Question

RNsRWe, ASN, RN · Mar 14, 2014

What do YOU think? Give your rationale :)

bibine85 · Mar 14, 2014

I say A because morphine tends to decrease RR

AngelAsherah · Mar 14, 2014

it's pain scale of 1. No chest pain is acceptable for pts with cardiac diseases. It should always be 0 out of 10 on pain scale. (+) chest pain means ischemia. 12bpm is still at the lower end of normal, it needs to be evaluated but it's not the priority.

paradios2014 · Mar 14, 2014

exactly right Angel;)..Common SE of Morphine: resp depression (12 is WNL--need to be monitored)..I would go with B...what's the answer?

mamoli · Mar 14, 2014

as morphine SE are respiratoy depression i will go for A because it can the rr can go more lower.as far as pain he already got the morphine and i think aspirin tooo and they are functioning well with the px .

nurseprnRN, BSN, RN · Mar 14, 2014

as morphine SE are respiratoy depression i will go for A because it can the rr can go more lower.as far as pain he already got the morphine and i think aspirin tooo and they are functioning well with the px .

1) Never answer more question than they ask. Just because you think someone's respiratory rate MIGHT go down doesn't mean it will, and they have not told you that it did. A rate of 12 is very normal. If you don't think so, sit down with a watch with a second hand right now and breathe every five seconds for three minutes by the clock. I'll bet you'll feel lightheaded, because that's more than most people lying down (as this patient surely is) breathe unnless they have some other pathology going on, and they have not told you he does. 12 is fine.

2) They didn't ask you about aspirin. That's not part of the scenario. They asked you what needs attention after you have given MS for the pain and he still has pain. I have no idea what "px" means.

Angel has it exactly right.

:flwrhrts:

paradios2014 · Mar 14, 2014

yay:) I was thinking the same way..thanks Grntea:)

nurseprnRN, BSN, RN · Mar 14, 2014

You will often see a distractor (plausible-sounding wrong answer) about respiratory rate in questions involving morphine, because they know that people with less critical thinking ability jump at that familiar sound bite without really thinking whether there's a better answer (like, "I don't care if his pain is negligible, it should be GONE if he's here for MI. So I have to do something else about that."). Sometimes the answer might have to do with respiratory rate, but be darned sure it is before you jump on it reflexively.

Think, people, think. NCLEX is more about "why" than anything else, because nursing is more about understanding and applying your knowledge about "why" than memorization of rote facts. Facts are important, of course they are. But a Rain Man can know a bazillion facts and not be able to make a proper decision. You have to know why some facts are important to pass NCLEX, and certainly, to be a nurse.

And a big shout-out to the person who asked an actual NCLEX question that wasn't about Pearson Vue, how many times can I flunk NCLEX, or what books to study or review classes to take. There are dozens, if not hundreds, of threads here on all of those-- search them (it takes five seconds to type your topic in the Search window up above), and you can participate in them, too.

If you have questions about NCLEX questions, ways to think about answering a given scenario, or the like, this is a great place to ask it.

Hershey12 · Mar 19, 2014

Thanks for the response guys. And I now clearly understand why B.) Pain scale of 1 is the answer.. I chose the wrong answer which is A, because I was only thinking about the effect of morphine in a person's RR but reading your rationale further explains why you really have to THINK before jumping into conclusions.. Thanks! Again, answer is letter B