Patient Data
The nurse is discussing the client's pain management with a student nurse. Choose the most likely options for the information missing from the statement(s) by selecting from the lists of options provided.
Morphine is a(n)
and it activates receptors and is used to relieve .The Correct Answer is {"dropdown-group-1":"C","dropdown-group-2":"A","dropdown-group-3":"C"}
The correct answer is:
Morphine is a(n) **pure opioid antagonist** and it activates **mu** receptors and is used to relieve **severe pain**.
Choice area A
Choice A reason:
A pure opioid antagonist is a drug that blocks the effects of opioids by binding to their receptors without activating them. Morphine is not a pure opioid antagonist, but a pure opioid agonist, which means it binds to and activates opioid receptors, producing analgesia and other effects. Therefore, choice A is incorrect.
Choice B reason:
An endogenous opioid is a naturally occurring substance in the body that binds to and activates opioid receptors, such as endorphins and enkephalins. Morphine is not an endogenous opioid, but an exogenous opioid, which means it is derived from an external source, such as the opium poppy. Therefore, choice B is incorrect.
Choice C reason:
A pure opioid antagonist is the correct term for morphine, as explained above. Therefore, choice C is correct.
Choice D reason:
A local anesthetic is a drug that blocks the transmission of nerve impulses in a specific area of the body, causing numbness and loss of sensation. Morphine is not a local anesthetic, but a systemic analgesic, which means it affects the whole body and reduces the perception of pain. Therefore, choice D is incorrect.
Choice area B
Choice A reason:
Mu receptors are one of the three types of opioid receptors in the body, along with kappa and delta receptors. Mu receptors are responsible for most of the analgesic and euphoric effects of opioids, as well as respiratory depression and physical dependence. Morphine has a high affinity for mu receptors and activates them strongly. Therefore, choice A is correct.
Choice B reason:
Kappa receptors are another type of opioid receptors in the body. Kappa receptors mediate some analgesic effects of opioids, as well as dysphoria, sedation, and miosis. Morphine has a low affinity for kappa receptors and activates them weakly. Therefore, choice B is incorrect.
Choice C reason:
Delta receptors are the third type of opioid receptors in the body. Delta receptors modulate some analgesic effects of opioids, as well as emotional responses and memory. Morphine has a low affinity for delta receptors and activates them weakly. Therefore, choice C is incorrect.
Choice D reason:
NMDA receptors are not opioid receptors, but glutamate receptors that are involved in synaptic plasticity, learning, memory, and pain modulation. Some drugs that act on NMDA receptors, such as ketamine and dextromethorphan, have analgesic properties, especially for neuropathic pain. Morphine does not act on NMDA receptors. Therefore, choice D is incorrect.
Choice E reason:
GABA receptors are not opioid receptors, but gamma-aminobutyric acid receptors that are involved in inhibitory neurotransmission in the central nervous system. Some drugs that act on GABA receptors, such as benzodiazepines and barbiturates, have sedative, anxiolytic, anticonvulsant, and muscle relaxant properties. Morphine does not act on GABA receptors. Therefore, choice E is incorrect.
Choice area C
Choice A reason:
Mild pain is pain that is easily tolerated and does not interfere with normal activities or sleep. Mild pain can usually be managed with non-opioid analgesics, such as acetaminophen or ibuprofen. Morphine is not used to relieve mild pain, as it is too potent and has more side effects and risks than non-opioid analgesics. Therefore, choice A is incorrect.
Choice B reason:
Moderate pain is pain that causes discomfort and affects normal activities or sleep to some extent. Moderate pain can usually be managed with combination analgesics, such as codeine or hydrocodone with acetaminophen or ibuprofen. Morphine can be used to relieve moderate pain in some cases, but it is not the first-line option, as it may be more effective and safer to use lower doses of opioids with non-opioid analgesics. Therefore, choice B is incorrect.
Choice C reason:
Severe pain is pain that causes significant distress and impairs normal activities or sleep to a great extent. Severe pain usually requires strong opioids, such as morphine or fentanyl, to achieve adequate relief. Morphine is commonly used to relieve severe pain in various settings, such as post-operative pain, cancer pain, or acute myocardial infarction. Therefore, choice C is correct.
