Deck 9: Pain Management

Question 1

The nurse is using a nonpharmacologic method to manage a client's pain,and applies a unit that applies low-voltage electrical stimulation directly over the pain area.When documenting this intervention,which term is the most appropriate for the nurse to use?

A)TENS unit
B)Nerve block
C)Functional restoration
D)Cutaneous stimulation

Answer 1

TENS unit

Question 2

The pain management team individualizes the analgesic regimen by guiding the adjustment of medication,dose,time intervals,and route of administration.When discussing this method of treating pain,which term is the most appropriate for the nurse to use?

A)Polypharmacy
B)Equianalgesia
C)Analgesia
D)Dose-reduction pharmacology

Answer 2

Equianalgesia

Question 3

The nurse would administer acetaminophen instead of ibuprofen if which effect was not desired?

A)Anti-inflammatory effects
B)Analgesic effects
C)Antipyretic effects
D)Antipyretic and anti-inflammatory effects

Answer 3

Anti-inflammatory effects

Question 4

The client has pain in the lower back that radiates down the leg as the result of a herniated disk compressing the sciatic nerve that began 4 months ago.When documenting this client's pain,which term will the nurse use?

A)Acute somatic pain
B)Acute visceral pain
C)Chronic neuropathic pain
D)Acute neuropathic pain

Question 5

The nurse is working on the orthopedic unit,and is caring for a client who complains of back pain.Which responses by the nurse would be appropriate when caring for this client?

A)"I'm sorry you're hurting.I want to make you feel better."
B)"People with back pain experience very different symptoms.Tell me more about your back."
C)"You had medication for your pain at 4 p.m. ,so I can't give you any more until 8 p.m. ,because the health care provider ordered it every 4 hours."
D)"Does anything other than your back hurt?"
E)"Why don't you try another position to make it feel better until it's time for more pain medication?"

Question 6

When caring for an older adult client who does not speak English,which assessment tool is the most appropriate for the nurse to use to assess this client's pain?

A)The FACES rating scale
B)An interpreter
C)The client's affect
D)The client's vital signs

Question 7

The hospice nurse is making a home visit to a client with terminal cancer.The client reports poor pain control,and the client's spouse says,"I'm giving such big doses of medication,I'm afraid she is going to overdose if I give her more." Which response by the nurse is the most appropriate?

A)"You're wise to be concerned.These are very strong medications you're administering."
B)"You want her to be comfortable but you don't want to endanger her life.Let's talk about the medication you're giving and warning signs you'll see if the dosage you're administering is too high."
C)"I hear what you're saying,but you're not giving enough pain medication,so she is in severe pain.You need to give more."
D)"You aren't giving adequate pain relief,and she is in severe pain as a result."

Question 8

The nurse is caring for a preschool-aged client who is in pain secondary to a compound fracture resulting from a motor vehicle crash.The nurse recognizes which items as true when providing care to this client?

A)It is best for the nurse to reason with the child in managing the pain.
B)The child will often respond with crying and anger because he perceives pain as a threat to security.
C)Try to avoid touching or holding the child to reduce the level of pain.
D)Appeal to the child's belief in magic by using a magic blanket to take away pain.
E)The child might consider pain a punishment for previous misbehaviors.

Question 9

The nurse administers a nonsteroidal anti-inflammatory drug (NSAID)to a client who is experiencing chronic pain.When teaching the client about this medication,which effects will the nurse include in the session?

A)Anti-inflammatory effects
B)Analgesic effects
C)Antipyretic effects
D)Sedating effects
E)Anesthetic effects

Question 10

The nurse enters the postoperative client's room and finds the client perspiring with fists clenched.As the nurse administers routine medications and provides care,the client is pleasant and cooperative.Which action by the nurse is the most appropriate?

A)Documenting "no complaints of pain offered" and assessing that the client is comfortable
B)Asking the client if pain is being experienced
C)Informing the client that he looks uncomfortable and asking him to describe his pain
D)Instructing the client to use the call bell if he experiences pain

Question 11

The nurse is caring for a client who had extensive surgery,and is now 6 days postoperative and getting out of bed for the first time later this morning.When the nurse assesses the client for pain,the client responds,"It hurts,but I don't want to take any more drugs.I don't want to end up addicted." Which response by the nurse is the most appropriate?

A)"If you don't take the pain medication on a regular schedule,you won't get addicted."
B)"People who have real pain are unlikely to become addicted to analgesics provided to treat the pain."
C)"You are wise to be concerned,and after 6 days it is probably time to stop taking narcotics if you can manage the pain in other ways."
D)"Don't worry about getting addicted.I will make sure you don't get addicted."

