Chapter 44 Pain Management Exam 84 Questions with Verified Answers
What are relationship assessments gathered from information during pain assessement?
... [Show More] - CORRECT ANSWER Subjective, gathered through health history, including pain experience and medical, mental health, and substance use components
Objective, information gathered through physical assessment and observation of clinical, behavioral, and psychological manifestations of pain
What are some categories for grouping related to type of pain? - CORRECT ANSWER (nociceptive, neuropathic, or psychogenic), category of pain (acute or chronic), cause (medical condition, disease process, or injury), or meaning (indication of improvement, sign of worsening condition, unrelated).
What are examples of relevance of the cues to the patients unique situation? - CORRECT ANSWER The pain experience is subjective, so individual responses can vary for the same types of injuries or experiences.
More than one problem can exist. Some assessment findings may be related to a medical condition or injury, but not necessarily related to pain.
Why does a nurse connect related cues? - CORRECT ANSWER To form a hypothesis appropriate for the patients unique pain experience.
What do Hypotheses idenitfy? - CORRECT ANSWER issues that the nurse should address to alleviate or control the patient's pain. The hypotheses can be actual problems the patient is currently facing (such as acute pain) or problems the patient is at risk for developing (such as risk for activity intolerance).
What are some Common International Classification of Nursing Practice (ICNP) nursing diagnoses that are associated with pain? - CORRECT ANSWER Anxiety
Acute Pain
Chronic Pain
Difficulty Coping
Inadequate Pain Control
Risk for Activity Intolerance
Pain Management Satisfaction
Risk for Negative Response to Nurse-Controlled Analgesia
Risk for Negative Response to Patient-Controlled Analgesia
What would be the ICNP diagnoses/Hypotheses based on these cues?
Injured arm playing basketball the previous day
Guarding arm and shoulder
Grimacing
Patient rates pain a 9 on a 0-10 pain scale - CORRECT ANSWER Acute pain
What would be the ICNP diagnoses/Hypotheses based on these cues?
Clenched teeth
Restlessness
Moaning
Patient rates pain an 8 on a 0-10 pain scale 1 hour after administration of prescribed pain medication, reflecting no change from the original pain scale rating assessed premedication. - CORRECT ANSWER Inadequate Pain Control
What would be the ICNP diagnoses/Hypotheses based on these cues?
Patient states that back was injured while working in the yard.
Patient grimaces and presents a bent posture when walking.
Patient states that pain level increases when walking or bending, and pain is relieved when lying down.
Health care provider imposed an activity restriction as a component of the treatment plan for back injury. - CORRECT ANSWER Risk for Activity Intolerance
What would be the ICNP diagnoses/Hypotheses based on these cues?
Long bone fracture (right femur)
Reported pain of 10 on a 0-10 pain scale
Request for pain medication
Elevated pulse and blood pressure - CORRECT ANSWER Acute Pain
What would be the ICNP diagnoses/Hypotheses based on these cues?
Skin on right leg pale and cool to touch
Decreased sensation in right foot
Weak pulses distal to fracture
Capillary refill of 4 seconds in right foot
Elevated pulse and blood pressure - CORRECT ANSWER Impaired Circulatory System Function
What would be the ICNP diagnoses/Hypotheses based on these cues?
Patient grimacing
Visible restlessness - CORRECT ANSWER Difficulty Coping
Which statement describes the process nurses use to organize and link cues for a patient experiencing pain?
A. Group collected cues according to type/category of pain, cause, or meaning.
B. Collect objective cues through the health history, including pain experience.
C. Apply critical thinking skills to cluster patient cues, linking them to the disease process.
D. Gather subjective cues through physical assessment and observation of manifestations of pain. - CORRECT ANSWER A
Which phrases describe potential hypotheses related to pain management?
Select all that apply.
1. Nursing interventions
2. Expected patient outcomes
3. Factors that alleviate pain
4. Issues the patient is at risk for developing
5. Actual problems the patient faces - CORRECT ANSWER 3,4,5
A patient is restless and moaning, and rates pain a 10 on a 0-10 pain scale 1 hour following administration of prescribed pain medication. Which hypothesis would the nurse identify?
A. Anxiety
B. Acute Pain
C. Inadequate Pain Control
D. Pain Management Satisfaction - CORRECT ANSWER C
What does a nurse do once hypotheses have been developed? - CORRECT ANSWER The nurse needs to prioritize them
Prioritization of hypotheses includes? - CORRECT ANSWER evaluating and ranking the hypotheses according to importance, including criteria such as urgency, likelihood, or risk
Questions to assist the nurse in prioritizing the hypotheses for patients experiencing pain Urgency - CORRECT ANSWER Which hypotheses are most likely to be life-threatening or affect airway, breathing, and circulation?
