Deck 28: Pain Management

Question 1

A sudden blow to the head results in pain that is transmitted by which type of fibers?

A) A-delta
B) B-gamma
C) C fibers
D) D-delta

Answer 1

A-delta

Question 2

The most important pathway for pain sensation is the:

A) corticospinal tract.
B) dorsal horn neural tract.
C) afferent tract.
D) spinothalamic tract.

Answer 2

spinothalamic tract.

Question 3

Endogenous opioids such as endorphins:

A) excite neural pathways.
B) contribute to analgesia.
C) cause muscle spasms.
D) release neurotensin.

Answer 3

contribute to analgesia.

Question 4

When assessing a client's pain, the nurse should question the client about location, intensity, quality of the pain, and

A) pain tolerance.
B) level of consciousness.
C) temporal pattern.
D) objective signs.

Question 5

Two hours after receiving a pain medication, the client states he or she still is suffering from pain. Which question is appropriate to ask the client first?

A) Do you need your pain medication now?
B) Have you ever had pain like this before?
C) Tell me where your pain is located.
D) Tell me more about your pain.

Question 6

The nurse identifies the pain described by a client whose back discomfort began after an automobile accident and has persisted for 8 months as:

A) acute.
B) recurrent.
C) chronic.
D) malignant.

Question 7

Which guideline regarding pain should be included in the nurse's education plan for a group of parents with infants and toddlers?

A) Pain can be a source of fear and threat to the toddler's security.
B) Toddlers are often reluctant to express pain.
C) Infants cannot express pain until 8 months of age.
D) Toddlers often try to be brave and not cry.

Question 8

The parents of a preschool child who is experiencing pain from ear surgery inform the nurse that the child is uncharacteristically withdrawn and seems ambivalent. What is the nurse's most appropriate action?

A) Explain that this is likely a normal, short-term response.
B) Facilitate further assessment by a pediatric psychiatrist.
C) Assess for further signs of emotional regression.
D) Assess the family for the signs of abuse.

Question 9

A client with peripheral neuropathy states, "Sometimes I get the worst pain from just a bedsheet brushing over my foot." What is the nurse's most appropriate action?

A) Document a nursing diagnosis of pain (chronic) related to neuropathy.
B) Document the client's allodynia.
C) Assess the passive range of motion of the client's foot.
D) Assess for further signs of hyperalgesia.

Question 10

When the male client on the first postoperative day after chest surgery appears stoic and does not ask for any pain medication, the nurse should:

A) document the client's lack of medication.
B) assume the client does not need medication.
C) ask the client's family if he ever uses pain medicines.
D) actively solicit information about the client's pain level.

Question 11

A nurse is assessing a client's pain. The nurse notes which database finding that is indicative of acute pain?

A) Pupil constriction
B) Decreased pulse rate
C) Increased blood pressure
D) Decreased respiratory rate

Question 12

The action of ibuprofen is to:

A) provide narcotic pain relief.
B) have an antiprostaglandin effect on the CNS.
C) close the gate of the A-delta fibers.
D) enhance the endorphins of the CNS.

Question 13

A nurse at the healthcare facility is administering a dose of opioid prescribed by the physician to a client with acute abdominal pain. However, the client tells the nurse that he or she has developed a sore throat and has difficulty swallowing. What other routes of administration can the nurse use to give the opioid narcotics to the client? Select all that apply.

A) Sublingual route
B) Rectal route
C) Intramuscular route
D) Transdermal route
E) Parenteral route

Question 14

A client with recurrent episodes of migraine headaches tells the nurse, "I am not comfortable taking medication for my pain." Which behavioral pain relief technique can the nurse use to help the client? Select all that apply.

A) Relaxation
B) Massage
C) Meditation
D) Biofeedback
E) Hypnosis

Question 15

The physician has ordered a patient-controlled analgesia (PCA) pump for a client. Which assessment finding would cause the nurse to question the order?

A) B/P 178/92 and pulse 118
B) Confused to time and place
C) Right shoulder immobilizer in place
D) Rates pain an 8 on a 1 to 10 scale

Question 16

A student nurse is preparing a presentation on pain management. What information regarding nonpharmacologic interventions should the student include?

A) Use cold packs for muscle spasms and surgical site pain.
B) Dry heat penetrates deeper than moist heat.
C) Ice packs should not be left on longer than 20 minutes.
D) Massage can stimulate circulation.
E) Distraction is useful for short pain periods.

Question 17

A nurse is caring for a client who is receiving morphine via a patient-controlled analgesia (PCA) pump. When assessing the client, the nurse notes that the client's respiratory rate is 4. What should the nurse do first?

A) Notify the physician.
B) Stop the PCA pump.
C) Administer naloxone.
D) Increase the primary IV rate.

Question 18

A nurse is evaluating the effectiveness of the preoperative education regarding pain control. Which statement by the client would indicate a need for further education?

A) "I will push my PCA button before I get up to go to the bathroom."
B) "I will have my wife push the PCA button when I'm asleep."
C) "I will bring my favorite music to listen to after my surgery."
D) "I will make sure to drink plenty of water so I don't get constipated from the pain medication."

Question 19

The nurse is administering medications to a client with neuropathic pain. The client asks, "Why am I getting an antidepressant medication since I'm not depressed." What is the best response by the nurse?

A) "All clients with pain have at least some depression."
B) "Antidepressants have been shown to have pain-relieving qualities in clients with neuropathic pain."
C) "Treating your depression, even if you don't think you have it, will help control your pain."
D) "The doctor thinks it will help with your pain."

Question 20

A nurse is assessing the pain of a client who has been diagnosed with a sprained ankle. The client describes the pain as aching and is able to identify the pain as occurring in the left ankle. The nurse identifies this as which type of pain?

A) Somatic
B) Visceral
C) Neuropathic
D) Persistent

Question 21

A client has just been started on opioid analgesia for pain control. The nurse assesses the client's level of sedation using a sedation scale and notes that the client is awake and alert. The nurse would assign which rating?

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

Question 22

A client is receiving opioid analgesia for pain control. The nurse is assessing the client for possible respiratory depression. Which method would be most reliable for the nurse to use to identify impending respiratory depression?

A) End-tidal CO₂
B) Pulse oximetry
C) Respiratory rate
D) Lung sounds

Question 23

A client presents to the facility complaining of acute pain. When assessing the client, the nurse understands that unrelieved acute pain can result in which physiologic responses? Select all that apply.

A) Decreased secretion of antidiuretic hormone
B) Gluconeogenesis
C) Protein anabolism
D) Increased secretion of cortisol
E) Decreased peripheral vascular resistance