SOLVED

 Question 11 A patient with a tension pneumothorax requires insertion of a pleural chest tube. The nurse assists the physician as multiple doses of a local anesthetic are administered prior to tube insertion. Which observation by the nurse warrants immediate physician attention? 1. The patient’s respiratory rate changes from 22 to 26 breaths per minute. 2. The patient complains of pain during anesthetic injections. 3. The patient’s systolic blood pressure changes from 156 to 138 mm Hg. 4. The patient’s heart rate changes from 100 beats per minute to 75 beats per minute. Question 12 Emergency department nurses are monitoring a patient for signs of pseudoaddiction to opioid substances. Which observation about the patient’s behavior can help confirm the diagnosis of pseudoaddiction? 1. The patient requires increasingly larger doses of medication for pain relief. 2. The patient appears sedated. 3. The patient appears less angry after pain relief is reported. 4. The patient appears intoxicated or drugged. Question 13 A patient with myocardial infarction is treated with intravenous morphine sulfate for chest pain. Which nursing action has the highest priority when administering this medication? 1. Determine the patient’s sedation level. 2. Check breath sounds every 15 minutes. 3. Observe for signs of opioid addiction. 4. Assess for medication infiltration into tissues. Question 14 A 78-year-old female patient is admitted to a medical–surgical unit with left lower extremity pain and discoloration. The patient’s laboratory values are as shown. Which statement by the nurse represents a clear understanding of this patient’s pain management needs? 1. “This patient may need more pain medication because of anemia.” 2. “This patient may need less pain medication because of acute renal failure.” 3. “This patient may need less pain medication because of diabetes mellitus.” 4. “This patient will need potassium replacement before pain treatment begins.” Question 15 Which actions should be considered by the nurse planning pain relief interventions for the patient with a history of substance abuse? 1. Planning for comorbid psychiatric disorder treatment 2. Administering long-acting analgesics 3. Using oral medications in place of intravenous ones when possible 4. Treating pain with NSAIDs instead of opioid drugs 5. Avoid using drugs that are similar in action to the abuse drug Question 16 A patient, with a history of drug addiction, has just been admitted following abdominal surgery. The patient is complaining of aching joints and muscles, and has a sudden onset of a runny nose. The nurse realizes these symptoms are seen during withdrawal from which commonly abused substance? 1. Barbiturates 2. Opiates 3. Cocaine 4. Alcohol Question 17 A patient, receiving moderate sedation for a colonoscopy, has progressed to a state of deep anesthesia. The nurse administering this sedation has which priority intervention? 1. Monitor the heart rate. 2. Contact the rapid response team. 3. Manage the airway and provide ventilation. 4. Monitor the blood pressure.   Question 18 A nurse is providing moderate sedation for a patient having a diagnostic endoscopy. Which actions should the nurse anticipate? 1. Bolus of a sedative 2. Using a drug with rapid onset 3. Titration of pain medication 4. Use of a combination of drugs in a single IV line 5. Monitor a slow continuous dose of medication Question 19 A patient has achieved pain control with an oral opioid and is tolerant of its sedative effects but is having severe constipation. The nurse has contacted the health care provider about prescribing a different opioid. What should the nurse anticipate regarding the new drug? 1. The new opioid will be administered by the intravenous route. 2. There will be an increased need to observe the patient for sedation. 3. The starting dose of the new medication will be lower than the equianalgesic dose of the original medication. 4. It will be necessary to add an adjuvant medication to achieve equal pain control. 5. The newly prescribed medication will be a pure opioid agonist. Question 20 A nurse is administering naloxone (Narcan) to a patient who is minimally responsive after receiving an opioid. Which nursing action is indicated? 1. Bolus the medication over 1–2 minutes. 2. Give the medication without dilution. 3. Discontinue the naloxone as soon as the patient’s respirations normalize. 4. Plan to repeat the dose every hour for the next 4 hours.