A patient who is receiving sustained-release morphine sulfate (MS Contin) every 12 hours for chronic pain experiences level 9 (0 to 10 scale) breakthrough pain and anxiety. Which action by the nurse is appropriate for treating this change in assessment?
Administer lorazepam (Ativan) 1 mg orally.
Offer immediate-release morphine 30 mg orally.
Suggest the patient take amitriptyline 10 mg orally.
Give Ibuprofen 400 to 800 mg orally.
The Correct Answer is B
B. Immediate-release morphine provides rapid pain relief and can effectively address breakthrough pain. The dose of 30 mg is reasonable given the severity of the pain.
A. Lorazepam is a benzodiazepine used to treat anxiety. While it may help with anxiety, it does not directly address the severe breakthrough pain experienced by the patient.
C. Amitriptyline is a tricyclic antidepressant used to treat neuropathic pain and depression. While it may help with chronic pain management, it is not appropriate for providing rapid relief for breakthrough pain or acute anxiety.
D. Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) commonly used for mild to moderate pain relief and inflammation. However, it is not typically used for severe breakthrough pain, especially in a patient already receiving opioid therapy.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
B. Alcohol consumption, especially beer and spirits, is associated with an increased risk of gout attacks as it can elevate uric acid levels in the body. Limiting alcohol intake can help prevent gout attacks.
A. While adequate hydration is important for overall health, limiting fluid intake to 1 liter per day may not be appropriate, especially considering that hydration can help prevent gout attacks.
C. While aspirin is commonly used for pain relief, it is not typically recommended for gout management.
D. High-purine foods such as red meat, organ meats, and certain seafood can exacerbate gout symptoms by increasing uric acid levels in the body. Therefore, closely following a high-purine diet would likely worsen gout symptoms rather than improve them.
Correct Answer is D
Explanation
D. Appendectomy is a common surgical procedure to remove the appendix and is considered a moderate surgical intervention. Early ambulation is generally encouraged for patients after appendectomy to prevent complications such as pneumonia, deep vein thrombosis, and ileus.
B. Knee replacement surgery is a major orthopedic procedure that requires early mobilization and rehabilitation to prevent complications such as blood clots, joint stiffness, and muscle weakness. However, the client needs more time before ambulation is initiated
A. Tonsillectomy is a relatively minor surgical procedure that typically does not significantly impact a patient's mobility or ability to ambulate. The patient who had a tonsillectomy one week ago is likely well-recovered and may not require immediate prioritization for ambulation.
C. Hernia repair surgery is typically considered a moderate surgical procedure. While early mobilization is generally beneficial for patients recovering from hernia repair surgery, it may not be as urgent as for patients undergoing major orthopedic surgeries like knee replacement.
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