The nurse administers an opioid analgesic to an older adult postoperative client in the surgical unit. Which is the most important intervention for the nurse to implement before leaving the client’s room?

Position the client to achieve their comfort.

Offer toileting and a sip of water.

Place side rails up x 4.

Instruct the client to ask for help before getting up.

None of the above.

Answer and Explanation

The Correct Answer is D

Choice A reason: Position the client to achieve their comfort is not the most important intervention, as it does not address the potential risks of opioid analgesics, such as respiratory depression, sedation, and falls. Comfort is important, but not the priority in this situation.

Choice B reason: Offer toileting and a sip of water is not the most important intervention, as it does not address the potential risks of opioid analgesics, such as respiratory depression, sedation, and falls. Toileting and hydration are important, but not the priority in this situation.

Choice C reason: Place side rails up x 4 is not the most important intervention, as it may not prevent the client from getting out of bed and falling. Side rails may also be considered a restraint, which can increase the risk of injury and agitation. Side rails are not a substitute for proper supervision and assistance.

Choice D reason: Instruct the client to ask for help before getting up is the most important intervention, as it can prevent the client from falling and injuring themselves. Opioid analgesics can impair the client's balance, coordination, and judgment, making them more prone to falls. The nurse should educate the client about the effects of opioids and the importance of asking for help before attempting to get out of bed.

Choice E reason: None of the above is not the correct answer, as there is one choice that is the most important intervention for the nurse to implement before leaving the client’s room.

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Correct Answer is B

Explanation

Choice A reason: This is incorrect because over-the-counter NSAIDs are not generally harmless, especially for older adults. NSAIDs can cause gastrointestinal bleeding, renal impairment, hypertension, and increased risk of cardiovascular events. Older adults are more susceptible to these adverse effects due to age-related changes in pharmacokinetics and pharmacodynamics, as well as the presence of comorbidities and polypharmacy. Therefore, NSAIDs should be used with caution and at the lowest effective dose for the shortest duration possible in older adults.

Choice B reason: This is correct because stool softeners and laxatives should be used with opioids. Opioids can cause constipation, which can lead to abdominal pain, nausea, vomiting, fecal impaction, and bowel obstruction. Older adults are more prone to constipation due to decreased intestinal motility, reduced fluid intake, and use of other medications that affect bowel function. Therefore, stool softeners and laxatives should be prescribed along with opioids to prevent and treat constipation in older adults.

Choice C reason: This is incorrect because opioids are not less effective in older clients than in younger clients. Opioids are potent analgesics that can relieve moderate to severe pain in older adults. However, opioids can also cause respiratory depression, sedation, confusion, delirium, falls, and dependence. Older adults are more sensitive to these side effects due to altered pharmacokinetics and pharmacodynamics, as well as the presence of cognitive impairment and frailty. Therefore, opioids should be used with caution and at the lowest effective dose for the shortest duration possible in older adults.

Choice D reason: This is incorrect because the dose limit for acetaminophen is not difficult to reach for older adults. Acetaminophen is a safe and effective analgesic for mild to moderate pain in older adults. However, acetaminophen can cause hepatotoxicity, especially at high doses or in combination with other medications that contain acetaminophen. The recommended maximum daily dose of acetaminophen for older adults is 3 grams, which can be easily reached if the patient is not aware of the amount of acetaminophen they are taking. Therefore, acetaminophen should be used with caution and at the lowest effective dose for the shortest duration possible in older adults.

A. Alter modifiable risk factors B. Maintain tight glycemic control C. Recognize disease in its early stages D. Prevent cardiovascular disease

Correct Answer is D

Explanation

Choice A reason: Altering modifiable risk factors is a good goal for anyone who wants to improve their health and wellness, but it is not specific to the case of the African American man who already has a normal blood pressure and no apparent health problems. Modifiable risk factors are those that can be changed by lifestyle choices, such as smoking, diet, exercise, stress, or alcohol consumption.

Choice B reason: Maintaining tight glycemic control is a relevant goal for people who have diabetes or prediabetes, as it can help prevent or delay the complications of high blood sugar, such as nerve damage, kidney damage, or eye damage. However, there is no indication that the African American man has diabetes or prediabetes, so this goal is not applicable to him.

Choice C reason: Recognizing disease in its early stages is a general goal for everyone who wants to prevent or treat health problems, but it is not specific to the case of the African American man who has no signs or symptoms of any disease. Moreover, this goal is more reactive than proactive, as it implies waiting for disease to occur rather than preventing it.

Choice D reason: Preventing cardiovascular disease is the best goal for the nurse to use to assist the African American man in maintaining his health and wellness into older age, as it is specific, proactive, and evidence-based. According to the American Heart Association, high blood pressure is a major risk factor for cardiovascular disease, and it is more prevalent and severe among African Americans than other racial groups. Therefore, the nurse would advise the African American man to monitor his blood pressure regularly, follow a healthy diet, exercise moderately, avoid smoking, and take medication if needed to prevent cardiovascular disease.

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The nurse administers an opioid analgesic to an older adult postoperative client in the surgical unit. Which is the most important intervention for the nurse to implement before leaving the client’s room?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Which of the following statements is true about analgesic medications for older adults?

Correct Answer is B

Explanation

An African American 58-year-old man in good health has a blood pressure of 120/73 mm Hg at his annual physical examination. Which of the following is the best goal for the nurse to use to assist him in maintaining his health and wellness into older age?

Correct Answer is D

Explanation

Which factors in the patient care environment should be routinely assessed to decrease the risk of falls? (Select all that apply.)

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