Opioid Quiz: Can You Manage Pain Safely?

1. A patient with severe cancer pain is prescribed oxycodone. Which side effect requires the most immediate intervention?

Drowsiness and mild nausea

Respiratory depression below 12 breaths/min

Dry mouth and urinary retention

Headache and dizziness

2. Which non-opioid adjuvant is commonly used alongside opioids for neuropathic pain?

Gabapentin or pregabalin

Penicillin

Metformin

Lisinopril

3. Transdermal fentanyl patches are used for chronic pain. When should a new patch be applied?

Every 24 hours

Every 48-72 hours

Once weekly

Once monthly

4. A patient on methadone maintenance therapy needs acute pain relief. Which consideration is most important?

Methadone should be discontinued immediately

Additional opioids may be needed; methadone does not provide acute analgesia

No other opioids can be safely given

NSAIDs are contraindicated

5. Which statement about opioid addiction is accurate for NCLEX nursing practice?

Addiction only occurs in patients with substance abuse history

Addiction is a compulsive behavior despite harm, distinct from physical dependence

All patients on opioids develop addiction

Addiction can be prevented by using only short-acting opioids

6. A patient develops miosis, bradycardia, and respiratory depression after opioid administration. What drug should be administered?

Flumazenil

Naloxone

Atropine

Epinephrine

7. Codeine is often combined with acetaminophen. What is the primary role of codeine in this combination?

To increase acetaminophen absorption

To provide mild to moderate analgesia with reduced side effects

To prevent liver toxicity

To enhance fever reduction

8. Which patient population requires the most careful opioid dosing and monitoring?

Young adults with acute pain

Elderly patients and those with renal/hepatic impairment

Patients with hypertension

Female patients only

9. A patient on long-acting morphine suddenly discontinues the medication. What is the priority concern?

Immediate withdrawal symptoms

Increased pain and potential return of disease symptoms

Overdose risk

Allergic reaction

10. The combination of opioids with NSAIDs is often used because it:

Eliminates the need for opioids entirely

Provides synergistic analgesia and reduces opioid requirements

Prevents all opioid side effects

Increases opioid absorption

11. Which opioid receptor is primarily responsible for analgesia?

Mu (μ) receptor

Delta (δ) receptor

Kappa (κ) receptor

Sigma (σ) receptor

12. Equianalgesic dosing is important when converting from one opioid to another. This means:

All opioids provide identical pain relief

Doses that provide equivalent analgesia despite different potencies

The dose should always be doubled when switching

Opioids cannot be safely interchanged

13. A patient reports severe constipation after starting morphine. Which intervention is most appropriate?

Discontinue morphine immediately

Implement a bowel regimen with stool softeners and increased fluids

Reduce the morphine dose only

Switch to acetaminophen

14. Naloxone (Narcan) is administered to reverse opioid effects. How long does its duration of action typically last?

30-60 minutes

2-4 hours

8-12 hours

24 hours

15. Which assessment finding suggests opioid overdose?

Pupil dilation and hyperreflexia

Pinpoint pupils and decreased consciousness

Tachycardia and hypertension

Agitation and tremors

16. A patient on chronic opioid therapy requires increasing doses to maintain pain relief. This phenomenon is called:

Physical dependence

Tolerance

Addiction

Pseudoaddiction

17. Fentanyl is preferred over morphine in certain patients because it:

Has no risk of respiratory depression

Does not bind to opioid receptors

Has minimal hepatic metabolism and good renal clearance

Causes less constipation

18. Which factor most increases the risk of opioid-induced respiratory depression?

Concurrent use of CNS depressants

Patient age over 65 years

History of asthma

Female gender

19. A patient receiving morphine develops respiratory depression with a rate of 8 breaths/min. What is the priority nursing action?

Administer naloxone and prepare for ventilatory support

Decrease the morphine dose by half

Monitor vital signs every 2 hours

Notify the provider at the next scheduled rounds