Which question asked by the nurse will give the most information about the patient’s metastatic
bone cancer pain?
a. “How long have you had this
... [Show More] pain?”
b. “How would you describe your pain?”
c. “How much medication do you take for
the pain?”
d. “How many times a day do you take
medication for the pain?”
ANS: B
2. A patient who uses a fentanyl (Duragesic) patch for chronic cancer pain suddenly complains of
rapid onset pain at a level 9 (0 to 10 scale) and requests “something for pain that will work now.”
How will the nurse document the type of pain reported by this patient?
a. Somatic pain
b. Referred pain
c. Neuropathic pain
d. Breakthrough pain
ANS: D
3. The nurse teaches a student nurse about the action of ibuprofen. Which statement, if made by the
student, indicates that teaching was effective?
a. “The drug decreases pain impulses in the
spinal cord.”
b. “The drug decreases sensitivity of the
brain to painful stimuli.”
c. “The drug decreases production of painsensitizing chemicals.”
d. “The drug decreases the modulating effect
of descending nerves.”
ANS: C
4. A nurse assesses a patient with chronic cancer pain who is receiving imipramine (Tofranil) in
addition to long-acting morphine. Which statement, if made by the patient, indicates to the nurse
that the patient is receiving adequate pain control?
a. “I’m not anxious at all.”
b. “I sleep 8 hours every night.”
c. “I feel much less depressed since I’ve
been taking the Tofranil.”
d. “The pain is manageable and I can
accomplish my desired activities.
ANS: D
5. A patient with chronic back pain has learned to control the pain with the use of imagery and
hypnosis. The patient’s spouse asks the nurse how these techniques work. Which response by the
nurse is best?
a. “The strategies work by affecting the
perception of pain.”
b. “These techniques block the pain
pathways of the nerves.”
c. “Both strategies prevent transmission of
painful stimuli to the brain.”
d. “The therapies slow the release of
chemicals in the spinal cord that cause
pain.”
ANS: A
6. A patient who is receiving sustained-release morphine sulfate (MS Contin) every 12 hours for
chronic pain experiences level 9 (0 to 10 scale) breakthrough pain and anxiety. Which action by
the nurse is best?
a. Provide amitriptyline (Elavil) 10 mg
orally.
b. Administer lorazepam (Ativan) 1 mg
orally.
c. Offer ibuprofen (Motrin) 400 to 800 mg
orally.
d. Give immediate-release morphine 30 mg
orally.
ANS: D
7. A patient with chronic neck pain is seen in the pain clinic for follow-up. In order to evaluate
whether the pain management is effective, which question is best for the nurse to ask?
a. “Can you describe the quality of your
pain?”
b. “Has there been a change in the pain
location?”
c. “How would you rate your pain on a 0 to
10 scale?”
d. “Does the pain keep you from doing
things you enjoy?”
ANS: D
8. A patient with second-degree burns has been receiving hydromorphone through patientcontrolled analgesia (PCA) for a week. The patient wakes up frequently during the night
complaining of pain. What action by the nurse is most appropriate?
a. Administer a dose of morphine every 1 to
2 hours from the PCA machine while the
patient is sleeping.
b. Consult with the health care provider
about using a different treatment protocol
to control the patient’s pain.
c. Request that the health care provider order
a bolus dose of morphine to be given
when the patient awakens with pain.
d. Teach the patient to push the button every
10 minutes for an hour before going to
sleep, even if the pain is minimal.
ANS: B
9. The nurse assesses that a patient receiving epidural morphine has not voided for over 10 hours.
What action should the nurse take initially?
a. Monitor for withdrawal symptoms.
b. Place an indwelling urinary catheter.
c. Ask if the patient feels the need to void.
d. Document this allergic reaction in the
patient’s chart.
ANS: C
10. When visiting a hospice patient, the nurse assesses that the patient has a respiratory rate of 11
breaths/minute and complains of severe pain. Which action is best for the nurse to take?
a. Inform the patient that increasing the
morphine will cause the respiratory drive
to fail.
b. Tell the patient that additional morphine
can be administered when the respirations
are 12.
c. Titrate the prescribed morphine dose
upward until the patient indicates
adequate pain relief.
d. Administer a nonopioid analgesic, such as
a nonsteroidal antiinflammatory drug
(NSAID), to improve patient pain control.
