Pain Medication Quiz

The nurse is administering medications to clients on an orthopedic unit. Which medication should the nurse question?

• Ibuprofen to a client diagnosed with back pain and a history of ulcers.

• Morphine to a client diagnosed with back pain rated at a 6.

• Methocarbamol to a client diagnosed with chronic back pain.

• Acetaminophen with codeine #3 to a client diagnosed with mild back pain.

Answer explanation

Ibuprofen is an NSAID. These decrease prostaglandin production in the stomach, increasing the client's risk of developing ulcers. This client has a known ulcer so the nurse should question the medication and discuss with the HCP.

The client diagnosed with low back pain is prescribed morphine sulfate. Which interventions should the nurse implement? Select all that apply.

• Teach the client to increase water and fiber in their diet.

• Teach the client about rating the pain on a numeric scale.

• Inform the client to rise quickly from a supine position.

• Administer anticonvulsant therapy around the clock.

• Tell the client to call for assistance when getting out of bed.

Answer explanation

Narcotic pain meds slow peristalsis in the small and large intestines, increasing the risk for constipation and fecal impaction.

The nurse should attempt to quantify the pain so that the effectiveness of interventions can be evaluated.

This is a safety issue. The client should call for assistance to prevent falls.

The nurse is administering 0900 medications to clients on a medical unit. Which medication should be administered first?

• Morphine to a client with low back pain.

• Chlorzoxazone to a client on bedrest.

• Acetaminophen to a client with a headache.

• Baclofen to a client with muscle spasms.

Answer explanation

A client having muscle spasms is a priority for the nurse. Muscle spasms can be extremely painful so this medication should be administered first.

The client is postoperative from a cervical laminectomy and is prescribed morphine sulfate by PCA pump. Which instruction regarding the pump should the nurse teach the client?

• Notify the nurse when needing pain medication.

• Press the button on the pump when the client feels pain.

• Have the significant other push the button on the pump frequently.

• Use the pain medication sparingly to prevent narcotic addiction.

Answer explanation

The client can push the button on the PCA pump whenever the client feels pain. There is a 4-hour lockout programmed into the machine to prevent overdose.

The nurse administered a narcotic pain medication to a client diagnosed with cancer and assesses the client 30 minutes later. Which data indicates the medication was effective?

• The client keeps his or her eyes closed and the drapes drawn.

• The client uses guided imagery to help with pain control.

• The client states that the pain has gone down 5 points on the pain scale.

• The client is lying at still as possible in the bed.

Answer explanation

Because pain is whatever the client says it is and occurs whenever the client says it does, a client report of reduced pain indicates the medication is effective.

A client comes to the ER vomiting blood (hematemesis). He has chronic pain which has been getting worse and he has been taking more pain medication than usual. What medication do you anticipate he has been taking for pain?

• ibuprofen

• acetaminophen

• oxycodone

• morphine

Answer explanation

Ibuprofen can cause GI bleeding if taken more than directed.

A nurse working in the PACU is recovering a client post-op exploratory laparotomy administers the prescribed hydromorphone IVP. Five minutes later the nurse assesses respirations of 8. Which intervention should the nurse implement?

• Ask the anesthesiologist to come assess the client.

• Administer naloxone IVP.

• Reassess the client's respiratory status in 20 minutes.

• Use an ambu bah and ventilate the patient.

Answer explanation

Hydromorphone (Dilaudid) is a potent narcotic. Naloxone (Narcan), a narcotic agonist, will reverse the effects of an opioid analgesic. This should be the nurse's first action.

A client with chronic pain is receiving acetaminophen multiple times per day. The nurse knows the maximum amount of acetaminophen a client can receive in a day is...

• 1g

• 2g

• 3g

• 4g

The nurse is administering opioid analgesics around the clock to a client. What are the most common side effects of these medications?

• Tachycardia

• Drowsiness

• Constipation

• Respiratory suppression

• Irritation

A nurse admitting a new client is discussing their current medications. The nurse discovers the client has been taking more than 4g of acetaminophen at least once a week. What labs should she anticipate will be ordered.

• CBC

• CMP

• kidney function tests

• liver function tests

Answer explanation

More than 4g of acetaminophen daily can cause hepatotoxicity.