The nurse is caring for a patient who has diabetes and reports chronic, burning leg pain even when taking oxycodone (OxyContin) twice daily. Which prescribed medication is the best choice for the nurse to administer as an adjuvant to decrease the patient's pain?

Naproxen

Amitriptyline

Celecoxib

Hydrocodone/Acetaminophen

Answer and Explanation

The Correct Answer is B

B. Amitriptyline is a tricyclic antidepressant that is often used in low doses to treat neuropathic pain, including diabetic neuropathy. It can help relieve burning, shooting, or stabbing pain often associated with this condition.

A. Naproxen is a nonsteroidal anti-inflammatory drug (NSAID) commonly used for relieving pain and inflammation associated with conditions like arthritis and musculoskeletal injuries. However, it is not typically used as a first-line treatment for neuropathic pain.

C. Celecoxib is a selective COX-2 inhibitor NSAID primarily used for its anti-inflammatory properties and pain relief in conditions like arthritis. While it may help with inflammation-associated pain, it is not specifically indicated for neuropathic pain.

D. While it may provide some relief, opioids are generally not recommended as first-line treatment for neuropathic pain due to their potential for dependence, tolerance, and other side effects.

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Correct Answer is B

Explanation

B. Pallor of the toes indicates compromised blood flow and is the earliest sign of circulatory impairment due to tightness of the cast.

A. Inability to move toes may be a sign of tightness in the cast, but it is not the first finding to be expected if the cast is too tight.

C. Change in temperature of the toes may be a sign of impaired circulation, but it is not the earliest finding to be expected.

D. Edema of the toes may occur as a result of compromised circulation, but it is not the first finding to be expected if the cast is too tight.

A. Teach the patient to push the button every 10 minutes for an hour before going to sleep, even if the pain is minimal. B. Request that the health care provider order a bolus dose of morphine to be given when the patient awakens with pain. C. Consult with the health care provider about using a different treatment protocol to control the patient's pain. D. Administer a dose of morphine every 1 to 2 hours from the PCA machine while the patient is sleeping.

Correct Answer is C

Explanation

C. This option is appropriate as the current treatment protocol is not effectively managing the patient's pain. The nurse can collaborate with the healthcare provider to reassess the patient's pain management needs and explore alternative strategies or adjustments to the PCA regimen.

A. This approach may lead to overmedication and increase the risk of adverse effects such as respiratory depression or sedation.

B. Requesting a bolus dose when the patient awakens with pain could be a part of the solution, but it should be carefully evaluated within the context of the overall pain management plan.

D. Administering scheduled doses of morphine from the PCA machine without the patient's input or based solely on time intervals is not recommended.

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The nurse is caring for a patient who has diabetes and reports chronic, burning leg pain even when taking oxycodone (OxyContin) twice daily. Which prescribed medication is the best choice for the nurse to administer as an adjuvant to decrease the patient's pain?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is assessing a client following the application of a leg cast for the treatment of a fracture. If the cast is too tight, which of the following findings should the nurse expect to observe first?

Correct Answer is B

Explanation

Correct Answer is C

Explanation

A nurse assessing a client who has multiple fractures in his left leg notes increasing edema. The nurse should recognize this finding as an early manifestation of which of the following complications?

A nurse is caring for an adolescent client who has a newly applied fiberglass cast for a fractured tibia. Which of the following is the priority action for the nurse to take?

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A nurse is teaching a client who has a fractured femur about fat emboli syndrome. Which of the following findings should the nurse include as a manifestation of a fat embolism?

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A nurse in a one-day surgery center is providing discharge teaching for a client who is postoperative following a partial meniscectomy. Which of the following instructions should the nurse include?