Deck 11: Pain Management

Question 1

The nurse is providing care to a patient who had an abdominal nevus removed who is reporting intense pain. Which action by the nurse is appropriate?
1)Administer the stronger analgesic ordered by the primary care provider.
2)Administer a nonnarcotic analgesic because the patient had minor surgery.
3)Notify the healthcare provider that the patient's pain is excessive for the minor surgery performed.
4)Attempt to divert the patient without administering an analgesic because the surgery was so minor.

Answer 1

1

Question 2

The nurse educator is developing a class on pain assessment and incorporates which information regarding the Wong-Baker FACES tool?
1)This tool is effective for patients who do not speak English.
2)This tool is effective for patients with expressive aphasia.
3)This tool is effective for patient from other cultures.
4)This tool is effective for patients with cognitive impairments.

Answer 2

2

Question 3

The nurse correlates which type of pain syndrome as being more prevalent in female patients?
1)Back pain
2)Interstitial cystitis
3)Cluster headaches
4)Visceral pain from the heart

Answer 3

2

Question 4

A nurse overhears another nurse say, "That patient is asking for pain medication again. He is constantly on the call bell, always reporting how severe his pain is, and I think he is just drug seeking. I am 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?
1)Informing the charge nurse of what was overheard
2)Completing an incident or variance report
3)Ignoring the situation because the patient is not this nurse's responsibility
4)Reminding the nurse, in private, that the sensation of pain is whatever the patient says it is

Question 5

In completing a pain assessment, the nurse chooses which scale for assessing the older adult?
1)Verbal rating scale
2)Visual Analog scale
3)Numeric pain intensity scale
4)Visual analog thermometer

Question 6

The nurse correlates compulsive behavior to take medications for their psychic effects without concerns to the negative consequences of continued use to which of the following behaviors?
1)Addiction
2)Allodynia
3)Drug seeking
4)Tolerance

Question 7

The nurse provides care for a patient who had knee replacement surgery 2 days ago. The patient reports pain of a 3 out of 10 and requests a pain medication before physical therapy. Which prescribed medication does the nurse administer to this patient?
1)30 mg morphine PO every 4 hr prn
2)800 mg ibuprofen PO every 8 hr prn
3)75 mg meperidine IV every 3 to 4 hr prn
4)2 mg hydromorphone IV every 3 to 4 hr prn

Question 8

A patient who is prescribed ibuprofen for low back pain asks if acetaminophen has the same pain management actions. What is the best response by the nurse?
1)"Both medications can be used interchangeably."
2)"Only acetaminophen can be used for temperature elevations."
3)"Only ibuprofen has anti-inflammatory effects."
4)"Both medications decrease inflammation."

Question 9

The nurse correlates which type of pain to the patient with 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?
1)Visceral pain
2)Referred pain
3)Somatic pain
4)Cutaneous pain

Question 10

The nurse is obtaining a pain history. The patient reports pain in the right ear. Which response by the nurse is the most appropriate?
1)"Is the pain minor?"
2)"Do you have anything else that hurts?"
3)"I will note that in the record. Is there anything else I should know?"
4)"Tell me more about the pain and what you do for it when it hurts."

Question 11

The nurse uses which term to document the maximum amount of pain a patient is able to tolerate?
1)Allodynia
2)Hyperalgesia
3)Pain tolerance
4)Pain threshold

Question 12

A patient who rates abdominal pain as a 10 on a 1 to 10 numeric scale is experiencing nausea, vomiting, and restlessness. The nurse correlates this clinical presentation to which type of pain?
1)Acute pain
2)Chronic pain
3)Neuropathic pain
4)Fibromyalgia pain

Question 13

Which nursing action will provide the patient with the most pain relief after abdominal surgery?
1)Offer pain relief before the patient complains of pain.
2)Assess the pain level every 4 hours around the clock.
3)Wait until the patient can describe the pain specifically.
4)Allow the patient to "sleep off" the anesthesia, and then offer pain medication.

Question 14

The nurse correlates the therapeutic effect of cold application to which physiological process?
1)Vasoconstriction
2)Increased blood flow
3)Facilitating nerve conduction
4)Decreasing threshold of nociceptive receptors

Question 15

The nurse is teaching a class on the perception of pain. What will the nurse teach as being the area of the brain where the electrochemical messages are interpreted into pain?
1)Thalamus
2)Limbic system
3)Cerebral cortex
4)Reticular system

Question 16

The nurse is providing care to a postoperative patient who is getting out of bed for the first time since surgery. When conducting the pain assessment, the patient states, "It hurts, but I do not want to take any more drugs. I do not want to end up addicted." Which response by the nurse is most appropriate?
1)"Don't worry about getting addicted. I will make sure you don't get addicted."
2)"If you don't take the pain medication on a regular schedule, you won't get addicted."
3)"Addiction typically requires taking the medication for weeks to months, and you should only need these medications for a few days."
4)"You are wise to be concerned; it is probably time to stop taking narcotics if you can manage the pain in other ways."

