Deck 32: Pain

Question 1

The nurse is teaching a client who sustained an ankle injury about cold application.Which instruction should the nurse include in the teaching plan?

A) Place the cold pack directly on the skin over the ankle.
B) Apply the cold pack to the ankle for 30 minutes at a time.
C) Check the skin frequently for extreme redness.
D) Keep the cold pack in place for at least 24 hours.

Answer 1

Check the skin frequently for extreme redness.

Question 2

A patient suddenly develops right lower-quadrant pain,nausea,vomiting,and rebound tenderness.How should the nurse classify this patient's pain?

A) Acute
B) Chronic
C) Intractable
D) Neuropathic

Answer 2

Acute

Question 3

A patient who underwent a left above-the-knee amputation complains of pain in his left foot.The nurse should document this finding as what type of pain?

A) Psychogenic
B) Phantom
C) Referred
D) Radiating

Answer 3

Phantom

Question 4

A patient is prescribed morphine sulfate 4 mg intravenously for postoperative pain.Which action should the nurse take before administering the medication?

A) Monitor the patient's respiratory status.
B) Auscultate the patient's heart sounds.
C) Check blood pressure in supine and sitting positions.
D) Monitor the patient for psychological drug dependence.

Question 5

The nurse uses his hands to direct energy fields surrounding the patient's body.After this intervention,the patient states that his pain has lessened.How should the nurse document the intervention?

A) Tactile distraction was performed and appeared effective in reducing pain.
B) Guided imagery was effective to relax the patient and reduce the pain.
C) Therapeutic touch was performed; patient verbalized lessening of pain after treatment.
D) Sequential muscle relaxation was performed; patient states pain is less.

Question 6

A patient develops a respiratory rate of 6 breaths/minute after receiving IV hydromorphone (Dilaudid)2 mg.Which medication should the nurse anticipate administering to this patient after notifying the prescriber of this side effect?

A) Physostigmine (Antilirium)
B) Flumazenil (Romazicon)
C) Naloxone (Narcan)
D) Protamine sulfate

Question 7

A patient reports using music therapy to help control chronic pain.Music therapy works by prompting the release of endogenous opioids during which stage of the pain process?

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

Question 8

After receiving ibuprofen (Motrin)800 mg orally for right hip pain,the patient states that his pain is 8 out of 10 on the numerical pain scale.Which action should the nurse take?

A) Use nonpharmacological therapy while waiting 3 more hours before the next dose.
B) Administer an additional 800-mg oral dose of ibuprofen right away.
C) Do nothing because the patient's facial expression indicates he is comfortable.
D) Notify the prescriber that the current pain management plan is ineffective.

Question 9

Which side effects associated with opioid use may improve after taking a few doses of the drug?

A) Constipation
B) Drowsiness
C) Dry mouth
D) Difficulty with urination

Question 10

A patient prescribed a nonsteroidal anti-inflammatory drug (NSAID),naproxen (Aleve,Naprosyn),for treatment of arthritis complains of stomach upset.What should the nurse instruct the patient to do?

A) Notify the prescriber immediately.
B) Take the medication with food.
C) Take the medication with 8 ounces of water.
D) Take the medication before bedtime.

Question 11

A client reports taking acetaminophen (Tylenol)to control osteoarthritis.Which instruction should the nurse give the patient requiring long-term acetaminophen use?

A) Caution the patient against combining acetaminophen with alcohol.
B) Explain that acetaminophen increases the risk for bleeding.
C) Advise taking acetaminophen with meals to prevent gastric irritation.
D) Explain that physical dependence may occur with long-term oral use.

Question 12

How should the nurse classify pain that a patient with lung cancer is experiencing?

A) Radiating
B) Deep somatic
C) Visceral
D) Referred

Question 13

In which process do peripheral nerves carry the pain message to the dorsal horn of the spinal cord?

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

Question 14

The nurse administers acetaminophen 325 mg and codeine 30 mg orally to a patient complaining of a severe headache.When should the nurse reassess the patient's pain?

A) 15 minutes after administration
B) 60 minutes after administration
C) 90 minutes after administration
D) Immediately before the next dose is due

Question 15

A patient who sustained rib fractures in a motor vehicle accident is complaining that his pain medication is ineffective.Inadequate pain control places this patient at risk for which complication?

A) Metabolic alkalosis
B) Pneumothorax
C) Pneumonia
D) Hemothorax

Question 16

When should the nurse assess pain?

A) Whenever a full set of vital signs is taken
B) During the admission interview
C) Every 4 hours for the first 2 days after surgery
D) Only when the patient complains of pain

Question 17

The nurse is assessing an intubated patient who returned from coronary artery bypass surgery 3 hours ago.Which assessment finding might indicate that this patient is experiencing pain?

A) Blood pressure 160/82 mm Hg
B) Temperature 100.6°F
C) Heart rate 80 beats/min
D) Oxygen saturation 95%

Question 18

The nurse plays music for a child with leukemia who is experiencing pain.Which pain management technique is this nurse using?

A) Distraction
B) Guided imagery
C) Sequential muscle relaxation
D) Hypnosis

Question 19

Which nursing diagnosis is most appropriate for the patient who returns from the postanesthesia care unit after undergoing right hemicolectomy surgery for colon cancer?

