# A postoperative client receiving intravenous morphine via patient-controlled analgesia (PCA) is found unresponsive with a respiratory rate of 6 breaths per minute and pinpoint pupils. The nurse should take immediate action.

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=620075&lang=en  
> language: en  
> subject: Medical Emergencies  
> category: PA

## Question

A postoperative client receiving intravenous morphine via patient-controlled analgesia (PCA) is found unresponsive with a respiratory rate of 6 breaths per minute and pinpoint pupils. The nurse should take immediate action.

Because ::선택::the client is exhibiting signs of opioid-induced respiratory depressionthe client is experiencing an allergic reaction to morphinethe client has developed postoperative atelectasis, the nurse should ::선택::administer naloxone as prescribed and provide ventilatory supportadminister flumazenil and prepare for intubationincrease the morphine dose to manage pain and monitor ::선택::respiratory rate, oxygen saturation, and level of consciousnessurine output and serum creatininepain score and incision site.

## Explanation

The client's unresponsiveness, bradypnea (respiratory rate 6), and pinpoint pupils are classic signs of opioid-induced respiratory depression. The nurse should administer naloxone, an opioid antagonist, as prescribed and provide ventilatory support with a bag-valve-mask if needed. Flumazenil is a benzodiazepine antagonist and is not indicated. Increasing morphine would worsen respiratory depression. After reversal, the nurse must monitor respiratory rate, oxygen saturation, and level of consciousness because naloxone's duration of action is shorter than many opioids, and re-sedation may occur.

## In-depth explanation

Quick answer
The client's unresponsiveness, bradypnea (respiratory rate 6), and pinpoint pupils are classic signs of opioid-induced respiratory depression. The nurse should administer naloxone, an opioid antagonist, as prescribed and provide ventilatory support with a bag-valve-mask if needed. Flumazenil is a benzodiazepine antagonist and is not indicated. Increasing morphine would worsen respiratory depression. After reversal, the nurse must monitor respiratory rate, oxygen saturation, and level of consciousness because naloxone's duration of action is shorter than many opioids, and re-sedation may occur.
Key cues
Use the client-specific assessment findings and timing in the scenario rather than a memorized diagnosis label.
Clinical reasoning
Connect the relevant cues to the safest nursing interpretation and action for this exact care setting.
Why the alternatives do not fit
The distractors are plausible in another context but are unsupported, mistimed, lower priority, or incomplete for the findings presented.
Priority and safety
Address immediate threats first, stay within nursing scope, and reassess the client after the selected intervention.
Takeaway
For linking opioid respiratory depression to reversal and reassessment, select responses that are both clinically supported and appropriate at this point in care.
**Sources**
- CDC Opioid Overdose Response

- FDA Drug Safety Information

## Clinical scenario

A postoperative client receiving intravenous morphine via patient-controlled analgesia (PCA) is found unresponsive with a respiratory rate of 6 breaths per minute and pinpoint pupils. The nurse should take immediate action.

## Key concepts

- **Opioid-induced respiratory depression** — A life-threatening adverse effect of opioids characterized by decreased respiratory rate, decreased level of consciousness, and pinpoint pupils.
- **Naloxone** — An opioid antagonist that rapidly reverses opioid effects, including respiratory depression, but has a shorter duration of action than many opioids.
- **Bradypnea** — Abnormally slow breathing rate, typically less than 12 breaths per minute in adults.

## Related questions

- [A nurse is caring for an alert adult client with type 1 diabetes who reports tremors, swea…](https://mymerci.kr/pages/nclex_q.php?qn_id=360524&lang=en)
- [A 58-year-old client arrives at the emergency department with crushing substernal chest pa…](https://mymerci.kr/pages/nclex_q.php?qn_id=362976&lang=en)
- [A 72-year-old client is brought to the emergency department by family who report that the …](https://mymerci.kr/pages/nclex_q.php?qn_id=363003&lang=en)
- [A 79-year-old client is admitted from a long-term care facility with diarrhea, decreased o…](https://mymerci.kr/pages/nclex_q.php?qn_id=363089&lang=en)
- [A 68-year-old client is admitted to the emergency department with suspected sepsis from a …](https://mymerci.kr/pages/nclex_q.php?qn_id=363987&lang=en)
- [A nurse is caring for an adult client in the emergency department who is suspected to have…](https://mymerci.kr/pages/nclex_q.php?qn_id=363993&lang=en)
- [A nurse is teaching a 72-year-old client with chronic heart failure (reduced ejection frac…](https://mymerci.kr/pages/nclex_q.php?qn_id=366202&lang=en)
- [A nurse is caring for an adult client admitted with diabetic ketoacidosis. Laboratory resu…](https://mymerci.kr/pages/nclex_q.php?qn_id=366294&lang=en)

## Read in another language

- [en](https://mymerci.kr/pages/nclex_q.php?qn_id=620075&lang=en)
- [ko](https://mymerci.kr/pages/nclex_q.php?qn_id=620075&lang=ko)
- [ja](https://mymerci.kr/pages/nclex_q.php?qn_id=620075&lang=ja)
- [zh-TW](https://mymerci.kr/pages/nclex_q.php?qn_id=620075&lang=zh-tw)
- [vi](https://mymerci.kr/pages/nclex_q.php?qn_id=620075&lang=vi)

---

More free questions: [NCLEX-RN Practice](https://mymerci.kr/pages/nclex_bank.php?lang=en)

_For study reference only. Always follow current clinical guidelines and your institution’s protocols._