Which patient may require a higher-than-expected dose of an opioid analgesic?
A patient 3 days after surgery.
A patient with cancer.
A patient with hypotension.
A patient with a concussion.
The Correct Answer is B
Choice A rationale
A patient 3 days after surgery may still require higher doses of opioids for pain management, but the duration and intensity of postoperative pain typically decrease over time. This patient may not necessarily require a higher-than-expected dose compared to others.
Choice B rationale
Patients with cancer often experience severe and chronic pain due to the disease itself or its treatments. These patients may develop tolerance to opioids over time, necessitating higher-than-expected doses to achieve adequate pain relief.
Choice C rationale
Hypotension is a contraindication for high doses of opioids, as opioids can cause further blood pressure reduction. This patient would require careful dose adjustment to avoid exacerbating hypotension.
Choice D rationale
Patients with a concussion are at risk of altered mental status and respiratory depression from opioids. Therefore, higher doses are generally avoided to prevent worsening of these conditions.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A rationale
Anticholinergic drugs do not cause pupil restriction; they relax the muscles around the eye, leading to dilation.
Choice B rationale
Decreased lacrimal secretions are a secondary effect of anticholinergics and not their primary purpose in ophthalmology.
Choice C rationale
Anticholinergics cause pupil dilation (mydriasis) by relaxing the muscles that constrict the pupil, allowing for a better examination of the eye's interior.
Choice D rationale
Sedation is not a primary effect of anticholinergics used in ophthalmology.
Correct Answer is B
Explanation
Choice A rationale
Peripheral edema is more commonly associated with right-sided heart failure rather than left-sided. This is because right-sided heart failure leads to systemic venous congestion, causing fluid to accumulate in the peripheral tissues, particularly in the legs and ankles.
Choice B rationale
Pulmonary edema is a major concern in left-sided heart failure due to the inability of the left ventricle to effectively pump blood out to the systemic circulation. This results in blood backing up into the pulmonary veins, leading to fluid accumulation in the lungs.
Choice C rationale
Liver edema, or hepatomegaly, is more typically seen in right-sided heart failure, where the failure of the right ventricle causes blood to back up into the systemic circulation, affecting the liver and other organs.
Choice D rationale
Abdominal edema, or ascites, is also more associated with right-sided heart failure. This condition occurs due to increased pressure in the veins and capillaries, leading to fluid leakage into the abdominal cavity.
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