If any of these issues exist, they must be addressed first.
Example: A patient who has experienced a motor vehicle accident may be in severe pain. Injury, such as a broken bone, may also cause inadequate circulation. Impaired circulation would be a priority to reduce pain, swelling, and damage to tissues.
Questions to assist the nurse in prioritizing the hypotheses for patients experiencing pain Likelihood - CORRECT ANSWER Which hypotheses are most likely? Which are least likely?
Example: A patient with no support system may be more likely to experience Difficulty Coping with Pain.
Questions to assist the nurse in prioritizing the hypotheses for patients experiencing pain Risk - CORRECT ANSWER Which hypotheses are the most serious or have the potential to increase the risk for complications?
Example: A patient who is immobilized as a result of an injury may be at Risk for Impaired Skin Integrity.
What should a nurse consider the impact of unique patient characteristics - CORRECT ANSWER such as culture, life experience, or prior pain experiences, when prioritizing hypotheses. Another consideration is which hypotheses may eliminate other problems if resolved.
Once hypotheses are prioritized, what are they used for? - CORRECT ANSWER plan patient goals and outcomes, which will be the foundation of generating the plan of care. The nurse should ensure a course of direction for personalized care tailored to the individual's unique needs, factoring in patient variables such as comorbidities.
The nurse should also consider legal and ethical aspects of managing pain and ensure alignment with the following: - CORRECT ANSWER The American Nurses Association (ANA) Standards of Practice
ANA Code of Ethics for Nurses
ANA position statement, "The Ethical Responsibility to Manage Pain and the Suffering It Causes" (ANA, 2018)
Pain assessment and management standards published by The Joint Commission
If the plan of care is designed according to the guidelines and regulations, nurses will be able to avoid problems related to pain management, such as? - CORRECT ANSWER -undertreatment of pain
-the underestimation of chronic pain prevalence -inadequate pain management
-potential inappropriate overutilization of pharmacologic therapies.
Why is interprofessional collaboration important? - CORRECT ANSWER It helps to determine patient outcomes and generate solutions for developing a comprehensive plan of care which ensures that the patients pain needs are met.
The ultimate goal of collaboration is progression of the patient toward the desired outcome of pain relief.
What are members of the interprofessional team? - CORRECT ANSWER nurses, advanced practice nurses, health care providers, music therapists, massage therapists, occupational therapists, physical therapists, pain management specialists, muscle manipulation specialists, social workers, psychologists, clergy, and other specialists who provide complementary therapies to manage pain in addition to medication.
What are some nonpharmacologic pain management activities may be delegated to unlicensed assistive personnel? - CORRECT ANSWER Changing bed linens
Darkening the room
Talking to the patient
Performing oral hygiene
Administering back rubs
Repositioning the patient
Patient goals should be developed as SMART goals: - CORRECT ANSWER Specific
Measurable or Meaningful
Attainable or Action-Oriented
Realistic or Results-Oriented
Timely or Time-Oriented
Patient goals can be short-term or long-term. What is the short term goal and long term goal for a patient ICNP Diagnosis/Hypothesis for Acute Pain - CORRECT ANSWER Short-term
Patient will report a pain level of less than 3 on a 0-10 scale within 1 hour of starting prescribed dose of analgesia.
Long-term
Patient will report a pain level of less than 3 on a 0-10 scale within 5 postoperative days.
Patient goals can be short-term or long-term. What is the short term goal and long term goal for a patient ICNP Diagnosis/Hypothesis for Activity Intolerance - CORRECT ANSWER Short-term
Patient will perform activities of daily living, reporting a pain level of 3 or less within 1 day of beginning new pain medication.
Long-term
Patient will perform activities of daily living, reporting a pain level of 3 or less within 1 week of beginning new pain medication.
Using your clinical judgement how do you Analyze cues? - CORRECT ANSWER Which potential conditions have cues similar to those the nurse identified when assessing the patient? (What are potential patient problems based on analysis of patient cues?)
Using your clinical judgement how do you Prioritize Hypotheses? - CORRECT ANSWER If left unmanaged, which cues have the potential to cause the most harm?
Using your clinical judgement how do you Generate Solutions? - CORRECT ANSWER What is the ideal patient state given what the nurse knows and has assessed?
Which questions would the nurse ask to assist in prioritizing hypotheses for patients experiencing pain?
Select all that apply.
1. Which hypotheses are most likely to occur?
2. Which hypotheses might affect the patient's airway?
3. Which hypotheses influence activities of daily living?
4. Which hypotheses can increase the risk for complications?
5. Which hypotheses are most likely to be life-threatening? - CORRECT ANSWER 1,2,4,5
Which factors influence legal and ethical aspects of generating solutions for pain management?
Select all that apply.
