Deck 13: Pain

Question 1

A patient has just had surgery.What pain control strategy is best?

A)Administer prn medications when requested.
B)Give pain medications around the clock at first.
C)Start with non-opioids then progress to opioids.
D)Ask the patient his or her preference for medication.

Answer 1

Give pain medications around the clock at first.

Question 2

The nurse caring for an older cognitively impaired patient with osteoarthritis in both hands assesses the patient for hand pain by

A)observing for facial grimacing when the patient uses a fork to eat.
B)being alert for signs of agitation when washing the patient's hands.
C)listening to detect moaning when patient makes a fist.
D)watching for signs that the patient is reluctant to shake hands.

Answer 2

being alert for signs of agitation when washing the patient's hands.

Question 3

The nurse is caring for four frail patients with pain.Which patient's pain medication prescription does the nurse question?

A)The patient taking pentazocine
B)The patient taking acetaminophen
C)The patient taking ibuprofen
D)The patient taking hydromorphone

Answer 3

The patient taking pentazocine

Question 4

When planning care for the older adult patient with a history of persistent pain,the nurse acknowledges the effects of the mind-body connection by including

A)regular pain assessments.
B)prompt response to reports of pain.
C)pain consults.
D)relaxation techniques.

Question 5

An older patient is being treated for arthritic pain with a nonsteroidal antiinflammatory drug (NSAID).Which question best assesses for side effects of this medication class?

A)"Have you noticed your heart skipping beats since you began taking this drug?"
B)"Did you know you should not to stand up too quickly?"
C)"Are you aware that you should take your pain medication with food?"
D)"Have you had any episodes of shortness of breath since starting this medicine?"

Question 6

A confused patient is admitted to the hospital after suffering a fall.When asked about pain,the patient does not respond.What action by the nurse is best?

A)Ask the patient again using different words.
B)Pantomime what you are asking the patient.
C)Observe the patient's nonverbal behaviors.
D)Ask the family members if they think the patient has pain.

Question 7

An older adult patient is prescribed an analgesic to manage the joint pain resulting from stiffness in his right shoulder.When the patient asks about alternative therapy techniques that might be helpful,the nurse suggests

A)applying ice packs to the area three to four times a day.
B)placing a moderately warm heating pad to the shoulder.
C)arranging for a professional massage on a weekly basis.
D)discussing electrical nerve stimulation with the physician.

Question 8

The nurse is caring for a 78-year-old patient with a history of chronic depression.The patient currently reports persistent left shoulder pain since having a fall a year ago.To best address the patient's pain,the nurse initially determines

A)if the patient is still at risk for falls.
B)the severity of the shoulder injury.
C)how effectively depression is being managed.
D)the patient's ability to effectively cope with pain.

Question 9

The nurse caring for an older adult patient experiencing pain from a nerve injury anticipates the patient will best achieve pain control when prescribed a(n)

A)narcotic.
B)opioid.
C)tricyclic antidepressant.
D)nonpharmacologic strategy

Question 10

The nurse is performing a pain assessment when the older adult patient reports pain in his left shoulder that radiates down into the forearm.The nurse should do which of the following first?

A)Recognizes that the patient is experiencing cardiac distress.
B)Alerts the rapid response team to provide emergency care.
C)Asks whether he has ever experienced this pain before.
D)Questions the patient about additional related symptoms.

Question 11

When planning nursing care for an older adult who is experiencing chronic pain,the nurse includes which of the following interventions? (Select all that apply. )

A)Maintain mobility.
B)Promote autonomy.
C)Manage any chronically painful condition.
D)Provide economically sensitive pain relief.
E)Support the patient's right to be pain-free.

Question 12

An older patient who lives alone is brought to the clinic by an adult child who reports the patient has become "depressed" and no longer wants to go out of the home.What action by the nurse is best?

A)Assess the patient for depression.
B)Ask the patient why activities are avoided.
C)Assess the patient for pain.
D)Assess the patient for elder abuse.

Question 13

A patient has constipation as a side effect of opioid analgesics.What menu choice indicates the patient understands nutritional therapy for this problem?

A)Scrambled eggs
B)White bread
C)Canned fruit
D)Oatmeal

Question 14

When planning care for the older adult experiencing pain,the nurse bases interventions on the realization that

A)generally pain control is less effective than it is for younger adults.
B)this cohort is less pain sensitive than younger adults.
C)older adults are more likely to verbally express pain than younger adults.
D)pain is undertreated in this cohort compared to younger adults.

Question 15

An older patient is observed grimacing whenever walking and getting in and out of bed.When assessed,the patient regularly denies having any pain.To best provide the patient with effective pain control,the nurse initially

A)discusses the effects of untreated pain on the patient's general wellness.
B)offers the patient a prescribed prn analgesic.
C)asks the patient why he is denying the presence of pain.
D)documents the symptoms that the patient is exhibiting.

Question 16

An older patient is hospitalized for the first time.After giving a dose of hydromorphone what assessment takes priority?

A)Pain level
B)Nausea
C)Urinary retention
D)Respiratory rate

Question 17

An older adult who injured her knee several years ago tells the nurse that she has been managing the resulting intermittent pain with a prescription for an opioid analgesic.The nurse is concerned with this treatment plan,primarily because

A)less expensive alternative analgesics are available.
B)this long-term need for an opioid warrants investigation.
C)aspirin would likely be as effective in managing the pain.
D)the knee should not still be causing pain for the patient.

Question 18

Acetaminophen is prescribed for a 70-year-old patient with chronic pain.When the patient reports to the nurse that the maximum daily dose of medication does not control the pain,the nurse responds

A)"Breakthrough pain can be managed with the addition of another analgesic."
B)"Transcutaneous electrical nerve stimulation (TENS)is often helpful."
C)"It sounds as though you have developed a tolerance for acetaminophen."
D)"We will need to get your provider to do a comprehensive pain assessment."

Question 19

An older adult lives alone at home and is being treated for chronic pain.The home health care nurse notes the adult is disheveled and has dirty dishes piled up in the sink which is unusual for the patient.What action by the nurse is best?

A)Notify adult protective services.
B)Arrange for hospitalization.
C)Assess the patient's pain.
D)Assess the patient's cognitive status.

Question 20

A director of nursing in a long-term care facility was concerned after reading that as many as 80% of residents have untreated pain.What action by the director is best?

A)Establish protocols for routine assessment.
B)Make a "pain plan" for every resident.
C)Involve family members in treating pain.
D)Educate the staff on how to assess pain.