Perioperative care: opioid-induced respiratory depression: practice question

A General Surgery question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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General Surgery · Perioperative care: opioid-induced respiratory depression

Sample item

An hour after a morphine bolus on a patient-controlled analgesia pump, a patient is drowsy with a respiratory rate of 6 and pinpoint pupils. After supporting the airway, what is the next step?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

A. Titrated intravenous naloxone

Reduced respiratory rate with pinpoint pupils and sedation indicates opioid toxicity. Naloxone is given in small titrated doses to restore respiration, without reversing analgesia fully, and may need repeating because it is shorter acting than morphine.

Option by option

  • A. Titrated intravenous naloxone (correct)

    Correct. Naloxone is the specific opioid antagonist and is titrated against respiratory rate.

  • B. Intravenous atropine

    Atropine treats bradycardia or anticholinesterase poisoning and does not reverse opioid effects.

  • C. Intravenous physostigmine

    Physostigmine is used for anticholinergic toxicity and would not reverse opioid depression.

  • D. Intravenous flumazenil

    Flumazenil antagonises benzodiazepines and has no effect on opioid toxicity.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this General Surgery question

What is the answer to this General Surgery question?

The best answer is A, Titrated intravenous naloxone. Reduced respiratory rate with pinpoint pupils and sedation indicates opioid toxicity.

Why is "Intravenous atropine" not the answer?

Atropine treats bradycardia or anticholinesterase poisoning and does not reverse opioid effects.

Why is "Intravenous physostigmine" not the answer?

Physostigmine is used for anticholinergic toxicity and would not reverse opioid depression.

Why is "Intravenous flumazenil" not the answer?

Flumazenil antagonises benzodiazepines and has no effect on opioid toxicity.

What concept does this question test?

It tests Perioperative care: opioid-induced respiratory depression in General Surgery. Naloxone is given in small titrated doses to restore respiration, without reversing analgesia fully, and may need repeating because it is shorter acting than morphine.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Perioperative care: opioid-induced respiratory depression?

Learn classic signs and eponyms alongside what they diagnose. Then use the flashcards and the other General Surgery questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.