1. Patient perception of pain
2. Professional standards of practice
3. Organizational policies and procedures
4. Regulatory pain management standards
5. Pain management position statements - CORRECT ANSWER 2,3,4,5
Which pain management activities can the nurse delegate to unlicensed assistive personnel?
Select all that apply.
1. Performing oral hygiene
2. Providing back rubs
3. Repositioning the patient
4. Administering pain medication
5. Calling the health care provider to request pain medication - CORRECT ANSWER 1,2,3
The nurse is caring for a patient who was involved in a mountain bike accident and is experiencing severe pain. The nurse determines that Acute Pain is the priority hypothesis. Which statement reflects a short-term outcome for the patient experiencing pain?
A. Patient will report a pain level of less than 3 on a 0-10 scale within 5 postoperative days.
B. Patient will report a pain level of less than 3 on a 0-10 scale within 1 hour of starting prescribed dose of analgesia.
C. Patient will perform activities of daily living, reporting a pain level of 3 or less within 1 day of beginning new pain medication.
D. Patient will perform activities of daily living, reporting a pain level of 3 or less within 1 week of beginning new pain medication. - CORRECT ANSWER B
Place the steps in the order that the nurse implements them when caring for a patient experiencing pain.
1. Organize and link patient cues related to pain.
2. Determine patient goals/outcomes related to pain management.
3. Complete a pain assessment.
4. Prioritize hypotheses related to pain and pain management.
5. Identify hypotheses related to pain and pain management. - CORRECT ANSWER 3,1,5,4,2
After assessing a patient with a fractured wrist, the nurse selects a hypothesis of Difficulty Coping. Which cues would lead the nurse to select this hypothesis?
Select all that apply.
1. The patient is grimacing.
2. The patient appears restless.
3. The patient has an elevated blood pressure and pulse.
4. The patient reports pain of 5 on a 0-10 pain scale.
5. The patient has decreased sensation in the fingers of the affected wrist. - CORRECT ANSWER 1,2,
Following a back injury that occurred while gardening, a patient states that the pain level increases when walking or bending but is relieved when lying down. Which hypothesis would the nurse identify?
A. Anxiety
B. Chronic Pain
C. Difficulty Coping
D. Risk for Activity Intolerance - CORRECT ANSWER D. Risk for Activity Intolerance
Patient cues indicate that the patient's activity level can be affected by the pain because the pain level increases when walking or bending and is relieved when lying down.
A patient presents to the emergency department immediately following an arm injury that occurred during a football game. The patient rates the pain in the left arm and shoulder an 8 on a 0-10 pain scale. The patient grimaces, guards the arm and shoulder, and clenches the teeth during the assessment. Which hypothesis would the nurse identify?
A. Acute Pain
B. Chronic Pain
C. Difficulty Coping
D. Inadequate Pain Control - CORRECT ANSWER A. Acute Pain
The patient cues indicate that the patient is experiencing Acute Pain (sudden onset, identifiable cause, behaviors).
The nurse is caring for a patient who was involved in a mountain bike accident and is experiencing severe pain. Which question would allow the nurse to prioritize hypotheses according to risk?
A. Which hypotheses are most likely to occur?
B. Which hypotheses are most likely to affect breathing?
C. Which hypotheses have the potential for complications?
D. Which hypotheses are most likely to be life-threatening as a result of injury? - CORRECT ANSWER C, Which hypotheses have the potential for complications?
This question will allow the nurse to identify the most serious hypotheses or those with the potential to increase the risk for complications.
The nurse is caring for a patient who reports pain of 9 on a 0-10 scale. The nurse administers the prescribed pain medication. Which statement reflects a patient goal developed in accordance with the SMART acronym?
A. Patient will state better pain management within 1 hour of starting prescribed pain medication.
B. Patient will verbalize an improvement in pain after taking prescribed dose of analgesia medication.
C. Patient will report a pain level of less than 3 on a 0-10 scale within 1 hour of starting prescribed dose of analgesia.
D. Patient will describe satisfactory pain control at a level less than 4 on a rating scale of 0-10. - CORRECT ANSWER C. Patient will report a pain level of less than 3 on a 0-10 scale within 1 hour of starting prescribed dose of analgesia.
Patient goal is a SMART goal: specific, measurable, attainable, realistic, and time-oriented.
Which collaborative team members may be involved in providing care to a patient with pain?
Select all that apply.
1. Art therapist
2. Physical therapist
3. Massage therapist
4. Pain management specialist
5. Muscle manipulation specialist - CORRECT ANSWER 2,3,4,5
Which strategy can the nurse use to care for an athlete who experiences occasional stress and muscle pain before or after sports?
