The nurse is providing discharge instructions for a client with metastatic cancer who is prescribed morphine for bone pain. Which information from the client indicates to the nurse an understanding of the medication?

Observe bowel movement pattern and take a stool softener.

Do not drink grapefruit juice after taking morphine.

Watch for signs of agitation and record any insomnia.

Take the benzodiazepine at the same time of taking the morphine.

Answer and Explanation

The Correct Answer is A

A. Observe bowel movement pattern and take a stool softener: Morphine commonly causes constipation due to reduced gastrointestinal motility. Recognizing this and taking preventive measures like a stool softener indicates a good understanding of how to manage one of the most frequent and bothersome side effects of opioid therapy.

B. Do not drink grapefruit juice after taking morphine: Grapefruit juice significantly interacts with certain medications, particularly those metabolized by CYP3A4 enzymes, but it has minimal clinical effect on morphine metabolism. This instruction is not relevant for morphine use.

C. Watch for signs of agitation and record any insomnia: While these symptoms can occasionally occur, they are not typical or expected side effects of morphine. More common effects include sedation, respiratory depression, and constipation.

D. Take the benzodiazepine at the same time of taking the morphine: Combining morphine with benzodiazepines increases the risk of severe sedation, respiratory depression, and overdose. Co-administration should be carefully managed and typically avoided unless specifically directed by the healthcare provider.

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Correct Answer is D

Explanation

A. Monitor urinary output: While monitoring output is important, it does not provide immediate diagnostic information regarding the cause of the client’s thirst. It is a supportive action but not the most efficient first step to investigate potential hyperglycemia.

B. Notify the healthcare provider (HCP): Notifying the HCP is appropriate if there are abnormal findings or the client’s condition worsens. However, the nurse should gather objective data—such as a blood glucose reading—before contacting the provider.

C. Prepare to give insulin: Insulin should not be administered without confirmation of elevated blood glucose. Giving insulin without verifying hyperglycemia could lead to serious complications, including hypoglycemia.

D. Obtain fingerstick blood glucose: Methylprednisolone, a corticosteroid, can raise blood glucose levels, and excessive thirst is a classic symptom of hyperglycemia. Checking the client’s blood glucose is the most appropriate first action to determine if elevated glucose is causing the symptom.

A. Ibuprofen B. Oral contraceptive C. Corticosteroids D. Epinephrine E. St. John's Wort F. Fluconazole

Correct Answer is ["B","C","D","F"]

Explanation

A. Ibuprofen: While ibuprofen can affect renal function and has its own risks in diabetes, it does not have a significant or consistent effect on insulin requirements. It is not a primary medication impacting glucose metabolism.

B. Oral contraceptive: Estrogen in oral contraceptives can cause increased insulin resistance, potentially requiring higher doses of insulin to maintain glucose control. Therefore, it can affect the client’s insulin needs.

C. Corticosteroids: Corticosteroids such as prednisone raise blood glucose levels by promoting gluconeogenesis and insulin resistance. Clients taking corticosteroids often require increased insulin dosing.

D. Epinephrine: Epinephrine stimulates glycogen breakdown and raises blood glucose levels as part of the stress response. It can significantly impact blood sugar control and thus influence insulin requirements.

E. St. John's Wort: St. John's Wort can interact with many medications, but its effect on insulin or blood glucose regulation is not strong enough to significantly alter insulin needs. It is more notable for affecting medications through liver enzyme induction.

F. Fluconazole: Fluconazole can inhibit the metabolism of some drugs and may increase insulin sensitivity in certain cases. It can alter glucose control by enhancing insulin action, which may lead to a need for insulin dose adjustments.

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The nurse is providing discharge instructions for a client with metastatic cancer who is prescribed morphine for bone pain. Which information from the client indicates to the nurse an understanding of the medication?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client who is taking methylprednisolone reports feeling thirsty. Which action should the nurse take first?

Correct Answer is D

Explanation

Patient Data Exhibits Which home medication(s) may affect the amount of insulin needed by the client? Select all that apply.

Correct Answer is ["B","C","D","F"]

Explanation

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