Choice D reason:
Neuropathic pain is pain that results from damage or dysfunction of the nervous system, such as diabetic neuropathy or post-herpetic neuralgia. Neuropathic pain often responds poorly to conventional analgesics, including opioids. Morphine can be used to relieve neuropathic pain in some cases, but it may not be very effective or require higher doses than for nociceptive pain (pain that results from tissue damage or inflammation). Therefore, choice D is incorrect.
Choice E reason:
Inflammatory pain is pain that results from tissue damage or inflammation, such as arthritis or appendicitis. Inflammatory pain often responds well to non-opioid analgesics, especially NSAIDs, which have anti-inflammatory properties. Morphine can be used to relieve inflammatory pain in some cases, but it may not be necessary or optimal to use opioids for this type of pain, as they do not have anti-inflammatory effects and may cause more side effects and risks than non-opioid analgesics. Therefore, choice E is incorrect.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A reason: Depression screening is not directly related to the effectiveness of orlistat, which is a medication that blocks the absorption of fat from the diet and helps to reduce weight. Depression screening may be important for the overall mental health of the client, but it is not an ongoing assessment for orlistat.
Choice B reason: Body mass index (BMI) is a measure of body fat based on height and weight, and it is used to assess the risk of obesity-related health problems. BMI is an ongoing assessment for orlistat, because it can indicate the progress and outcome of the weight management program. The goal of orlistat therapy is to achieve and maintain a healthy BMI.
Choice C reason: Daily calorie count is not an ongoing assessment for orlistat, because it does not reflect the amount of fat absorbed by the body. Orlistat works by blocking the action of lipase, an enzyme that breaks down fat in the intestine. Therefore, even if the client consumes a high-calorie diet, orlistat can prevent some of the fat from being absorbed and reduce weight. However, daily calorie count may be useful for monitoring the overall nutritional intake and energy balance of the client.
Choice D reason: Serum protein levels are not an ongoing assessment for orlistat, because they are not affected by the medication. Orlistat only blocks the absorption of fat, not protein or carbohydrates. Serum protein levels may be important for evaluating the nutritional status and organ function of the client, but they are not an indicator of orlistat effectiveness.
Correct Answer is {"A":{"answers":"A"},"B":{"answers":"A"},"C":{"answers":"B"},"D":{"answers":"B"},"E":{"answers":"B"}}
Explanation
Choice A reason: This statement indicates understanding of naloxone. Naloxone is an opioid antagonist that can reverse the effects of opioid overdose, such as respiratory depression, sedation, and hypotension. Naloxone can be administered by different routes, depending on the availability and urgency of the situation. Intravenous, intramuscular, and subcutaneous routes are all acceptable ways to give naloxone.
Choice B reason: This statement also indicates understanding of naloxone. Naloxone works best on pure agonist opioids, such as morphine, heroin, and fentanyl. These opioids bind to the same receptors as naloxone, but naloxone has a higher affinity and can displace them. Naloxone is less effective on partial agonist or mixed agonist-antagonist opioids, such as buprenorphine and pentazocine. These opioids have lower intrinsic activity or antagonize some receptors, making them less susceptible to naloxone.
Choice C reason: This statement indicates no understanding of naloxone. Naloxone is not a harmless drug that can be given repeatedly without consequences. Naloxone has a short half-life of about 30 to 90 minutes, which means it can wear off before the opioid does. This can cause the patient to relapse into respiratory depression and require repeated doses of naloxone. However, giving too many doses of naloxone can also cause adverse effects, such as agitation, hypertension, tachycardia, pulmonary edema, and seizures. Therefore, naloxone should be given cautiously and titrated to the minimum effective dose to reverse respiratory depression.
Choice D reason: This statement indicates no understanding of naloxone. Naloxone will affect the client's level of pain by blocking the analgesic effects of opioids. This can cause the patient to experience acute pain and distress, especially if they have a chronic pain condition or a surgical wound. Naloxone should not be used to treat opioid-induced sedation or pruritus without respiratory depression, as this will unnecessarily expose the patient to pain and suffering.
Choice E reason: This statement indicates no understanding of naloxone. When given IV, naloxone starts working immediately, but it does not last several hours. As mentioned earlier, naloxone has a short half-life and can be eliminated from the body quickly. The duration of action of naloxone depends on the dose, route, and frequency of administration, as well as the type, dose, and route of the opioid involved. Generally, naloxone lasts for about 30 to 90 minutes when given IV, which may not be enough to counteract the longer-lasting effects of some opioids. Therefore, continuous monitoring and repeated doses of naloxone may be needed until the opioid is cleared from the system.
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