# A 55-year-old client with chronic back pain is being discharged on oxycodone ER (OxyContin) 20 mg PO every 12 hours plus oxycodone IR 5 mg every 4 to 6 hours as needed for breakthrough pain. Which client statement indicates correct understanding of safe use?

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=375156&lang=en  
> language: en  
> subject: Medical Emergencies  
> category: PA

## Question

A 55-year-old client with chronic back pain is being discharged on oxycodone ER (OxyContin) 20 mg PO every 12 hours plus oxycodone IR 5 mg every 4 to 6 hours as needed for breakthrough pain. Which client statement indicates correct understanding of safe use?

## Option

1. I will share leftover pills with my friend who has knee pain.
2. I will crush the OxyContin to make it easier to swallow if I have trouble taking the pill.
3. I will swallow the OxyContin tablet whole, take it on schedule even when pain is mild, use the IR oxycodone only for breakthrough pain, avoid alcohol and benzodiazepines, and store it locked away from family and visitors. **✔ Correct answer**
4. I can drink one glass of wine each evening with my pills.

**Correct answer: 3**

## Explanation

Oxycodone is available as immediate-release (IR, every 4 to 6 hours) for short or breakthrough pain and as extended-release (ER, OxyContin, every 12 hours) for chronic stable pain. Critical safety teaching: (1) ER tablets must be swallowed whole — chewing, crushing, dissolving, snorting, or injecting destroys the controlled-release matrix and delivers a fatal bolus dose; (2) take the ER on schedule regardless of pain level; use the IR only for breakthrough pain because skipping ER doses causes withdrawal and over-relying on IR causes oscillating analgesia and risk; (3) never combine opioid with alcohol or benzodiazepines because of synergistic respiratory depression — boxed warning; (4) household and storage safety — keep locked, count pills, dispose of unused pills via take-back program or FDA flush list; (5) constipation prophylaxis from day 1, fall precautions, drowsiness, do not drive until tolerance is known; (6) sharing prescription opioids is illegal and unsafe (different tolerance, lethal); (7) report sedation that progresses, slow breathing, dizziness, nausea or constipation that does not respond to bowel regimen, and any unintentional exposure of a child or pet. Crushing, alcohol, or sharing are direct contraindications.

## In-depth explanation

OxyContin must be swallowed whole, never combined with alcohol or benzos, never shared, and stored locked. Substitution by IR for breakthrough only; the ER stays scheduled.

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