The nurse is caring for a client in the hospital who has been taking an analgesic for pain related to a chronic illness and has developed a tolerance to the medication. What is the appropriate action by the nurse?

Suggest a consultation with a psychiatrist to treat the client's addiction.

Inform the client that they will not be able to receive more medication than the health care provider has prescribed.

Tell the client the nurse will ask the health care provider to prescribe a non-narcotic analgesic.

Consult with the prescriber regarding the need for an increased dose of the drug and not to reduce the frequency of administration.

Answer and Explanation

The Correct Answer is D

A. Suggest a consultation with a psychiatrist to treat the client's addiction: Tolerance is a physiological response to long-term opioid use, not necessarily a sign of addiction. Labeling the client as addicted without behavioral signs of misuse is inappropriate and stigmatizing.
B. Inform the client that they will not be able to receive more medication than the health care provider has prescribed: This response dismisses the client's need for adequate pain control. Tolerance may require dose adjustment, and concerns should be communicated compassionately to the prescriber.
C. Tell the client the nurse will ask the health care provider to prescribe a non-narcotic analgesic:
Switching to a non-narcotic medication may not provide effective relief for someone with a chronic condition and established tolerance. Medication adjustments should be based on the client’s needs and pain response.
D. Consult with the prescriber regarding the need for an increased dose of the drug and not to reduce the frequency of administration: Tolerance may require a dose increase to maintain pain relief. The nurse’s role includes advocating for appropriate pain management and collaborating with the provider for safe and effective adjustments.

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Correct Answer is D

Explanation

A. Have the client placed in restraints: Restraints should only be used as a last resort when the client poses a danger to themselves or others. They require a provider’s order and must follow strict guidelines. It is not the first step in managing a combative client.
B. Refuse to start the IV: Refusing care delays necessary treatment and does not address the issue of safety. The nurse has a duty to provide care using appropriate support and safety measures.
C. Give the client a sedative prior to starting the IV: Administering a sedative requires a provider's order and should not be done solely for ease of IV insertion. Sedation is not a routine intervention and must be clinically justified.
D. Ask for assistance: Having another trained staff member present increases safety and reduces the risk of needlestick injury. Assistance ensures proper restraint of movement without violating patient rights or safety protocols.

A. Dyspnea when ambulating from the bathroom B. A noted irregular pulse rate prior to Lanoxin (digoxin) administration C. Pulsus paradoxus on vital sign assessment D. Cyanosis with a pulse oximetry level of 92%

Correct Answer is C

Explanation

A. Dyspnea when ambulating from the bathroom: Mild exertional dyspnea is common in cardiac clients and may not require immediate provider notification unless it worsens or becomes unrelieved with rest.
B. A noted irregular pulse rate prior to Lanoxin (digoxin) administration: An irregular pulse may warrant holding the medication and further assessment, but it is not always an emergency unless associated with hemodynamic instability or bradycardia.
C. Pulsus paradoxus on vital sign assessment: Pulsus paradoxus, a significant drop in systolic blood pressure during inspiration, may indicate cardiac tamponade or severe pericardial effusion. It is a critical finding that requires immediate medical attention.
D. Cyanosis with a pulse oximetry level of 92%: While cyanosis is concerning, a SpO₂ of 92% may be acceptable for some cardiac or pulmonary patients. Further monitoring is needed, but it may not require urgent notification unless oxygen levels drop further.

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The nurse is caring for a client in the hospital who has been taking an analgesic for pain related to a chronic illness and has developed a tolerance to the medication. What is the appropriate action by the nurse?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is D

Explanation

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Correct Answer is C

Explanation

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