RN HESI Pharmacology Exam
RN HESI Pharmacology Exam ( 31 Questions)
Patient Data
History and Physical
The client is a 42-year-old female who had a right above-the-knee amputation for osteomyelitis. The client has a drain in place and a surgical dressing that will need to be changed by the surgeon on post-op day 1.
Nurses Notes
1400: Started continuous morphine in the left antecubital vein peripheral intravenous line. No redness, edema, or bleeding noted at the site. Vital signs are heart rate 77 bpm, blood pressure 118/74 mmHg, respiratory rate 16 breaths/min.
Orders:
- Admit to the surgical floor
- Clear liquid diet, advance as tolerated
- Continuous cardiorespiratory monitoring
- Morphine 1 mg/hr intravenously
- Alert surgeon to signs of bleeding or infection in the surgical site
What other medications would the nurse expect the surgeon to prescribe along with morphine? Select all that apply.
Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) that has analgesic, anti-inflammatory, and antipyretic effects. Ibuprofen can be prescribed along with morphine to enhance the pain relief and reduce the inflammation caused by the surgery. Ibuprofen can also reduce the opioid requirement and the risk of opioid-related side effects, such as nausea, constipation, and respiratory depression. Therefore, choice A is correct.
Propofol is a short-acting intravenous anesthetic agent that induces and maintains anesthesia and sedation. Propofol is not prescribed along with morphine for post-operative pain management, as it is not an analgesic and has a high risk of hypotension, bradycardia, and respiratory depression. Propofol is only used in controlled settings, such as the operating room or the intensive care unit, under close monitoring and supervision. Therefore, choice B is incorrect.
Methadone is a long-acting synthetic opioid that has analgesic and opioid substitution effects. Methadone is not prescribed along with morphine for post-operative pain management, as it is not indicated for acute pain and has a high risk of accumulation, overdose, and addiction. Methadone is mainly used for chronic pain or opioid dependence treatment, under strict regulation and monitoring. Therefore, choice C is incorrect.
Senna is a stimulant laxative that increases the intestinal motility and promotes bowel movements. Senna can be prescribed along with morphine to prevent or treat constipation, which is a common side effect of opioids. Senna can improve the comfort and quality of life of the client who is receiving opioid therapy. Therefore, choice D is correct.
Docusate sodium is a stool softener that increases the water content and softness of the stool. Docusate sodium can be prescribed along with morphine to prevent or treat constipation, which is a common side effect of opioids. Docusate sodium can improve the comfort and quality of life of the client who is receiving opioid therapy. Therefore, choice E is correct.
Naloxone is an opioid antagonist that reverses the effects of opioids by displacing them from their receptors. Naloxone is not prescribed along with morphine for post-operative pain management, as it would counteract the analgesic effect of morphine and cause withdrawal symptoms. Naloxone is only used in emergency situations, such as opioid overdose or respiratory depression, as a rescue medication. Therefore, choice F is incorrect.
Choice A reason:
Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) that has analgesic, anti-inflammatory, and antipyretic effects. Ibuprofen can be prescribed along with morphine to enhance the pain relief and reduce the inflammation caused by the surgery. Ibuprofen can also reduce the opioid requirement and the risk of opioid-related side effects, such as nausea, constipation, and respiratory depression. Therefore, choice A is correct.
Choice B reason:
Propofol is a short-acting intravenous anesthetic agent that induces and maintains anesthesia and sedation. Propofol is not prescribed along with morphine for post-operative pain management, as it is not an analgesic and has a high risk of hypotension, bradycardia, and respiratory depression. Propofol is only used in controlled settings, such as the operating room or the intensive care unit, under close monitoring and supervision. Therefore, choice B is incorrect.
Choice C reason:
Methadone is a long-acting synthetic opioid that has analgesic and opioid substitution effects. Methadone is not prescribed along with morphine for post-operative pain management, as it is not indicated for acute pain and has a high risk of accumulation, overdose, and addiction. Methadone is mainly used for chronic pain or opioid dependence treatment, under strict regulation and monitoring. Therefore, choice C is incorrect.
Choice D reason:
Senna is a stimulant laxative that increases the intestinal motility and promotes bowel movements. Senna can be prescribed along with morphine to prevent or treat constipation, which is a common side effect of opioids. Senna can improve the comfort and quality of life of the client who is receiving opioid therapy. Therefore, choice D is correct.
Choice E reason:
Docusate sodium is a stool softener that increases the water content and softness of the stool. Docusate sodium can be prescribed along with morphine to prevent or treat constipation, which is a common side effect of opioids. Docusate sodium can improve the comfort and quality of life of the client who is receiving opioid therapy. Therefore, choice E is correct.
Choice F reason:
Naloxone is an opioid antagonist that reverses the effects of opioids by displacing them from their receptors. Naloxone is not prescribed along with morphine for post-operative pain management, as it would counteract the analgesic effect of morphine and cause withdrawal symptoms. Naloxone is only used in emergency situations, such as opioid overdose or respiratory depression, as a rescue medication. Therefore, choice F is incorrect.