Patient Data

The nurse is discussing the client's pain management with a student nurse.

Choose the most likely options for the information missing from the statement(s) by selecting from the lists of options provided.

Morphine is a
___
and it activates
_
receptors and is used to relieve
____

Answer and Explanation

The Correct Answer is {"dropdown-group-1":"A","dropdown-group-2":"B","dropdown-group-3":"A"}

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.

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Correct Answer is {"dropdown-group-1":"B","dropdown-group-2":"D","dropdown-group-3":"A"}

Explanation

Increasing heart rate: Increasing heart rate is not the mechanism of thiazide diuretics or ACE inhibitors. It would raise blood pressure by increasing cardiac workload. Effective antihypertensives aim to lower or stabilize heart rate, not increase it.
Reducing stroke volume: Thiazide diuretics reduce stroke volume by lowering blood volume through sodium and water excretion. This decreases cardiac output and helps lower blood pressure, particularly in volume-sensitive hypertension.
Suppressing the appetite: Suppressing appetite is unrelated to the action of thiazide diuretics or ACE inhibitors. These drugs target fluid balance and vascular tone, not the central nervous system mechanisms that regulate hunger.
Decreasing serum sodium levels: Both thiazide diuretics and ACE inhibitors contribute to decreased serum sodium levels, which helps lower blood volume. This reduction supports blood pressure control but must be monitored to avoid hyponatremia.
Reducing systemic vascular resistance: ACE inhibitors lower blood pressure by reducing systemic vascular resistance through vasodilation. Blocking angiotensin II prevents arterial constriction, easing the workload on the heart and lowering afterload.

A. Measure hourly urinary output. B. Evaluate level of consciousness. C. Monitor numeric pain scale. D. Auscultate bowel sounds.

Correct Answer is C

Explanation

A. Measure hourly urinary output: Pentoxifylline primarily affects blood flow by decreasing blood viscosity and improving red blood cell flexibility, enhancing peripheral circulation. Urinary output is not directly influenced by this medication and is not a reliable indicator of its effectiveness for intermittent claudication.

B. Evaluate level of consciousness: While monitoring neurological status is important for many clients, changes in consciousness are not expected indicators of pentoxifylline effectiveness. The primary therapeutic target is the improvement of blood flow and reduction of pain during walking, not mental status changes.

C. Monitor numeric pain scale: Pentoxifylline is used to treat intermittent claudication by improving blood flow to the limbs, reducing muscle pain during exertion. A decrease in reported pain levels on a numeric scale during walking activities is the most direct and meaningful measure of the medication’s effectiveness.

D. Auscultate bowel sounds: Pentoxifylline does not have a primary effect on gastrointestinal motility or bowel function. Monitoring bowel sounds would not provide useful information about whether the drug is effectively relieving the client's symptoms of intermittent claudication.

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Naxlex Comprehensive Predictor Exams

Patient Data Select from Word Choices to complete the sentence. The thiazide diuretic works to decrease the client's blood pressure by ______, and the angiotensin converting enyzme (ACE) inhibitor works to decrease the client's blood pressure by ________ and _______

Correct Answer is {"dropdown-group-1":"B","dropdown-group-2":"D","dropdown-group-3":"A"}

Explanation

The nurse assesses a client with intermittent claudication who is receiving pentoxifylline. Which assessment should the nurse perform to determine the effectiveness of the medication?

Correct Answer is C

Explanation

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