Opioid agonists are some of the most potent analgesics available for moderate to severe pain.
Correct Answer
True
Opioids have been used for thousands of years for their powerful pain-relieving effects, originating from the opium poppy plant.
Question 2
The term opiate strictly refers to any synthetic pain medication.
Correct Answer
False
Opiate strictly refers to agents derived from the opium poppy (heroin, morphine, codeine). Opioid is the broader term that includes both natural and synthetic agents.
Question 3
Fentanyl is a synthetic opioid that shares chemical resemblance to naturally occurring opioids like morphine.
Correct Answer
False
Fentanyl shares no chemical resemblance to naturally occurring opioids, which means it can be a safe alternative for clients with documented morphine allergy.
Question 4
Codeine must be converted to morphine in the liver via CYP2D6 to be effective.
Correct Answer
True
Genetic variation in CYP2D6 production causes unpredictable effects: slow metabolizers get inadequate relief, rapid metabolizers risk respiratory depression.
Question 5
Meperidine is routinely recommended as a first-line analgesic for chronic pain.
Correct Answer
False
Meperidine produces a toxic metabolite (normeperidine) that accumulates in clients with poor renal function, causing risk for delirium and seizures.
Question 6
The most common use for meperidine today is to treat severe shivering (rigors) that may occur after general anesthesia.
Correct Answer
True
Because of its toxic metabolite, meperidine is no longer routinely used as an analgesic but is still used to interrupt postoperative rigors.
Question 7
Methadone has a short half-life of approximately 2 hours.
Correct Answer
False
Methadone has a long half-life of up to 59 hours, which helps prevent opioid withdrawal symptoms in clients being treated for opioid use disorder.
Question 8
Opioid intoxication classically presents as a triad of reduced consciousness, slow breathing, and pinpoint pupils.
Correct Answer
True
This classic triad (miosis, respiratory depression, and altered consciousness) helps identify opioid overdose in clinical settings.
Question 9
Tolerance to opioid analgesic effects develops slowly over many years of use.
Correct Answer
False
Tolerance develops rapidly to the analgesic and euphoric properties of opioids, leading to dose escalation to achieve the same effects.
Question 10
Clients who lose opioid tolerance during abstinence are at risk for overdose if they relapse at their previous dose.
Correct Answer
True
Clients who stop using opioids may lose tolerance, and using their previous dose after a period of abstinence can cause more effects than intended, including fatal overdose.
Question 11
Opioid withdrawal is frequently life-threatening.
Correct Answer
False
Opioid withdrawal is rarely life-threatening, though it causes significant discomfort including cramping, diarrhea, nausea, sweating, and tachycardia.
Question 12
Gastrointestinal effects of opioid withdrawal include abdominal cramping, diarrhea, nausea, and vomiting.
Correct Answer
True
GI symptoms are among the most common and distressing effects of opioid withdrawal.
Question 13
Naloxone is an opioid agonist used to enhance the effects of morphine.
Correct Answer
False
Naloxone is an opioid antagonist that reverses the effects of opioid overdose, including respiratory depression.
Question 14
Concomitant use of benzodiazepines and opioids may result in profound sedation, respiratory depression, coma, and death.
Correct Answer
True
Both drug classes are CNS depressants, and their combined effects significantly increase the risk of fatal respiratory depression.
Question 15
Methadone and buprenorphine are used to help manage opioid use disorders.
Correct Answer
True
These medications reduce withdrawal symptoms and cravings, helping clients maintain abstinence from illicit opioid use.
Question 16
Hydromorphone is a semisynthetic derivative of morphine used for moderate to severe pain.
Correct Answer
True
Hydromorphone shares some chemical structure with naturally occurring opioids and is available in both IV and oral forms.
Question 17
The American Academy of Pediatrics currently recommends codeine for use in children.
Correct Answer
False
The AAP does not recommend codeine for children due to unpredictable metabolism via CYP2D6, which can lead to dangerous respiratory depression in rapid metabolizers.
Question 18
Fentanyl is available only in intravenous form.
Correct Answer
False
Fentanyl is available in IV form for acute severe pain and also in transdermal patches for long-lasting analgesia in chronic pain conditions.
Question 19
Opioid use disorders affect more than 16 million people worldwide.
Correct Answer
True
Over 2.1 million of those individuals reside in the United States, and the opioid epidemic accounts for approximately 120,000 deaths annually worldwide.
Question 20
Piloerection (goosebumps) is a symptom of opioid withdrawal.
Correct Answer
True
Piloerection occurs as part of the flu-like symptoms category of opioid withdrawal, along with rhinorrhea, shivering, and myalgias.
Question 21
Opioids produce their effects via opioid receptors including mu, delta, and kappa receptors.
Correct Answer
True
The mu receptor is primarily responsible for analgesia and euphoria, while delta and kappa receptors mediate additional analgesic and other effects.
Question 22
Clients on methadone do not need to disclose their methadone use to other prescribing providers.
Correct Answer
False
Clients should disclose methadone use because it has variable pharmacokinetics and interacts with many medications that can affect its metabolism.
Question 23
The opioid epidemic in the United States is one of the biggest health crises the country has ever faced.
Correct Answer
True
Opioid misuse and addiction have led to unprecedented overdose deaths, prompting widespread public health interventions and policy changes.
Question 24
Flumazenil is the reversal agent for opioid overdose.
Correct Answer
False
Flumazenil reverses benzodiazepine overdose. Naloxone is the reversal agent for opioid overdose.
Question 25
Dilated pupils and tachycardia are signs of opioid withdrawal, not opioid intoxication.
Correct Answer
True
Opioid intoxication causes pinpoint pupils (miosis), while withdrawal causes dilated pupils (mydriasis), tachycardia, and sympathetic nervous system activation.