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Nursing Opioid Use and Safety Worksheet

Total questions: 20

Worksheet time: 30mins

Name
Class
Date
1.

A client who had abdominal surgery 4 hours ago reports pain rated 8/10. The nurse notes RR 10/min, BP 92/60 mmHg, P 54 bpm, and O₂ sat 88% on room air. What is the nurse’s priority action?

a)

Hold the opioid dose and notify the provider

b)

Administer prescribed morphine IV as ordered

c)

Reassess pain in 30 minutes

d)

Document the findings and continue monitoring

2.

The nurse is educating a patient about opioid use at home. Which teaching point is most important for safety?

a)

Take the medication before pain becomes severe

b)

Store opioids in a locked cabinet

c)

Increase fluids to prevent constipation

d)

Avoid caffeine with medication

3.

A nurse finds a discrepancy in the controlled substance count for oxycodone. What should the nurse do first?

a)

Notify the nurse manager and follow facility protocol

b)

Correct the count alone and sign it

c)

Ignore it until the next shift

d)

Ask another nurse to fix it

4.

A patient receives morphine 2 mg IV push. After 15 minutes, the patient reports pain relief and RR 14. What should the nurse do?

a)

Continue to monitor and document effectiveness

b)

Administer naloxone

c)

Give another 2 mg immediately

d)

Hold future doses

5.

A patient who received morphine now shows pinpoint pupils, slow respirations, and low LOC. Which order should the nurse expect?

a)

Administer naloxone

b)

Increase IV fluids

c)

Prepare for intubation

d)

Reassess in 30 minutes

6.

A patient who received morphine now shows pinpoint pupils, slow respirations, and low LOC. Which order should the nurse expect?

a)

Naloxone 0.4 mg IV

b)

Atropine 0.5 mg IV

c)

Epinephrine 1 mg IM

d)

Diazepam 10 mg IV

7.

A patient receiving fentanyl reports feeling lightheaded and dizzy upon standing. Which intervention is most appropriate?

a)

Encourage rapid position changes

b)

Instruct to rise slowly and dangle legs before standing

c)

Hold the medication permanently

d)

Increase opioid dose to compensate

8.

Which nursing diagnosis is most appropriate for a patient on opioids who has RR 8/min and pulse oximetry of 89%?

a)

A. Activity intolerance related to weakness

b)

B. Impaired gas exchange related to slow breathing

c)

C. Ineffective airway clearance related to secretions

d)

D. Anxiety related to hypoxia

9.

Before administering morphine to a postoperative client, which assessment should the nurse perform first?

a)

Assess level of pain and location

b)

Assess respiratory rate and depth

c)

Check bowel sounds

d)

Check urine output

10.

Which statement by the client indicates understanding of acetaminophen teaching?

a)

I can take this for inflammation.

b)

I’ll avoid alcohol while taking this medicine.

c)

It’s safe to take up to 5 grams a day.

d)

I’ll take this on an empty stomach.

11.

A client arrives at the ED after ingesting a large amount of acetaminophen. What medication does the nurse expect to administer?

a)

Naloxone (Narcan)

b)

Acetylcysteine (Mucomyst)

c)

Atropine sulfate

d)

Protamine sulfate

12.

Which early signs should the nurse monitor for in acetaminophen toxicity?

a)

Nausea, vomiting, abdominal discomfort

b)

Jaundice and confusion

c)

Hypotension and bleeding gums

d)

Bradycardia and hypothermia

13.

A client with postoperative urinary retention is prescribed bethanechol. Which assessment finding indicates the medication is effective?

a)

The client reports relief of pain

b)

The client voids within 1 hour of administration

c)

The client reports decreased bladder pressure

d)

The client’s BP increases slightly

14.

A client is brought to the ER with anaphylaxis after a bee sting. Which assessment finding indicates that epinephrine is effective?

a)

Decreased heart rate

b)

Improved airway and decreased wheezing

c)

Decreased blood pressure

d)

Increased drowsiness

15.

A client taking ibuprofen for arthritis reports black tarry stools. What should the nurse do first?

a)

Encourage more fluids

b)

Document as expected

c)

Hold the medication and notify the provider

d)

Suggest taking it with food

16.

A nurse is caring for a client with arthritis who reports taking large doses of aspirin for pain relief. Which finding indicates salicylate toxicity (salicylism)?

a)

Blurred vision

b)

Tinnitus and dizziness

c)

Constipation

d)

Bradycardia

17.

A nurse is teaching a client prescribed low-dose aspirin therapy. Which statement by the client indicates a need for further teaching?

a)

I’ll take aspirin with a full glass of water.

b)

I’ll stop taking aspirin if I notice black stools.

c)

I can take ibuprofen at the same time for extra pain relief.

d)

I’ll notify my dentist that I’m on aspirin.

18.

A client with a history of peptic ulcer disease asks if they can take aspirin for headaches. What should the nurse respond?

a)

It’s safe if you take it with milk.

b)

You should avoid aspirin and use acetaminophen instead.

c)

Take enteric-coated aspirin only.

d)

Take a proton pump inhibitor with it.

19.

The nurse is assessing a child with a recent viral infection whose parent reports giving aspirin for fever. Which complication should the nurse suspect?

a)

Reye’s syndrome

b)

Stevens–Johnson syndrome

c)

Toxic epidermal necrolysis

d)

Guillain–Barré syndrome

20.

The nurse is caring for an older adult on daily aspirin and notices bruising on the arms and legs. What is the priority nursing action?

a)

Notify the healthcare provider.

b)

Administer vitamin K.

c)

Discontinue aspirin immediately.

d)

Apply ice to the bruises.