The nurse accidentally administers 15 mg of morphine IM to a client who had been given another dose of morphine 15 mg IM about 30 minutes earlier. What action should the nurse be prepared to take?

Assistance with endotracheal intubation

Administration of protamine sulfate

Administration of naloxone (Narcan)

Administration of oxygen

Answer and Explanation

The Correct Answer is C

A. Endotracheal intubation might be necessary in severe cases of respiratory depression, but it is not the first step in addressing opioid overdose.
B. Protamine sulfate is the antidote for heparin, not morphine.
C. Naloxone (Narcan) is an opioid antagonist that can rapidly reverse the effects of opioid overdose, including respiratory depression.
D. Administration of oxygen is supportive care but does not address the root cause of opioid overdose.

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Correct Answer is C

Explanation

A. The maturation phase is the final phase of wound healing and involves the strengthening and remodeling of collagen fibers.
B. The proliferation phase is the second phase of wound healing, characterized by the formation of new tissue and blood vessels.
C. The inflammation phase is the first phase of wound healing, during which the body's initial response to injury involves hemostasis and inflammation. This phase includes vasodilation, increased permeability of blood vessels, and the influx of white blood cells to clean the wound.
D. The remodeling phase is another term for the maturation phase, the final phase of wound healing.

A. The client may have adapted so successfully to the presence of chronic pain that measures for relief are unnecessary. B. Opioid-based analgesics may have little if any effect on reducing the quality of chronic pain. C. The actual intensity of chronic pain is difficult to assess because the client may complain constantly. D. Heart rate, blood pressure, and pulse rate may be normal while the client is experiencing pain.

Correct Answer is D

Explanation

A. While some clients with chronic pain may develop coping mechanisms, this does not mean that measures for relief are unnecessary. Pain management is still crucial for maintaining quality of life.
B. Opioid-based analgesics can be effective for some individuals with chronic pain, but their effectiveness can vary and they may not always be the best option due to potential side effects and the risk of dependence.
C. Chronic pain can be challenging to assess, but the perception and expression of pain are subjective and can vary greatly among individuals. Constant complaints of pain do not necessarily mean the pain intensity is difficult to assess; rather, it indicates the need for thorough pain evaluation.
D. Chronic pain often does not trigger the same physiological responses as acute pain. Therefore, vital signs such as heart rate, blood pressure, and pulse rate may remain normal even while the client is experiencing pain. This can make it more challenging to assess the presence and intensity of pain solely based on these parameters.

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The nurse accidentally administers 15 mg of morphine IM to a client who had been given another dose of morphine 15 mg IM about 30 minutes earlier. What action should the nurse be prepared to take?

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Naxlex Comprehensive Predictor Exams

A nurse is preparing to teach a group of newly licensed nurses about the first phase of wound healing. Which of the following processes should the nurse plan to discuss?

Correct Answer is C

Explanation

In providing care to a client with chronic pain, which of the following characteristics or client responses should the nurse expect?

Correct Answer is D

Explanation

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