Deck 15: Pain Management

Question 1

The patient has hypotension, receives as much opioid analgesia as the prescription allows, and continues to have difficulty sleeping at night because of pain.Which should the nurse implement to relieve pain and improve sleep?

A) Encourage controlled breathing.
B) Provide a glass of warm milk at bedtime.
C) Give a sedative 1 hour before sleep.
D) Increase fluids and reposition the patient.

Answer 1

Encourage controlled breathing.

Question 2

The patient received treatment for a sprained ankle and is receiving home care instructions regarding cold therapy.Which instructions does the nurse include?

A) Place the gel pack on the ankle for 30 minutes every 4 hours.
B) Wrap the ankle with a lightweight cloth before applying the ice bag to it.
C) Wrap the elastic bandage firmly before applying the ice to the ankle.
D) Immerse the foot in a pan of ice water every 2-4 hours.

Answer 2

Wrap the ankle with a lightweight cloth before applying the ice bag to it.

Question 3

The nurse cares for several postoperative patients using patient-controlled analgesia (PCA) pain management with a combination of an opioid and a local anesthetic agent on the first postoperative day.Which patient will the nurse assess first?

A) A patient after a bowel resection for recurrent colon cancer
B) A patient after an internal fixation of an ankle fracture
C) A first-time hospitalized patient after amputation of a leg
D) A patient with emphysema who had a lung tumor resection

Answer 3

A first-time hospitalized patient after amputation of a leg

Question 4

The patient who receives patient-controlled analgesia (PCA) with an opioid analgesic reports that the pain level is 9 on a scale of 0-10.Which action does the nurse take first?

A) Elevates the head of the bed (HOB) to 30 degrees.
B) Increases the interval between demand doses.
C) Increases the demand and the basal doses.
D) Checks patient manipulation of the PCA button.

Question 5

The nurse massages the patient to promote relaxation.Which is a suitable intervention for the nurse to implement during the massage?

A) Use the friction technique over the spine.
B) Assess for pain, anxiety, and discomfort.
C) Instruct the patient to sit upright and forward.
D) Knead the patient's scalp with warm lotion.

Question 6

The school nurse provides first aid to the 10-year-old student with a new uncomplicated arm fracture.The nurse wants to provide nonpharmacological pain relief and minimize regional edema.Which first-aid treatment does the nurse provide for the patient?

A) A cold compress
B) A covered ice bag
C) An aquathermia pad
D) A moist heat compress

Question 7

The patient with metastatic bone pain from cancer reports nausea and vomiting after receiving periodic opioid analgesia intravenously.Which can the nurse implement to manage the patient's pain effectively without nausea and vomiting?

A) Dispense the opioid 30 minutes after providing food.
B) Combine the opioid with a sedative or an antihistamine.
C) Collaborate with the provider about antiemetic drug therapy.
D) Replace the analgesic with a nonsteroidal antiinflammatory agent.

Question 8

The nursing assistive personnel (NAP) reports that the patient is dizzy during a warm sitz bath.Before moving the patient, what action by the nurse is the priority?

A) Check the patient's pulse rate.
B) Dry off the patient completely.
C) Ask the patient if he or she is able to ambulate.
D) State that dizziness is common.

Question 9

The nurse decides that collaboration with the health care provider is needed to review and possibly adjust the dose of analgesic for an 87-year-old patient.What is the most likely rationale for this request?

A) Older adults have higher risks of injury with intramuscular (IM) injections.
B) Analgesics aren't necessary for older adults because of decreased pain sensation.
C) Impaired cognition impairs reporting of pain by older patients.
D) Liver and kidney metabolism is usually slower in older adults.

Question 10

In the postanesthesia care unit the nurse applies an ice bag to the patient's leg at the surgical site.Which therapeutic effect does the nurse expect from this treatment?

