Review Opioid Analgesics

Analgesics and Pain Management Medications > Pharmacology

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Opioid Analgesics

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Total Questions : 5

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Question 1:

A nurse is caring for a client who is receiving intravenous morphine for postoperative pain.
The nurse should monitor the client for which adverse effects of morphine?

A. Respiratory depression B. Hyperthermia C. Tachycardia D. Hypertension.

Answer and Explanation

Choice A:

Morphine is an opioid analgesic that can cause respiratory depression by decreasing the sensitivity of the respiratory center in the brainstem to carbon dioxide levels. This can lead to hypoventilation, hypoxia, and even death if not treated promptly.

Choice B:

Hyperthermia is not a common adverse effect of morphine. Morphine can cause sweating and flushing, but it does not increase body temperature.

Choice C:

Tachycardia is not a common adverse effect of morphine. Morphine can cause bradycardia by stimulating the vagus nerve and reducing sympathetic activity.

Choice D:

Hypertension is not a common adverse effect of morphine. Morphine can cause hypotension by dilating peripheral blood vessels and reducing cardiac output.

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Question 2:

A nurse is administering nalbuphine to a client who has moderate pain. The client asks the nurse how this drug works.
What should the nurse say?

A. “It binds to and activates mu and kappa receptors, producing strong pain relief and sedation.” B. “It binds to and partially activates mu receptors, producing moderate pain relief and less breathing problems than other opioids.” C. “It binds to and activates kappa receptors, producing pain relief and sedation, and blocks mu receptors, preventing respiratory depression.” D. “It binds to and blocks mu and kappa receptors, reversing the effects of other opioids.”.

Answer and Explanation

Choice A:

It describes the mechanism of action of pure opioid agonists, such as morphine or fentanyl, which bind to and activate both mu and kappa receptors, producing strong pain relief and sedation, but also respiratory depression and dependence.

Choice B:

It describes the mechanism of action of partial opioid agonists, such as buprenorphine or tramadol, which bind to and partially activate mu receptors, producing moderate pain relief and less respiratory depression than pure opioid agonists, but also less analgesia.

Choice C:

Nalbuphine is a mixed opioid agonist-antagonist that binds to and activates kappa receptors, producing pain relief and sedation, and blocks mu receptors, preventing respiratory depression. This makes it a safer option than pure opioid agonists for clients who have moderate pain and are at risk of respiratory complications.

Choice D:

It describes the mechanism of action of opioid antagonists, such as naloxone or naltrexone, which bind to and block both mu and kappa receptors, reversing the effects of other opioids, but also precipitating withdrawal symptoms.

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Question 3:

A nurse is preparing to administer codeine to a client who has a cough. The client asks the nurse why codeine is used for cough suppression.
What should the nurse say?

A. “Codeine acts on opioid receptors in the brain and spinal cord to block pain signals from reaching your cough center.” B. “Codeine acts on opioid receptors in your lungs to reduce inflammation and mucus production that trigger your cough reflex.” C. “Codeine acts on opioid receptors in your brainstem to suppress the activity of your cough center and decrease your urge to cough.” D. “Codeine acts on opioid receptors in your throat to numb the nerve endings that stimulate your cough reflex.”.

Answer and Explanation

Choice A:

Codeine does not block pain signals from reaching your cough center. Codeine blocks pain signals from reaching your brain and spinal cord, which is how it works as an analgesic or pain reliever.

Choice B:

Codeine does not act on opioid receptors in your lungs. Codeine does not reduce inflammation or mucus production that trigger your cough reflex.

Choice C:

Codeine acts on opioid receptors in your brainstem to suppress the activity of your cough center and decrease your urge to cough. This is how codeine works as an antitussive or cough suppressant.

Choice D:

Codeine does not act on opioid receptors in your throat. Codeine does not numb the nerve endings that stimulate your cough reflex.

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Question 4:

A nurse is reviewing the medication history of a client who is prescribed buprenorphine for chronic pain.
The nurse should identify that which medication can interact with buprenorphine and increase the risk of serotonin syndrome?

A. Fluoxetine B. Metformin C. Omeprazole D. Lisinopril.

Answer and Explanation

Choice A:

Fluoxetine can interact with buprenorphine and increase the risk of serotonin syndrome. Serotonin syndrome is a serious drug reaction that occurs when there is too much serotonin in the body. It can cause symptoms such as agitation, confusion, muscle rigidity, fever, seizures and coma.

Choice B:

Metformin is not known to have any serotonergic effects or interact with buprenorphine.

Choice C:

Omeprazole is not known to have any serotonergic effects or interact with buprenorphine.

Choice D:

Lisinopril is not known to have any serotonergic effects or interact with buprenorphine.

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Question 5:

A nurse is teaching a client who has chronic pain about the use of transdermal fentanyl.
Which statements by the client indicate understanding of the teaching? Select all that apply.

A. “I should change the patch every 72 hours.” B. “I should apply the patch to a clean, dry, and hairless area of skin.” C. “I should cut the patch in half if I need a lower dose.” D. “I should avoid exposing the patch to heat sources.” E. “I should dispose of the used patch by flushing it down the toilet.”.

Answer and Explanation

Choice A:

The client should change the patch every 72 hours and apply it to a clean, dry, and hairless area of skin. This ensures that the patch adheres well and delivers the medication at a steady rate.

Choice B:

The client should change the patch every 72 hours and apply it to a clean, dry, and hairless area of skin. This ensures that the patch adheres well and delivers the medication at a steady rate.

Choice C:

The client should not cut the patch in half. This can damage the patch and cause fentanyl to leak out or be absorbed too quickly.

Choice D:

The client should avoid exposing the patch to heat sources, such as heating pads, electric blankets, saunas, or hot tubs. Heat can increase the absorption of fentanyl and cause an overdose.

Choice E:

The client should dispose of the used patch by folding it onto itself and placing it in a sealed container or a special disposal pouch.Flushing the patch down the toilet can contaminate the water supply and pose a risk to others.

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Opioid Analgesics

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