NCLEX CRUSADE ACADEMY TEST - 2 ESSENTIAL DRUG FOR EMERGENCY SITUATIONS

1. Which mechanism best explains how opioid medications reduce pain?. They block sodium channels in peripheral nerves. They inhibit pain transmission by acting on central nervous system receptors. They increase serotonin release in the spinal cord. They stimulate inflammatory mediators.

2. What is the most life threatening adverse effect associated with opioid medications?. Nausea. Pruritus. Respiratory depression. Urinary retention.

3. Which opioid is classified as a core opioid used in pain management?. Morphine. Naloxone. Ibuprofen. Ketamine.

4. When applying a transdermal opioid patch, what is the first step the nurse should take?. Apply heat to the skin. Remove the previously applied patch. Apply lotion to the skin. Shave the area thoroughly.

5. Which action should the nurse avoid when applying a transdermal opioid patch?. Cleaning the skin. Rotating application sites. Applying heat over the patch. Documenting date and time.

6. Epidural catheter placement is typically performed between which vertebral levels?. T1T2. L3L4. C1C2. S1S2.

7. Which condition is a strict contraindication for epidural administration of opioids?. Mild anxiety. Skeletal or spinal anomalies. Controlled hypertension. Seasonal allergies.

8. What nursing assessment is mandatory after epidural analgesia placement?. Eye examination. Neurological and neurovascular assessment. Skin allergy testing. Hearing assessment.

9. Which opioid is considered high risk for causing profound respiratory depression?. Fentanyl. Acetaminophen. Aspirin. Lidocaine.

10. Which vital sign must be monitored most closely when administering opioids?. Respiratory rate. Temperature. Oxygen saturation only. Blood glucose.

11. What is the primary gastrointestinal complication of codeine?. Diarrhea. Severe constipation. Ulcers. Pancreatitis.

12. Which intervention helps prevent constipation caused by codeine?. Restrict fluids. Increase fiber and fluids. Bed rest. Decrease ambulation.

13. In which situation should the nurse question an order for meperidine (Demerol)?. Patient with migraine. Patient with renal disease. Patient with minor injury. Patient with mild anxiety.

14. Why should meperidine be avoided in patients with head injuries?. It causes dehydration. It increases intracranial pressure. It lowers heart rate. It reduces blood pressure excessively.

15. Naloxone (Narcan) works by which mechanism?. Activating opioid receptors. Blocking opioid receptors. Increasing dopamine release. Stimulating respiratory centers directly.

16. What is the primary clinical goal of naloxone administration?. Reduce inflammation. Reverse respiratory depression. Increase sedation. Promote sleep.

17. Naloxone is ineffective for reversing overdose from which substance?. Morphine. Fentanyl. Barbiturates. Hydromorphone.

18. What is the onset of action for IV naloxone?. 30 minutes. 10-15 minutes. 1-2 minutes. 2 hours.

19. What major risk occurs after naloxone reverses opioid effects?. Hypoglycemia. Sudden severe pain return. Bradycardia. Vision loss.

20. What serious complication can occur when naloxone is given to opioid dependent patients?. Stroke. Acute withdrawal syndrome. Kidney failure. Liver damage.

21. Why must patients receiving naloxone be monitored continuously after administration?. Risk of hypothermia. Opioids may outlast naloxone and cause rebound respiratory depression. Risk of bleeding. Risk of seizures.