A) Decreased pain and diaphoresis
B) Decreased bleeding and vasoconstriction
C) Vasodilation and decreased blood flow
D) Increased oxygenation and increased inflammation

Question 11

The nurse prepares an oral opioid analgesic for the patient who has dementia and pain.After checking the patient's medication administration record (MAR) for the last administration time and the patient's response to pain medication, the nurse chooses the correct analgesic and compares the patient's picture and wristband to the medical record.Which is the most important intervention for the nurse to implement next?

A) Fill a glass with water.
B) Record the administration time.
C) Check the medication dose.
D) Help the patient to sit upright.

Question 12

The nurse plans care for four patients receiving heat therapy.Which patient will the nurse consult with the provider about this order?

A) Osteoarthritis
B) Nephrolithiasis
C) Chronic bronchitis
D) Peripheral neuropathy

Question 13

The adult patient who receives morphine sulfate intravenously by patient-controlled analgesia (PCA) tells the nurse that the pain level is 8 on a scale of 0-10.Which is the best intervention for the nurse?

A) Check the volume of morphine in the PCA syringe.
B) Check the frequency of patient-controlled dosing.
C) Collaborate with the provider to increase basal rate.
D) Check the PCA pump for malfunction.

Question 14

The nurse teaches the patient progressive self-relaxation techniques.Which would the nurse implement first?

A) Direct the patient to envision sailing on a sailboat.
B) Instruct the patient to increase respiratory rate and depth.
C) Establish the patient's ability to participate and cooperate.
D) Darken the patient's room significantly and close the door.

Question 15

The nurse teaches the patient in ambulatory care to apply ice packs to an injured knee.What instructions does the nurse include in patient teaching?

A) Leave the ice on for no more than 5 minutes.
B) Remove the ice pack when the ice melts completely.
C) A cold pack has the potential to cause tissue damage.
D) Apply ice for an hour and then apply a heating pad.

Question 16

The patient reports slight burning-like pain and numbness on the skin under a cold compress.Which action by the nurse is most appropriate?

A) Reassure the patient that some numbness is expected.
B) Assess the entire patient before continuing the treatment.
C) Remove the compress and assess the affected area.
D) Provide a warm blanket for the patient's treatment.

Question 17

The nurse wants to use massage to promote relaxation.In which patient diagnosis would massage be potentially contraindicated?

A) Spinal cord injury
B) Hypertension
C) Acute asthma
D) Crohn's disease

Question 18

The nurse and a student nurse receive a patient in the post anesthesia recovery unit and assesses the epidural analgesic infusion.Which assessment finding by the student is the nurse's priority?

A) The catheter tubing does not have a filter needle.
B) The distal end of the tubing is attached to the catheter.
C) The infusion contains an opioid and a local anesthetic.
D) The pump settings match the provider prescription.

Question 19

The nurse assesses the patient who is 2 days postoperative to determine the need for continuing patient-controlled analgesia (PCA).Which information does the nurse use to decide that the patient is ready for oral administration of analgesia?

A) Patient is hypoventilating.
B) Pain level ranges from 2 to 4.
C) Sedation level is consistent.
D) RR is 26 breaths/minute.

Question 20

The patient receives opioid analgesia along with naproxen after a total abdominal hysterectomy.Which patient information leads the nurse to collaborate with the provider about this prescription?

A) The patient has not had a bowel movement since surgery.
B) The patient declines a massage after analgesic administration.
C) Respiratory rate drops from 22 to 16 breaths/min.
D) The patient receives famotidine for esophageal reflux.

Question 21

The nurse assesses the patient and realizes that patient pain is interfering with postoperative therapies.Which assessment findings indicate the patient may be a candidate for nonpharmacological interventions? (Select all that apply.)

A) The patient has used guided imagery in the past successfully.
B) Nonpharmacological relaxation methods appeal to the patient.
C) The provider plans to discharge the patient to home in 2 days.
D) The patient understands written information on relaxation techniques.
E) The patient cannot receive additional analgesia for unresolved pain.