.

A. Analgesic B. Anesthetic C. Antidote D. Anti-inflammatory E. Antiemetic F. Antipyretic G. Antiepileptic

Correct Answer is ["A","D","F"]

Explanation

Aspirin is a salicylate with multiple pharmacologic actions, but its main therapeutic effects are pain relief, reduction of inflammation, and fever reduction. Understanding these effects helps guide its appropriate clinical use and patient education.

Rationale for correct answers:

A. Analgesic:
Aspirin inhibits prostaglandin synthesis, which reduces pain, making it effective for mild to moderate pain such as headaches, musculoskeletal pain, or postoperative discomfort.

D. Anti-inflammatory:
By inhibiting cyclooxygenase (COX) enzymes, aspirin reduces the production of prostaglandins involved in inflammation, making it useful in conditions like arthritis.

F. Antipyretic:
Aspirin acts on the hypothalamic heat-regulating center to lower fever, helping manage febrile conditions.

Rationale for incorrect answers:

B. Anesthetic:
Aspirin does not produce loss of sensation. Local or general anesthetics are required for that effect.

C. Antidote:
Aspirin cannot reverse toxic effects of other drugs; it has no antidotal properties.

E. Antiemetic:
Aspirin does not prevent nausea or vomiting. Other medications like ondansetron are used for that purpose.

G. Antiepileptic:
Aspirin does not prevent seizures; antiepileptic drugs are required for seizure control.

Take-home points:

Aspirin’s primary actions are analgesic, anti-inflammatory, and antipyretic.
It does not act as an anesthetic, antidote, antiemetic, or antiepileptic.
Understanding these effects ensures safe and effective use while minimizing unnecessary or ineffective administration.

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For the patient who is taking nalbuphine (Nubain), what should the nurse do? Select all that apply

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Several patients have standard orders for acetaminophen as needed for pain. While reviewing their histories and assessments, the nurse discovers that one of the patients has a contraindication to acetaminophen therapy. Which patient should receive an alternate medication?

Correct Answer is C

Explanation

While preparing aspirin for a patient, the nurse reviewed which of the pharmacologic effects of salicylates? Select all that apply

Correct Answer is ["A","D","F"]

Explanation

A patient states during a medical history that he takes several acetaminophen tablets throughout the day. The nurse teaches the patient that the dosage should not exceed which amount?

A patient is receiving an opioid via a PCA pump as part of his postoperative pain management program. During rounds, the nurse finds him unresponsive, with respirations of 8 breaths/min and blood pressure of 102/58 mm Hg. After stopping the opioid infusion, what should the nurse do next?

The nurse is administering an intravenous dose of morphine sulfate to a 48-year-old postoperative patient. The dose ordered is 3 mg every 3 hours as needed for pain. The medication is supplied in vials of 4 mg/mL. How much will be drawn into the syringe for this dose?

A patient is admitted to the emergency department in respiratory depression following self-injection with hydromorphone. The admitting nurse knows that which drug will reverse respiratory depression caused by opioid overdose?

Assessing a patient following IV morphine administration, the nurse notes cold, clammy skin; a pulse of 40 beats/min; respirations of 10 breaths/min; and constricted pupils. Which medication will the patient likely need next?

An opioid analgesic is prescribed for a patient. The nurse checks the patient's medical history knowing this medication is contraindicated in which disorder? Select all that apply

For the patient who is taking nalbuphine (Nubain), what should the nurse do? Select all that apply

A patient is taking aspirin for arthritis. Which adverse reaction should the nurse teach the patient to report to the health care provider?