# Thirty minutes after receiving an IV opioid, a postoperative client is difficult to awaken. Respirations are 7/min and shallow, oxygen saturation is 84%, and the pupils are pinpoint. For each group, select all responses that apply.

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> url: https://mymerci.kr/pages/nclex_q.php?qn_id=603013&lang=en  
> language: en  
> subject: Medical Emergencies  
> category: PA

## Question

Thirty minutes after receiving an IV opioid, a postoperative client is difficult to awaken. Respirations are 7/min and shallow, oxygen saturation is 84%, and the pupils are pinpoint. For each group, select all responses that apply.

Findings that support an opioid-overdose response

Inability to awaken to voice

Slow, shallow respirations

Pinpoint pupils

Incisional pain rated 6 of 10 before the opioid

Immediate response actions

Support breathing and activate emergency assistance

Administer naloxone according to the emergency protocol

Leave the client alone once the eyes open after naloxone

Induce vomiting to remove the opioid

## Explanation

Unresponsiveness, slow shallow breathing, and pinpoint pupils support opioid overdose. Support ventilation, summon emergency help, and give naloxone per protocol. Continue observation because opioid toxicity can recur after naloxone.

## In-depth explanation

Quick answer
Cues: cannot awaken, slow shallow breathing, and pinpoint pupils. Actions: support breathing/emergency response and naloxone.
Why this is the best response
The cluster after an IV opioid indicates life-threatening respiratory depression, so ventilation and reversal cannot wait.
Why the alternatives do not fit
Earlier pain does not explain the current respiratory failure. Improvement after naloxone may be temporary, and induced vomiting does not reverse an injected opioid.
**Sources**
- CDC — What to Do If You Think Someone Is Overdosing

- CDC/NIOSH — Responding to a Suspected Opioid Overdose

## Key concepts

- **Naloxone** — An opioid antagonist used to reverse opioid-induced respiratory depression.
- **Recurrent toxicity** — Respiratory depression can return after initial improvement, so continued monitoring is required.

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