Question 12

According to the World Health Organization Three-Step Approach,if the nurse is caring for a client complaining of mild pain that persists after using full doses of step 1 medications,which medications can the nurse administer?

A)Codeine
B)Fentanyl
C)Oxycodone with acetaminophen
D)Hydrocodone with ibuprofen
E)Morphine

Question 13

The nurse is working on a surgical unit,and overhears another nurse say,"That client is asking for pain medication again.He is constantly on the call bell,always reporting how severe his pain is,and I think he's just drug-seeking.I'm going to make him wait the full 4 hours before I give this medication again." Which action by the nurse is the most appropriate in this situation?

A)Ignoring the situation because the client in question is not this nurse's responsibility
B)Entering the nurses' station,reprimanding the nurse,and completing an incident or variance report
C)Pulling the second nurse aside and providing a reminder that the sensation of pain is subjective,and that professionals have a duty to believe clients' reports of their symptoms
D)Informing the charge nurse of what was overheard

Question 14

The nurse working in a surgical center is caring for a client who had an abdominal nevus removed.The client is complaining of intense pain.Which action by the nurse is the most appropriate?

A)Administer a nonnarcotic analgesic because the client had minor surgery.
B)Attempt to divert the client without administering an analgesic because the surgery was so minor.
C)Administer the stronger analgesic ordered by the primary care provider.
D)Notify the health care provider that the client's pain is excessive for the minor surgery performed.

Question 15

The nurse is obtaining a pain history.The client reports pain in the right ear.Which response by the nurse is the most appropriate?

A)"Is the pain minor?"
B)"Do you have anything else that hurts?"
C)"Tell me more about the pain and what you do for it when it hurts."
D)"I'll note that in the record.Is there anything else I should know?"

Question 16

The client with a sprained ankle is complaining of pain in the injured area.Which term will the nurse use when documenting this client's pain?

A)Visceral pain
B)Somatic pain
C)Physiological pain
D)Neuropathic pain

Question 17

When conducting a pain history,which data is not essential for the nurse to obtain regarding the client's pain?

A)Intensity,quality,and patterns
B)Precipitating factors,alleviating factors,and associated symptoms
C)Effects on activities of daily living,coping resources,and affective responses
D)Significant other's assessment of the pain

Question 18

When documenting the maximum amount of pain a client can tolerate,which term is the most appropriate for the nurse to use?

A)Pain threshold
B)Hyperalgesia
C)Pain tolerance
D)Allodynia

Question 19

The nurse working on the labor and delivery unit has noticed how differently each client responds to the pain associated with labor.Which reasons does the nurse attribute to these various responses to pain?

A)Ethnic and cultural values
B)Developmental stage
C)Past experience with pain
D)Physiological functioning of the brain
E)Meaning of pain

Question 20

The nurse is caring for a client who is experiencing acute pain.Which action by the client,noted by the nurse during the assessment,is considered an associated symptom of pain?

A)Changing position
B)Crying
C)Grimacing
D)Vomiting

Question 21

A client who recently had surgery is medicated prior to return to the nursing unit.Which assessment finding warrants the need for a more in-depth assessment when determining the client's score on the sedation scale?

A)The client is sleeping but is easy to arouse.
B)The client is somnolent,with minimal or no response to physical stimulation.
C)The client is slightly drowsy,but arouses easily with minimal physical stimulation.
D)The client is awake and alert visiting with family at the bedside.

Question 22

The nurse documents the assessment and interventions performed to relieve the client's pain on a pain management flow sheet.Why is this documentation important?

A)Reduces time spent on documentation.
B)Clarifies and communicates each client's pain experience.
C)Accurately documents the pain management efforts performed by the nurse.
D)Enhances pain relief efforts.
E)Ensures continuity of care.

Question 23

The nurse is initiating a client-controlled anesthesia (PCA)pump delivering morphine sulfate for an older school-age client post-appendectomy.Prior to connecting the PCA tubing to the client's IV fluid line,which action by the nurse is the priority?

A)Clamping the PCA tubing
B)Delivering the loading dose
C)Setting the safety parameters for the infusion on the PCA pump
D)Clamping the client's primary IV fluid line

Question 24

The nurse is instructing the client on how to use the client-controlled analgesia (PCA)pump.Which statement made by the client indicates an appropriate understanding of the nurse's instructions regarding the use of the PCA pump?

A)"I will push the button continually until I am pain free."
B)"I will likely overdose on pain medication with the use of the button."
C)"I will let my family control my pain medicine by allowing them to push the button."
D)"I will push the button when the pain becomes severe."

Question 25

After administering an opioid analgesic,the nurse assesses the client using the sedation scale and finds the client sleeping and arousable,but the client drifts off to sleep during conversation.Which level of sedation is appropriate for the nurse to document for this client in the medical record?

