Deck 32: Pain Management

Question 1

A patient in sickle cell crisis states that the pain is lessened when watching television.The patient's physiological response is best attributed to which of the following?

A) The perception of pain
B) Nociceptor stimulation
C) A negative protective reflex response
D) The application of the gate control theory

Answer 1

The application of the gate control theory

Question 2

A registered nurse,who has practiced for more than 20 years and has had a lot of experience caring for postsurgical patients,was questioned by a student nurse about why many nurses do not give the full amount of pain medication ordered by surgeons.The nurse replied that the literature shows that many nurses do not give the full amount of pain medication because they:

A) do not believe that the patient is experiencing that much pain.
B) do not want to contribute to pain medication addiction.
C) believe that limiting the amount of pain medication lowers costs.
D) are concerned about drug interactions with pain medication and other postsurgical medications.

Answer 2

do not want to contribute to pain medication addiction.

Question 3

When a person touches a hot stove,the resulting cellular damage causes a reaction that converts the stimuli into a pain impulse.What is the term for this conversion?

A) Transduction
B) Transmission
C) Perception
D) Modulation

Answer 3

Transduction

Question 4

An older adult nurse has been seeing a rheumatologist for the management of Rheumatoid Arthritis (RA).The patient also uses herbal remedies and seeks acupuncture for pain relief and reads the latest research regarding RA.This coping style is best described as a(n)______ loci of control.

A) external
B) interior
C) internal
D) exterior

Question 5

When a person cuts a finger,nerve impulses travel to the spinal cord along afferent peripheral nerve fibers.What is this process?

A) Transduction
B) Transmission
C) Perception
D) Modulation

Question 6

The patient who has undergone triple cardiac bypass surgery 1 week ago is being seen for a follow up appointment at their health care facility.The incisions are healing well,but the patient is complaining of pain at the incision sites on his legs.The nurse knows that this is _____ pain.

A) acute
B) chronic/persistent noncancer
C) chronic episodic
D) idiopathic

Question 7

A student nurse is assessing the pain of a teenage patient with cancer.The student nurse ask the patient about precipitating factors,quality,relieving factors,where the pain is,the severity of pain,and the effect of the pain has on the patient.What is the other indicator that the student nurse should make part of this pain assessment?

A) Medications the patient is taking for pain
B) Timing of the pain
C) Side effects of the patient's chemotherapy
D) The patient's ability to take oral pain medication

Question 8

A smiling and cooperative patient complains of severe pain.Nurses caring for patients who report pain need to recognize and avoid common misconceptions and myths about pain.To properly care for patients in pain,nurses need to remember which of the following?

A) Chronic pain is psychological in nature.
B) Patients are the best authority of their pain experience.
C) Regular use of narcotic analgesics leads to drug addiction.
D) The amount of tissue damage is reflected in the severity of the pain perceived.

Question 9

A patient is admitted to the trauma unit with the diagnosis of spinal cord injury resulting from an ATV accident.The health care provider has diagnosed the patient as a paraplegic.Which of the following is one of the most important topics for patient teaching to prevent further injury to the patient?

A) Reminding him that he can be injured and not feel pain below his waist
B) Suggesting that his parents purchase a motorized wheelchair to prevent arm muscle strain
C) Reminding the patient to decrease fluid intake due to lack of mobility
D) Reminding the patient to drink plenty of fluids to maintain hydration

Question 10

A terminally ill patient with cancer is experiencing increased pain.Nursing implications used to care for this patient include which of the following?

A) Giving medications as needed
B) Using the World Health Organization three-step approach
C) Using a holistic approach to pain management
D) Holding regular doses to prevent life-threatening side effects

Question 11

A graduate nurse is working for a diabetes unit.The nurse manager has prepared a very thorough orientation,which includes check-offs for taking vital signs.The nurse manager has informed the graduate nurse that their hospital has adopted the Joint Commission's pain standard and that they will be assessing five vital signs.The graduate nurse knows that the fifth vital sign is which of the following?

A) Arterial blood gasses
B) Blood sugar
C) Blood pressure
D) Pain

Question 12

Aspirin and ibuprofen are classified as:

A) narcotics.
B) nonopioids.
C) opioids.
D) nonsteroidal antiinflammatory analgesics.

Question 13

A patient has a morphine sulfate patient controlled analgesia (PCA)to control postoperative pain.When the nurse enters the room,the patient complains of pain.The nurse's first response is which of the following?

A) Stop the infusion.
B) Call the physician or health care provider immediately.
C) Ask the patient to describe the pain.
D) Speak to the patient in a calming tone to reduce anxiety.

