A hospice nurse is caring for a client who has terminal cancer and takes PO morphine for pain relief. The client reports that he had to increase the dose of morphine this week to obtain pain relief. Which of the following scenarios should the nurse document as the explanation for this situation?
The client has become addicted to the medication.
The client is experiencing episodes of confusion.
The client not been taking the medication properly.
The client developed tolerance to the medication.
The Correct Answer is D
Tolerance refers to where there is reduced responsiveness to a drug due to prolonged exposure to the drug requiring higher doses to achieve the same effect. This effect requires progressive increment in dosages of the medication which may increase the risk for toxicity.
A. Addiction is characterized by compulsive efforts to acquire the drug despite being aware of its adverse consequences
C and D are not related to the continuous need for higher doses of morphine
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
pulling the auricle down and back, is recommended for pediatric clients for proper visualization. It also helps prevent the eardrops from pooling at the entrance of the ear canal, allowing them to flow more effectively into the ear.
A, pulling the auricle down and out is not recommended as it may lead to pooling of the drop and spillage
CThis is not recommended in children
D Pulling the auricle up and back is recommended for adults.
Correct Answer is B
Explanation
Wernicke- Korsakoff is a neurological disorder that occurs commonly in malnourished alcoholic due to thiamine deficiency. It presents confusion, ataxia, visual disturbances and low blood pressure. It is managed by administration of thiamine to prevent permanent brain damage.
A . although alcohol can cause cardiomyopathy and cardiac arrhythmias, it is not directly related to Wernicke- Korsakoff syndrome
C. chronic alcoholism can lead to liver cirrhosis and esophageal varices but is not directly related to Wernicke-Korsakoff psychosis.
D. isolation is not necessary as Wernicke-Korsakoff psychosis is not a communicable disease.
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