A)1
B)2
C)3
D)4

Question 26

Which can the nurse safely delegate to the unlicensed assistive personnel (UAP)?

A)Initial assessment of pain
B)Regular reassessment of pain
C)Providing a massage and repositioning the client in pain
D)Administration of an oral analgesic

Question 27

Nurses must be aware of cultural considerations when assisting clients with pain tolerance.Which statement made by the nurse indicates an understanding of cultural awareness?

A)"Nurses must know that all pain is the same no matter what culture the client comes from."
B)"Nurses must not ask probing questions about the client's pain,as this is considered inappropriate."
C)"Nurses should treat all clients the same regardless of cultural differences."
D)"Nurses must understand that different cultures deal with pain in very different ways.Nurses must not judge the client based on any misconceptions of pain and treatment of pain."

Question 28

Pain is a complex phenomenon that affects both the physical and mental areas.When teaching the client about pain,which statement made by the client would indicate appropriate understanding?

A)"Cancer pain usually only lasts a short time."
B)"Acute pain is usually rapid and can vary in intensity."
C)"Chronic pain may be acute,chronic,or intermittent."
D)"Chronic pain usually only lasts a little while."

Question 29

The client reports difficulty sleeping related to anxiety.Which nonpharmacologic pain management intervention might the nurse consider performing in order to relax the client?

A)Acupuncture
B)Acupressure
C)Massage
D)Distraction

Question 30

The nurse is administering a back massage to the client.Place the steps in the proper order of performance.

A)Massage the areas over the right and left iliac crests.Response
B)Move your hands up the center of the back.Response
C)Massage the sacral area using smooth,circular strokes.Response
D)Massage both scapulae.Response
E)Move your hands down the side of the back.

Question 31

The nurse is assessing a client's chronic pain.The client indicates the pain is in the upper right quadrant of the abdomen,rates the pain as a 9 on a 1-10 scale,and describes the pain as sharp and continuous.What else would the nurse assess regarding this client's pain?

A)Onset,duration,and recurrence
B)Location
C)Intensity
D)Quality

Question 32

The postoperative client has been noting a steady decline in the amount of pain experienced over the past week.Today,upon awakening,the pain is far more severe even at rest.Which priority intervention should the nurse perform for this client?

A)Assessing the client fully and notifying the health care provider
B)Explaining to the client that it is not unusual to have a recurrence of severe pain in the rehabilitative phase of recovery
C)Administering stronger opioid analgesics and documenting in the client's medical record
D)Explaining that the extra activity the client has been performing is the cause of the increased discomfort

Question 33

The nurse administered an oral analgesic to a client complaining of a mild-to-moderate headache.Which activity would the nurse consider to help relieve the client's discomfort until the analgesic takes effect?

A)Reading or watching TV
B)Video or computer games
C)Slow rhythmic breathing
D)Crossword puzzles

Question 34

The unlicensed assistive personnel (UAP)informs the nurse that the client is complaining of severe postoperative pain and requests pain medication.Which action would be appropriate for the nurse to perform?

A)Give the client an analgesic.
B)Assess the client's pain and respond as indicated.
C)Ask the UAP for more data regarding the client's pain.
D)Tell the UAP to inform the client that the nurse will be in as soon as possible.

Question 35

The nurse is teaching progressive muscle relaxation techniques to the client.Which rationale will the nurse include in the teaching session for progressive muscle relaxation?

A)It is a form of diversion that keeps your mind off of your stress.
B)By releasing muscle tension,the negative effects of stress can be lessened.
C)By relaxing the muscles,the pain the client is experiencing will cease.
D)It is a good form of exercise that will help you get into better shape so you won't experience any more pain.

Question 36

Many clients have misconceptions regarding assessment and treatment of pain.Which statement by the client indicates the need for additional clarification?

A)"If I don't report pain,it does not necessarily mean that I don't have any pain."
B)"I can have a back rub and think of relaxing thoughts to help decrease the amount of medication I take for pain."
C)"The best judge of the existence and severity of pain is the nurse who is taking care of me."
D)"I will be asked to rate my pain on a predetermined scale."

Question 37

The nurse is applying a TENS unit to a client in pain.Prior to applying the electrodes,which action by the nurse is the most appropriate?

A)Turning the unit on
B)Washing,rinsing,and drying the designated area with soap and water
C)Increasing the amplitude to the desired setting
D)Changing the battery

Question 38

The nurse is assisting the client with the use of guided imagery.Which action by the nurse is the most appropriate when initiating guided imagery?

A)Asking the client to take slow,full diaphragmatic/abdominal breaths
B)Asking the client to use progressive muscle relaxation exercises
C)Guiding the client toward a most beautiful or peaceful place
D)Suggesting a place where the client will find peace