Question 14

A student nurse is caring for an elderly patient with rheumatoid arthritis.The patient states that he or she experiences constant pain,is having difficulty sleeping,and has lost weight over the past 2 months.The patient is very tearful and states,"I'm not sure how long I can keep going with this pain." What is the most important question for the student nurse to ask the patient?

A) "Have you started a new diet?"
B) "Have you ever thought of suicide?"
C) "What are you taking for your pain?"
D) "Do you take naps during the day?"

Question 15

Pain impulses are sent to the brain,where the central nervous extracts information regarding location,duration and quality of the pain impulse.What is this process?

A) Transduction
B) Transmission
C) Perception
D) Modulation

Question 16

An adult patient has just undergone surgery for repair of a torn left knee anterior cruciate ligament (ACL).When informing the patient of several pain relief interventions,the nurse most appropriately urges the patient to select which of the following?

A) NSAIDs
B) Nonopioids
C) Adjuvant therapy
D) Patient-controlled analgesia pain management

Question 17

A patient with developmental disabilities and poor verbal communication skills has been admitted for observation after a motor vehicle accident.The patient has been moaning,facial grimacing,and restless since being admitted to the floor.The nurse needs to first assess the patient for which of the following?

A) Safety, because the patient will not use the call light
B) Hydration, because the patient is not able to verbally communicate his or her needs
C) Bathroom privileges, because of lack of communication skills
D) Pain, because the patient is unable to communicate effectively

Question 18

According to established standards,nurses must frequently assess patients experiencing pain.The most appropriate action for the nurse to take when assessing a patient's pain is which of the following?

A) Ask what precipitates pain.
B) Question the patient about the location of the pain.
C) Offer the patient a pain scale to objectify the patient's response.
D) Use closed-ended questions to find out about the patient's sensations.

Question 19

When a person accidentally touches a hot pan,their protective reflex causes them to immediately withdraw their hand from the hot pan.This protective reflex is known as which of the following?

A) Transduction
B) Transmission
C) Perception
D) Modulation

Question 20

A registered nurse working for the emergency department sees a lot of patients who seek services because of pain.The nurse is aware that pain is which of the following?

A) Caused by a single physiological sensation
B) Caused by a specific stimulus
C) Subjective
D) Universally the same for everyone

Question 21

A patient is started on morphine via patient-controlled analgesia (PCA)to control persistent cancer pain.The nurse knows that to prevent central nervous system (CNS)depression the patient should do which of the following?

A) Monitor IV site for patency.
B) Monitor the patient closely for the 15 minutes.
C) Record baseline blood pressure and respiratory rates before the start of the medication.
D) Give a small dose of naloxone prior to starting the morphine.

Question 22

The student nurse is working on the surgical floor.The student nurse is assigned to take care of a patient with hemiplegia and communication deficits from a previous stroke.The patient is 1-day postoperative from abdominal surgery.Which of the following interventions would promote comfort and help the patient remain pain free? (Select all that apply.)

A) Keep the bed sheet wrinkle free.
B) Only change wet dressings or bed linens once a shift.
C) Remove noxious stimuli from the room.
D) Continue to use the establish pain scale for this patient.
E) Give pain medication after ambulation down the hall.

Question 23

The patient is being seen for chronic back pain.The patient states,"I'm always in pain,and I don't like taking the pain medication because it makes me sleepy.I have to work to support my family." The nurse is aware that this patient may be a candidate for cutaneous stimulation.Cutaneous stimulation includes which of the following? (Select all that apply.)

A) TENS unit
B) NSAIDs
C) Massage
D) Yoga
E) Ice bags

Question 24

The hospice nurse is assessing the patient at home for the first time.The patient has a lot of questions regarding what the role hospice will have as the illness progresses.The patient states,"I don't want to be in pain and kept alive,but I'm not ready to die either." What is the best response that will educate the patient of the role hospice will play in his or her care?

A) Hospice will make sure you are pain free, how long you live is up to you and the doctor.
B) Hospice focuses on the quality of life, including pain management, rather than how long you will live.
C) Hospice will give you enough pain medication to keep you pain free. This is a higher priority than quality of life.
D) Hospice allows you time to get your affairs in order.

Question 25

A patient presents to the emergency department with a large leg laceration received in a bicycle accident.The nurse knows that the physician or health care provider chose a local anesthetic because of which of the following? (Select all that apply.)

A) The patient appears very apprehensive.
B) It has very few side effects.
C) The potential for hemorrhage precludes the use of IV anesthesia.
D) It produces temporary loss of sensation by inhibiting nerve conduction.
E) It allows sedative effects to calm the patient.