Question 17

Which of the following nonsteroidal anti-inflammatory medications does the nurse recognize as most effective in treating post-operative pain in patients after thoracic surgery?
1)Ibuprofen
2)Ketorolac
3)Naproxen
4)Celecoxib

Question 18

The nurse teaches an older adult patient prescribed acetaminophen with hydrocodone (Percocet) for the treatment of moderate pain ways to decrease the occurrence of constipation. Which patient statement indicates a correct understanding of the information presented?
1)"I will increase my daily intake of water."
2)"I will eat white rice several times each week."
3)"I will include cheese in my diet at every meal."
4)"I will include white bread in my meal planning."

Question 19

In the patient being treated with corticosteroids for an acute flare of arthritis, the nurse correlates which finding to a possible adverse reaction to this medication?
1)Hypoglycemia
2)Decreased appetite
3)Weight loss
4)Delirium

Question 20

The patient with a sprained ankle is complaining of pain in the injured area. Which term will the nurse use when documenting this patient's pain?
1)Somatic pain
2)Visceral pain
3)Neuropathic pain
4)Persistent pain

Question 21

According to the World Health Organization Three-Step Approach, if the nurse is caring for a patient reporting mild pain that persists after using full doses of step 1 medications, which medications can the nurse administer? Select all that apply.
1)Codeine
2)Fentanyl
3)Morphine
4)Hydrocodone with ibuprofen
5)Oxycodone with acetaminophen

Question 22

Which action by the nurse is the best when initiating guided imagery with a patient as a method to control pain?
1)Suggesting a place where the patient will find peace
2)Guiding the patient toward a most beautiful or peaceful place
3)Asking the patient to use progressive muscle relaxation exercises
4)Asking the patient to take slow, full diaphragmatic/abdominal breaths

Question 23

The nurse teaches a patient diagnosed with fibromyalgia methods to decrease pain. Which patient statement indicates the need for additional education?
1)"I will remove the heating pad if my skin becomes reddened."
2)"I will take an over-the-counter pain medication such as ibuprofen for mild discomfort."
3)"Although I know that I will have chronic pain, I am hopeful it can be managed with medications."
4)"I will have to stop walking on the treadmill every day because exercise is not good for me."

Question 24

The nurse is managing the care of a patient prescribed a transcutaneous electrical nerve stimulation (TENs) unit to manage low back pain. Which statement by the patient indicates the need for additional information?
1)"This should decrease my back pain."
2)"This device operates on batteries."
3)"I will have electrodes surgically implanted in my spine."
4)"I will feel tingling and vibrations in my back."

Question 25

In preparing an educational session for new graduate nurses, the pain clinical specialist includes which information related to the characteristics of acute pain? Select all that apply.
1)Unpredictable intensity
2)Short duration
3)More responsive to pain management than chronic pain
4)Sudden onset
5)Typically lasts longer than a few months

Question 26

The nurse administers an NSAID to a patient who is experiencing chronic pain. When teaching the patient about this medication, which effects will the nurse include in the session? Select all that apply.
1)Sedating effects
2)Analgesic effects
3)Anesthetic effects
4)Antipyretic effects
5)Anti-inflammatory effects

Question 27

The nurse is working on the orthopedic unit and is caring for a patient who reports back pain. Which responses by the nurse would be appropriate when caring for this patient? Select all that apply.
1)"Does anything other than your back hurt?"
2)"I'm sorry you're hurting. I want to make you feel better."
3)"Why don't you try another position until it's time for more pain medication?"
4)"You had medication for your pain at 4 p.m., so I can't give you any more until 8 p.m."
5)"People with back pain experience very different symptoms. Tell me more about your back pain."

Question 28

The nurse is creating a pain management plan using the three-step approach for a patient with intractable pain. Which interventions should the nurse include in this plan? Select all that apply.
1)Administer an opioid analgesic first.
2)Administer a nonopioid analgesic first.
3)Administer a mild opioid analgesic last.
4)Administer analgesics on patient request.
5)Administer a combination opioid/nonopioid second.

Question 29

The nurse monitors for which adverse side effects in patients receiving opioids for post-operative pain? Select all that apply.
1)Nausea
2)Vomiting
3)Diarrhea
4)Respiratory depression
5)Urinary incontinence

Question 30

In screening patients for the risk of chronic pain, the nurse identifies patients with which of the following disorders? Select all that apply.
1)Trauma
2)Migraine headaches
3)Low back pain
4)Post-operative cholecystectomy
5)Peripheral neuropathy

Question 31

The nurse must intervene if heat application is prescribed to treat pain in the patient with which disorder?
1)Menstrual cramps
2)Acute appendicitis
3)Herniated nucleus pulposus
4)Nausea and vomiting