Mechanism of Action
A nurse is explaining how opioids relieve pain. Which of the following best describes the action of opioid agonists?
A. Stimulate GABA receptors
B. Inhibit serotonin uptake
C. Bind to opioid receptors to block pain signals
D. Inhibit prostaglandin synthesis
C. Bind to opioid receptors to block pain signals
Which is the most life-threatening adverse effect of opioids?
A. Constipation
B. Sedation
C. Respiratory depression
D. Urinary retention
C. Respiratory depression
Which of the following is a full opioid agonist used for severe pain?
A. Naloxone
B. Butorphanol
C. Morphine
D. Buprenorphine
C. Morphine
Which of the following is classified as an opioid agonist-antagonist?
A. Fentanyl
B. Morphine
C. Nalbuphine
D. Hydrocodone
C. Nalbuphine
What is the name of the opioid antagonist used to reverse overdose?
A. Naltrexone
B. Fentanyl
C. Hydromorphone
D. Buprenorphine
A. Naltrexone
Which receptor site is primarily activated by opioid agonists to produce pain relief?
A. Alpha-2
B. Mu
C. Beta
D. Delta
B. Mu
A nurse is monitoring for signs of opioid overdose. Which symptom is most concerning?
A. Miosis
B. Nausea
C. Confusion
D. Bradypnea
D. Bradypnea
Hydromorphone is prescribed. What is an appropriate nursing action?
A. Administer for constipation
B. Monitor for respiratory depression
C. Encourage caffeine use
D. Teach about muscle spasms
B. Monitor for respiratory depression
Why are opioid agonist-antagonists used in patients with a history of substance abuse?
A. They enhance euphoria
B. They have higher abuse potential
C. They have a ceiling effect for respiratory depression
D. They are less effective for pain
C. They have a ceiling effect for respiratory depression
Which nursing priority is most important after administering naloxone?
A. Start a Foley catheter
B. Monitor for opioid withdrawal
C. Offer food and drink
D. Apply a heating pad
B. Monitor for opioid withdrawal
What is the main neurotransmitter-related effect of opioids at the spinal cord level?
A. Increased dopamine activity
B. Blocking substance P release
C. Enhanced serotonin reuptake
D. Decreased norepinephrine binding
B. Blocking substance P release
What teaching point is most important to reduce constipation in patients on opioids?
A. Limit fluid intake
B. Take with milk
C. Increase fiber and fluids
D. Take antacids regularly
C. Increase fiber and fluids
Which medication is also used to treat opioid withdrawal symptoms?
A. Methadone
B. Codeine
C. Acetaminophen
D. Furosemide
A. Methadone
A patient on butorphanol is transitioning from full agonists. What should the nurse monitor for?
A. Tachycardia
B. Withdrawal symptoms
C. Hepatotoxicity
D. Bradycardia
B. Withdrawal symptoms
Which finding indicates naloxone was effective?
A. Sedation level increases
B. Respirations increase to 14/min
C. Pain level decreases
D. Heart rate drops to 40 bpm
B. Respirations increase to 14/min
A client asks why opioids can make them feel euphoric. The nurse explains this is due to:
A. Reduced GABA release in the cortex
B. Increased dopamine in reward pathways
C. Inhibition of norepinephrine
D. Alpha-1 receptor stimulation
B. Increased dopamine in reward pathways
Which opioid-related adverse effect is not dose-dependent and may not resolve over time?
A. Nausea
B. Tolerance
C. Constipation
D. Sedation
C. Constipation
Which of the following is the strongest opioid listed?
A. Fentanyl
B. Codeine
C. Tramadol
D. Hydrocodone
A. Fentanyl
A patient asks if buprenorphine will help with pain. What is the correct response?
A. “It won’t affect pain at all.”
B. “It provides mild pain relief with less risk of addiction.”
C. “It only helps if you are allergic to morphine.”
D. “It works exactly like naloxone.”
B. “It provides mild pain relief with less risk of addiction.”
Naloxone may need to be re-administered because:
A. Its half-life is shorter than most opioids
B. It enhances opioid effects
C. It causes hypertension
D. It builds tolerance
A. Its half-life is shorter than most opioids
Which of the following best describes the action of an opioid agonist-antagonist?
A. Blocks all opioid receptors to reverse overdose
B. Fully stimulates mu receptors for euphoria
C. Stimulates kappa while blocking mu receptors
D. Reduces serotonin release in CNS
C. Stimulates kappa while blocking mu receptors
A client on morphine complains of dizziness and hypotension. The nurse attributes this to:
A. Histamine release causing vasodilation
B. Increased catecholamines
C. Hyponatremia
D. Decreased renal perfusion
A. Histamine release causing vasodilation
Why must fentanyl patches be used cautiously?
A. They have poor absorption
B. The onset is immediate
C. They can cause delayed respiratory depression
D. They are short acting
C. They can cause delayed respiratory depression
What is the benefit of partial opioid agonists like buprenorphine?
A. Reduced pain relief
B. Increased risk of euphoria
C. Lower risk of dependency
D. Immediate reversal of overdose
C. Lower risk of dependency
Which adverse effect is commonly seen with naloxone administration?
A. Bradycardia
B. Hallucinations
C. Opioid withdrawal symptoms
D. Rhabdomyolysis
C. Opioid withdrawal symptoms