ANS: C
11. The nurse is completing the medication reconciliation form for a patient admitted with chronic
cancer pain. Which medication is of most concern to the nurse?
a. Amitriptyline (Elavil) 50 mg at bedtime
b. Ibuprofen (Advil) 800 mg 3 times daily
c. Oxycodone (OxyContin) 80 mg twice
daily
d. Meperidine (Demerol) 25 mg every 4
hours
ANS: D
12. The nurse reviews the medication administration record in order to choose the most appropriate
pain medication for a patient with cancer who describes the pain as “deep, aching and at a level 8
on a 0 to 10 scale”. Which medication should the nurse administer?
a. Fentanyl (Duragesic) patch
b. Ketorolac (Toradol) tablets
c. Hydromorphone (Dilaudid) IV
d. Acetaminophen (Tylenol) suppository
ANS: C
13. The nurse is caring for a patient who has diabetes and complains of chronic burning leg pain
even when taking oxycodone (OxyContin) twice daily. When reviewing the orders, which
prescribed medication is the best choice for the nurse to administer as an adjuvant to decrease
the patient’s pain?
a. Aspirin (Ecotrin)
b. Celecoxib (Celebrex)
c. Amitriptyline (Elavil)
d. Acetaminophen (Tylenol)
ANS: C
14. A patient who uses a fentanyl (Duragesic) patch for chronic abdominal pain caused by ovarian
cancer asks the nurse to administer the prescribed hydrocodone (Vicodin) tablets, but the patient
is asleep when the nurse returns with the medication. Which action is best for the nurse to take?
a. Wake the patient and administer the
hydrocodone.
b. Wait until the patient wakes up and
reassess the pain.
c. Suggest the use of nondrug therapies for
pain relief instead of additional opioids.
d. Consult with the health care provider
about changing the fentanyl (Duragesic)
dose.
ANS: A
15. The following medications are prescribed by the health care provider for a middle-aged patient
who uses long-acting morphine (MS Contin) for chronic back pain, but still has ongoing pain.
Which medication should the nurse question?
a. Morphine (Roxanol)
b. Pentazocine (Talwin)
c. Celecoxib (Celebrex)
d. Dexamethasone (Decadron)
ANS: B
16. The nurse is caring for a 1-day postoperative patient who is receiving morphine through patientcontrolled analgesia (PCA). What action by the nurse is a priority?
a. Check the respiratory rate.
b. Assess for nausea after eating.
c. Inspect the abdomen and auscultate bowel
sounds.
d. Evaluate the sacral and heel areas for
signs of redness.
ANS: A
17. A patient who has fibromyalgia tells the nurse, “I feel depressed because I ache too much to play
golf.” The patient says the pain is usually at a level 7 (0 to 10 scale). Which patient goal has the
highest priority when the nurse is developing the treatment plan?
a. The patient will exhibit fewer signs of
depression.
b. The patient will say that the aching has
decreased.
c. The patient will state that pain is at a level
2 of 10.
d. The patient will be able to play 1 to 2
rounds of golf.
ANS: D
18. A patient who has just started taking sustained-release morphine sulfate (MS Contin) for chronic
arthritic joint pain following a traumatic injury complains of nausea and abdominal fullness.
Which action should the nurse take initially?
a. Administer the ordered antiemetic
medication.
b. Tell the patient that the nausea will
subside in about a week.
c. Order the patient a clear liquid diet until
the nausea decreases.
d. Consult with the health care provider
about using a different opioid.
ANS: A
19. A patient with terminal cancer–related pain and a history of opioid abuse complains of
breakthrough pain 2 hours before the next dose of sustained-release morphine sulfate (MS
Contin) is due. Which action should the nurse take first?
a. Use distraction by talking about things the
patient enjoys.
b. Administer the prescribed PRN
immediate-acting morphine.
c. Suggest the use of alternative therapies
such as heat or cold.
d. Consult with the doctor about increasing
the MS Contin dose.
ANS: B
20. Which nursing action could the nurse delegate to unlicensed assistive personnel (UAP) when
caring for a patient who is using a fentanyl (Duragesic) patch and a heating pad for treatment of
chronic back pain?
a. Check the skin under the heating pad.
b. Take the respiratory rate every 2 hours.
c. Monitor sedation using the sedation
assessment scale.
d. Ask the patient about whether pain control
is effective.
ANS: B [Show Less]