Deck 6: Pain Assessment

Question 1

A patient who had extensive surgery asks the nurse for pain medication for a pain of 9 on a scale of 0 to 10. The nurse completes an assessment of this patient's pain and agrees to give pain medication. When the nurse returns to the patient with the ordered intravenous pain medication, she notices the patient's eyes are closed and he appears to be sleeping. What is the nurse's appropriate action at this time?

A) Lock up the medication in a safe location until the patient awakens.
B) Arouse the patient to confirm he still wants the medication.
C) Give the medication as ordered and agreed to.
D) Consult a colleague about what action to take.

Answer 1

Give the medication as ordered and agreed to.

Question 2

In the labor and delivery department, the nurse notices that two women who are in labor are responding differently to their contractions. The first woman, who is having her first baby, has rated her pain as a "7," seems agitated, and has asked for pain medication. The second woman, who is having her third baby, has also rated her pain as a "7," but is calmer and says she does not need anything for pain at this time. What explains the differences in the outward responses to pain between these women?

A) Pain tolerance
B) Pain threshold
C) Nociception
D) Physiologic stress

Answer 2

Pain tolerance

Question 3

A patient with gout is complaining of severe, throbbing pain in the great toe. What type of pain is this patient experiencing?

A) Neuropathic pain
B) Somatic pain
C) Referred pain
D) Visceral pain

Answer 3

Somatic pain

Question 4

A patient reports "right shoulder pain that comes and goes" as the chief complaint. During the physical examination, the patient asks why the upper right abdomen is being examined for shoulder pain. What is the appropriate response from the nurse?

A) "A comprehensive examination is required to determine the cause of your pain."
B) "There may be associated problems that have not produced any symptoms yet that we want to identify."
C) "Yes, this can be confusing, but if you will be patient I'm sure we can find something to help you."
D) "It does seem odd, but the gallbladder doesn't have pain receptors of its own, so the pain shows up in the shoulder."

Question 5

Which patient has pain caused by abnormal processing of sensory input from the peripheral nervous system?

A) The patient who has aching pain from muscle strain
B) The patient who has burning pain along the sciatic nerve
C) The patient who has cramping pain from a tumor in the colon
D) The patient who has throbbing pain from arthritis

Question 6

A patient has had chronic back pain for several years. On assessment, the nurse notes that the patient sits quietly in a chair, reads a book, talks with a companion, and does not appear to be in pain. When questioned, the patient rates the pain as a 6 on a scale of 0 to 10. How does the nurse interpret these data?

A) Many patients cannot be believed when they complain of severe pain lasting many months.
B) Patients may not have the same objective responses to chronic pain because of compensation over time.
C) The patient probably has already taken a very effective pain medication.
D) This patient is probably not having as much pain as reported initially, and more assessment is required.

Question 7

How do nurses assess a patient's pain?

A) By assessing physiologic changes of the patient
B) By understanding the sensory experience related to the amount of tissue damage
C) By the patient's medical diagnosis or surgical procedure
D) By asking the patient to rate the pain being experienced

Question 8

The nurse is performing a symptom analysis of a patient with pain. Which questions below are appropriate for a symptom analysis? (Select all that apply.)

A) Have you had any other symptoms such as nausea, vomiting, and sweating?
B) Where is the pain located?
C) Have you had a pain like this before?
D) What does the pain feel like?
E) What do you do to make your pain better?
F) In your culture, how are you encouraged to express your pain?

Question 9

Which patient would be expected to experience acute pain?

A) A patient who had abdominal surgery 8 hours ago
B) A patient who has cancer and has been receiving treatment for 4 months
C) A patient who states that he or she has lived with severe pain for many years
D) A patient who has been treated unsuccessfully over the past year for back pain

Question 10

A patient with a partial small bowel obstruction describes the pain as "cramping, off-and-on pain that spreads over my stomach." What type of pain is this patient experiencing?

A) Referred pain
B) Phantom pain
C) Somatic pain
D) Visceral pain

Question 11

A nurse is assessing a patient who complains of awful abdominal pain and rates it as a 9 on a scale of 0 to 10. Which of the following physiologic signs may accompany acute pain? (Select all that apply.)

A) Tachycardia
B) Irritability
C) Increased blood pressure
D) Depression
E) Insomnia
F) Sweating

Question 12

The nurse notes in the patient's history that the patient has persistent, malignant pain. What is the meaning of this type of pain?

A) The pain has been present for at least 2 weeks.
B) The pain began after recent surgery and is associated with healing incisions.
C) The pain has been present for 6 or more months.
D) The pain has been present since surgery to remove cancer.

Question 13

How do nurses assess pain of neonates or of adults with dementia or decreased level of consciousness? (Select all that apply.)

A) Ask family or caregivers what indicators they think may indicate the patient's pain.
B) Review results of blood tests for signs of pain.
C) Administer the ordered analgesic to the patient.
D) Identify any physiologic signs of pain.
E) Examine the patient for possible causes of pain.

Question 14

A patient admitted to the emergency department with "excruciating chest pain, above the rating of 10," has a heart rate of 55, rapid, irregular respirations, complains of nausea, and is too weak to move to the stretcher without aid. Which component of the nervous system is the cause of this patient's response to pain?

A) Parasympathetic
B) Sympathetic
C) Central
D) Peripheral

Question 15

A patient who had an amputation of his lower leg comes to the clinic with a complaint of pain. He asks, "How I can be feeling pain in my foot-my foot is gone?" What is the appropriate response from the nurse?

A) "After your amputation, pain perception increases."
B) "Amputating your leg caused abnormal processing of sensory input by the peripheral nervous system."
C) "Stimulation of nerves from your leg sends impulses to the brain so that you feel pain even though your leg is no longer there."
D) "When sensory nerves enter the spinal cord, they stimulate nerves from unaffected organs in the same spinal cord segment as those neurons in areas where injury or disease is located."