A nurse is caring for a patient who reports pain in his left leg that he rates as an 8 on a scale from 0 to 10 and states that he feels tingling and numbness in his toes.

The patient has an order for morphine sulfate 2 mg IV bolus PRN every two hours for pain greater than 7, last administered three hours ago, and ibuprofen 400 mg PO PRN every four hours for pain less than or equal to 7, last administered six hours ago.

What action should the nurse take first?

Administer morphine sulfate 2 mg IV bolus.

Administer ibuprofen 400 mg PO.

Assess the patient’s leg for circulation, sensation, and movement.

Reassess the patient’s pain in 15 minutes.

Answer and Explanation

The Correct Answer is C

The correct answer is choice C. Assess the patient’s leg for circulation, sensation, and movement.

This is because the patient’s symptoms of pain, tingling, and numbness in his left leg could indicate a potential complication of impaired blood flow or nerve damage after surgery. The nurse should prioritize assessing the patient’s leg for any signs of compromised circulation, sensation, or movement before administering any pain medication.

Choice A is wrong because administering morphine sulfate 2 mg IV bolus without assessing the patient’s leg could mask the symptoms of a serious problem and delay appropriate interventions. Morphine sulfate is a potent opioid analgesic that can cause respiratory depression, sedation, and constipation.

Choice B is wrong because administering ibuprofen 400 mg PO without assessing the patient’s leg could also mask the symptoms of a serious problem and delay appropriate interventions. Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) that can cause gastrointestinal bleeding, renal impairment, and increased risk of cardiovascular events.

Choice D is wrong because reassessing the patient’s pain in 15 minutes without assessing the patient’s leg could result in the worsening of the patient’s condition and increased risk of complications. The nurse should not delay assessing the patient’s leg for any signs of impaired circulation, sensation, or movement.

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Correct Answer is C

Explanation

The correct answer is choice C) Chest pain.

This is because chest pain can be a sign of a serious cardiovascular event, such as a heart attack or stroke, which can be fatal.

Celecoxib is a nonsteroidal anti-inflammatory drug (NSAID) that belongs to the class of cyclooxygenase-2 (COX-2) inhibitors.These drugs can increase the risk of cardiovascular thrombotic events, especially in patients with a history of heart disease or risk factors.

Therefore, the nurse should instruct the client to report chest pain immediately and seek emergency medical attention.

Choice A) Constipation is wrong because it is not a common or serious side effect of celecoxib.

Constipation can be caused by many factors, such as diet, dehydration, lack of exercise, or other medications.It can be managed by increasing fluid and fiber intake, using laxatives or stool softeners as needed, and consulting a doctor if it persists or worsens.

Choice B) Nausea is wrong because it is a common but mild side effect of celecoxib that usually goes away with time or can be reduced by taking the medication with food or milk.

Nausea is not a sign of a serious adverse reaction and does not require immediate medical attention.

Choice D) Headache is wrong because it is also a common but mild side effect of celecoxib that can be treated with over-the-counter pain relievers, such as acetaminophen or ibuprofen.

However, the client should avoid taking aspirin or other NSAIDs with celecoxib, as this can increase the risk of gastrointestinal bleeding and ulcers

A. Serum creatinine B. Serum potassium C. Serum albumin D. Serum bilirubin.

Correct Answer is D

Explanation

The correct answer is choice D. Serum bilirubin.The nurse should monitor the client’s serum bilirubin level closely because acetaminophen, a non-opioid analgesic, can cause hepatotoxicity and acute liver failure in cases of overdose.

Serum bilirubin is a marker of liver function and damage.

A high level of serum bilirubin indicates jaundice, a sign of liver injury.

Choice A is wrong because serum creatinine is a marker of kidney function and damage.Acetaminophen has limited nephrotoxicity compared to NSAIDs.

Choice B is wrong because serum potassium is not directly affected by acetaminophen.

Serum potassium is an electrolyte that reflects fluid and acid-base balance in the body.

Choice C is wrong because serum albumin is a protein that is synthesized by the liver.

Although serum albumin may be low in chronic liver disease, it is not a sensitive indicator of acute liver injury caused by acetaminophen overdose.

Normal ranges for serum bilirubin are 0.3 to 1.2 mg/dL for adults and 1 to 12 mg/dL for newborns.

Normal ranges for serum creatinine are 0.6 to 1.2 mg/dL for men and 0.5 to 1.1 mg/dL for women.

Normal ranges for serum potassium are 3.5 to 5 mEq/L for adults and children.

Normal ranges for serum albumin are 3.4 to 5.4 g/dL for adults and children.

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Naxlex Comprehensive Predictor Exams

A client with osteoarthritis has been prescribed celecoxib (Celebrex). The nurse should instruct the client to report which of the following adverse effects immediately?

Correct Answer is C

Explanation

The nurse is caring for a client who has been prescribed acetaminophen, a non-opioid analgesic, for mild pain. Which laboratory test result should the nurse monitor closely in this client?

Correct Answer is D

Explanation

A nurse is teaching a client who has cancer pain about the use of oral oxycodone with acetaminophen (Percocet). Which statement by the client indicates a need for further teaching?

A patient who has chronic low back pain is prescribed oxycodone (OxyContin) for long-term use. Which of the following interventions should the nurse implement to prevent complications from this medication? (Select all that apply.)

The primary health care provider instructs the nurse to obtain the patient’s pain level every four hours. Which actions by the nurse help facilitate the pain assessment? Select all that apply.

A nurse is teaching a client who has chronic pain about nonpharmacological pain management techniques. Which of the following statements by the client indicates an understanding of the teaching? (Select all that apply.).

A patient with chronic back pain is prescribed gabapentin as an adjuvant analgesic. The nurse should instruct the patient to report which of the following adverse effects?

Which statement made by a client taking aspirin indicates an understanding of its use?

(Select all that apply) A patient with postoperative pain is prescribed hydroxyzine as an adjuvant analgesic. The nurse should teach the patient about which of the following benefits of this medication.