Which patient may require a higher-than-expected dose of an opioid analgesic?
A patient 3 days after surgery.
A patient with cancer.
A patient with hypotension.
A patient with a concussion.
The Correct Answer is B
Choice A rationale
A patient 3 days after surgery may still require higher doses of opioids for pain management, but the duration and intensity of postoperative pain typically decrease over time. This patient may not necessarily require a higher-than-expected dose compared to others.
Choice B rationale
Patients with cancer often experience severe and chronic pain due to the disease itself or its treatments. These patients may develop tolerance to opioids over time, necessitating higher-than-expected doses to achieve adequate pain relief.
Choice C rationale
Hypotension is a contraindication for high doses of opioids, as opioids can cause further blood pressure reduction. This patient would require careful dose adjustment to avoid exacerbating hypotension.
Choice D rationale
Patients with a concussion are at risk of altered mental status and respiratory depression from opioids. Therefore, higher doses are generally avoided to prevent worsening of these conditions.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A rationale
The Drug Enforcement Agency (DEA) primarily focuses on the enforcement of controlled substances laws and regulations, not the approval and testing of medications.
Choice B rationale
The Joint Commission on Accreditation of Healthcare Organizations (JCAHO) accredits and certifies healthcare organizations and programs, but it does not control medication testing.
Choice C rationale
The Centers for Disease Control and Prevention (CDC) focuses on public health and disease prevention, not the scientific testing of medications.
Choice D rationale
The Food and Drug Administration (FDA) is responsible for protecting public health by ensuring the safety, efficacy, and security of human and veterinary drugs, biological products, and medical devices through rigorous scientific testing. .
Correct Answer is D
Explanation
Choice A rationale
Cardiac glycosides are not known for increasing heart rate. Instead, they tend to decrease heart rate by enhancing vagal tone and increasing the refractory period of the atrioventricular node, which helps in controlling heart rate, especially in atrial fibrillation.
Choice B rationale
Cardiac glycosides actually increase the force of myocardial contractions. They inhibit the sodium-potassium ATPase pump, which leads to an increase in intracellular sodium and calcium levels in the myocardial cells, thus increasing the force of contraction.
Choice C rationale
Cardiac glycosides do not significantly decrease conduction velocity. They primarily affect the contractility and heart rate but their influence on conduction velocity is relatively mild.
Choice D rationale
Cardiac glycosides improve renal blood flow and increase urine output by increasing the cardiac output and reducing the activation of the renin-angiotensin-aldosterone system. This helps in relieving symptoms of heart failure.
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