The practical nurse (PN) is reinforcing discharge instructions for a client with metastatic cancer who is prescribed morphine for bone pain. Which information from the client indicates to the PN an understanding of the medication?
Take the benzodiazepine at the same time as taking the morphine
Observe bowel movement pattern and take a stool softener
Do not drink grapefruit juice after taking morphine
Watch for signs of agitation and record any insomnia
The Correct Answer is B
Choice A reason: Taking a benzodiazepine with morphine is incorrect, as it increases sedation and respiratory depression risk, a dangerous opioid side effect. This indicates misunderstanding, as morphine’s primary management focuses on pain and side effects like constipation, not concurrent sedative use.
Choice B reason: Observing bowel movements and using a stool softener shows understanding, as morphine causes constipation by slowing gastrointestinal motility via opioid receptors. Proactive management with stool softeners prevents complications like impaction, aligning with safe opioid use in cancer pain management.
Choice C reason: Grapefruit juice avoidance is irrelevant to morphine, as it affects drugs metabolized by CYP3A4, not opioids. Morphine is metabolized via glucuronidation, unaffected by grapefruit. This indicates misunderstanding, as it does not address morphine’s key side effects or management.
Choice D reason: Watching for agitation or insomnia is not a primary concern with morphine, which causes sedation. These symptoms may relate to other conditions, but they do not reflect understanding of morphine’s effects, like constipation, making this choice incorrect.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A reason: Keratolytic agents, like salicylic acid, break down keratin in psoriatic plaques, softening scaly skin and reducing peeling. This promotes shedding of thickened, dead skin cells, improving skin texture. Softer, less scaly skin directly indicates the medication’s effect on hyperkeratotic lesions, confirming therapeutic success.
Choice B reason: Absence of purulent drainage indicates no infection but is not the primary goal of keratolytics. These agents target scale reduction, not infection. Psoriasis lesions are typically not purulent, so this finding is unrelated to the medication’s intended effect on skin texture.
Choice C reason: Reduced redness and swelling suggest decreased inflammation, which is not the primary action of keratolytics. Anti-inflammatory agents, like corticosteroids, target these symptoms, while keratolytics focus on scale removal. This finding is irrelevant to the medication’s specific role in psoriasis management.
Choice D reason: Full range of motion without pain relates to joint function, possibly in psoriatic arthritis, but is unrelated to keratolytics, which treat skin lesions. Keratolytics do not affect joint inflammation or mobility, making this choice incorrect for assessing the medication’s skin-specific effects.
Correct Answer is A
Explanation
Choice A reason: Famotidine, an H2 receptor blocker, reduces gastric acid production, alleviating epigastric pain caused by acid-related conditions like gastritis or ulcers. Decreased pain indicates the drug’s effectiveness in lowering acid levels, protecting the gastric mucosa, and promoting healing, making this the primary clinical outcome.
Choice B reason: Weight loss of 3 pounds is not a direct indicator of famotidine’s effectiveness. It may result from unrelated factors like diet or illness. Famotidine targets acid reduction, not weight, so this finding is irrelevant to assessing the drug’s therapeutic impact on gastric conditions.
Choice C reason: Decreased nighttime awakenings may occur with reduced pain but are not a specific measure of famotidine’s effectiveness. Awakenings could relate to other factors, like sleep disorders. Pain reduction is a more direct indicator of the drug’s action on acid-related symptoms.
Choice D reason: A positive stool antigen test indicates Helicobacter pylori infection, not famotidine’s effectiveness. Famotidine reduces acid but does not eradicate H. pylori, which requires antibiotics. This finding is unrelated to the drug’s primary role in acid suppression and symptom relief.
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