A) Acute pain secondary to surgery
B) Acute pain (abdominal)secondary to surgery for colon cancer
C) Chronic pain secondary to cancer diagnosis
D) Chronic pain (abdominal)secondary to abdominal surgery

Question 20

Which drug might the primary care provider prescribe to help facilitate pain management in a client with chronic pain?

A) Selective serotonin reuptake inhibitor
B) Selective norepinephrine reuptake inhibitor
C) Narcotic analgesic
D) Anti-emetic

Question 21

Which pain management task can be safely delegated to nursing assistive personnel (NAP)?

A) Assessing the quality and intensity of the patient's pain
B) Evaluating the effectiveness of pain medication
C) Providing a therapeutic back massage
D) Administering an oral dose of acetaminophen

Question 22

A patient had a bowel resection 5 days ago.Which request by the patient might alert the nurse that the patient has a history of substance abuse?

A) Oral pain medication once every 6 to 8 hours
B) Patient-controlled analgesic
C) Oral pain medications instead of the IM form
D) Only nonpharmacological pain measures

Question 23

Despite being provided with interventions,a client continues to experience extreme pain.What should the nurse do to enhance this client's comfort?

A) Determine whether the plan was implemented correctly.
B) Increase the use of nonpharmacological interventions.
C) Ask the healthcare provider to change pain medication.
D) Determine whether the client is being truthful when evaluating pain level.

Question 24

The nurse prepares a client for patient-controlled analgesia (PCA).What should the nurse assess in this client prior to the infusion beginning? Select all that apply.

A) Disease process
B) Respiratory status
C) Laboratory values
D) Family involvement
E) Level of consciousness

Question 25

A patient with Raynaud's disease receives no symptomatic relief with diltiazem (Cardizem).Which surgical intervention might be a treatment option for this patient to help provide symptomatic relief?

A) Cordotomy
B) Rhizotomy
C) Neurectomy
D) Sympathectomy

Question 26

A patient diagnosed with lung cancer who is receiving morphine (MS Contin)complains of constipation.Which instruction by the nurse might help relieve the patient's constipation? Select all that apply.

A) "Be sure the amount of fruit,vegetables,and fiber in your diet is adequate."
B) "Drink at least eight 8-ounce glasses of water each day."
C) "Avoid using stool softeners because they may become habit forming."
D) "Increase your exercise routine to include 1 hour of exercise a day."
E) "Take a laxative every day."

Question 27

A 73-year-old patient admitted after a stroke has expressive aphasia.Which pain intensity scale would be appropriate to use with this patient? Select all that apply.

A) Visual analog
B) Numerical rating
C) Wong-Baker FACES rating
D) Simple descriptor
E) Revised Faces Pain Scale

Question 28

A patient with a history of mitral valve replacement,hypertension,and type 2 diabetes mellitus undergoes emergency surgery to remove an embolus in the right leg.Which factor contraindicates the use of epidural analgesia in this patient?

A) Anticoagulant therapy
B) Diabetes mellitus
C) Hypertension
D) Embolectomy

Question 29

Nursing assistive personnel (NAP)ask why so many clients seem to be complaining of pain.What should the nurse emphasize to the NAP about pain? Select all that apply.

A) Pain is subjective.
B) Pain is measured objectively.
C) Pain is whatever the client says it is.
D) Pain exists when the client says it does.
E) Your expectations of clients' pain are influenced by individual values.

Question 30

Which action should the nurse take first when the patient has a score of -4 on the sedation rating scale?

A) Stimulate the patient.
B) Prepare to administer naloxone (Narcan).
C) Administer a dose of pain medication.
D) Notify the physician immediately.

Question 31

What is typically the most reliable indicator of pain?

A) Patient's self-report
B) Past medical history
C) Description by caregiver(s)
D) Behavioral cues

Question 32

After undergoing dural puncture while receiving epidural pain medication,a patient complains of a headache.Which action can help alleviate the patient's pain?

A) Encourage the client to ambulate to promote flow of spinal fluid.
B) Offer caffeinated beverages to constrict blood vessels in his head.
C) Encourage deep breathing and coughing to increase CSF pressure.
D) Restrict oral fluid intake to prevent excess spinal pressure.

Question 33

An older adult receiving hospice care has dementia as a result of metastasis to the brain and bone cancer has progressed to an advanced stage.Why might the client fail to request pain medication as needed?

A) Experiences less pain than in earlier stages of cancer
B) Cannot communicate the character of his pain effectively
C) Recalls pain at a later time than when it occurs
D) Relies on caregiver to provide pain relief without asking

Question 34

Which expected outcome is best for the patient with a nursing diagnosis of Acute Pain related to movement and secondary to surgical resection of a ruptured spleen and possible inadequate analgesia?

A) The patient will verbalize a reduction in pain after receiving pain medication and repositioning.
B) The patient will rest quietly when undisturbed.
C) On a scale of 0 to 10,the patient will rate pain as a 3 while in bed or as a 4 during ambulation.
D) The patient will receive pain medication every 2 hours as prescribed.

Question 35

The nurse notes that clients have different thresholds and levels of pain that are not consistent with the health problem or condition.What should the nurse remember about influencers of pain? Select all that apply.

A) Age
B) Culture
C) Emotions
D) Previous experiences
E) Socioeconomic status