A. Collaborate with a massage therapist
B. Request a prescription for pain medication
C. Gather objective data through the health history
D. Provide education regarding breakthrough pain - CORRECT ANSWER A. Collaborate with a massage therapist
Collaboration with interprofessional team members is an important component of pain management. Massage therapists use hands-on manipulation of soft tissue to benefit patients with occasional stress and muscle pain.
The nurse collaborates with unlicensed assistive personnel (UAP) to implement care for patients experiencing pain. Which action can the nurse delegate to UAP?
A. Administering morphine sulfate for pain
B. Darkening the room to create a peaceful environment
C. Performing massage and range-of-motion exercises
D. Asking the health care provider to prescribe lorazepam for anxiety - CORRECT ANSWER B. Darkening the room to create a peaceful environment
The nurse maintains ultimate responsibility for overseeing the implementation and documentation of all pain-related care, and some nonpharmacologic pain management activities may be delegated to UAP, such as darkening the room.
The provider prescribed pain and anxiety medications for a postoperative patient. The lowest pain rating the patient reports during the shift is 7 on a 0-10 pain scale. Which interprofessional team members would the nurse collaborate with to determine nonpharmacologic solutions for the patient?
Select all that apply.
1. Music therapist
2. Physical therapist
3. Massage therapist
4. Health care provider
5. Pain management specialist - CORRECT ANSWER 1,2,3,5,
Which solution involves the collaboration of a primary health care provider, nurse, and pharmacist when caring for a patient with pain from an injury to an extremity?
A. Ordering a music therapist consult
B. Providing assistance with ambulation
C. Elevating the extremity and applying an ice pack
D. Administering acetaminophen/oxycodone - CORRECT ANSWER D. Administering acetaminophen/oxycodone
Administration of acetaminophen/oxycodone requires collaboration of a health care provider, nurse, and pharmacist.
A 40-year-old patient presents to the emergency department with a fracture of the right femur following a four-wheeler accident. The nurse organizes relevant cues and links them to form hypotheses, as depicted in the table.
Organizing/Linking Cues
-Long bone fracture (right femur)
-Reported pain of 10 on 0-10 pain scale
-Request for pain medication
-Elevated pulse and blood pressure
ICNP Diagnoses /Hypotheses
Acute Pain
Organizing/Linking Cues
-Patient grimacing
-Visible restlessness
ICNP Diagnoses /Hypotheses
Difficulty Coping
Organizing/Linking Cues
-Long bone fracture (right femur)
ICNP Diagnoses /Hypotheses
Risk for Impaired Patient Mobility
Organizing/Linking Cues
-Skin on right leg pale and cool to touch
-Decreased sensation in right foot
-Weak pulses distal to fracture
-Capillary refill of 4 seconds in right foot
-Elevated pulse and blood pressure
ICNP Diagnoses /Hypotheses
Impaired Circulatory System Fun - CORRECT ANSWER D. Neurovascular checks of right leg within normal limits
The patient cues reflect that Impaired Circulatory System Function is the most urgent, most serious, and most likely hypothesis.
What is the most appropriate way to assess the pain of a patient who is oriented and has recently had surgery?
a. Assess the patients body language.
b. Observe cardiac monitor for increased heart rate.
c. Ask the patient to rate the level of pain.
d. Ask the patient to describe the effect of pain on the ability to cope. - CORRECT ANSWER C
A nurse is caring for a patient who recently had an abdominal hysterectomy and states that she is experiencing severe pain. The patients blood pressure is 110/60, and her heart rate is 60. Additionally, the patient does not appear to be in any distress. Which response by the nurse is most therapeutic?
a. Your vitals do not show that you are having pain; can you describe your pain?
b. You do not look like you are in pain.
c. OK, I will go get you some narcotic pain relievers immediately.
d. What would you like to try to alleviate your pain? - CORRECT ANSWER D
Which of the following statements made by a patient reflects that the patient understands the relationship between the gate control theory of pain and the use of meditation to relieve pain?
a. Meditation controls pain by blocking pain impulses from coming through the gate.
b. Meditation will help me sleep through the pain because it opens the gate.
c. Meditation stops the occurrence of pain stimuli
d. Meditation alters the chemical composition of pain neuroregulators, which closes the gate. - CORRECT ANSWER A
A nursing student is planning care for an elderly patient who is experiencing pain. Which of the following statements made by the nursing student indicates the need for the nursing professor to clarify the nursing students knowledge?
a. Older patients often have difficulty determining what is causing their pain.
b. It is safe to administer opioids to older adults as long as you start with small doses and frequently assess the patients response to the medication.
c. As adults age, their ability to perceive pain decreases.
d. Patients who have dementia probably experience pain, and their pain is not always well controlled. - CORRECT ANSWER B
The nurse is caring for two patients; both are having a nysterectomy after a complicated birth. The second patient has uterine cancer. What will most likely influence hysterectomy. The first patient is having the the experience of pain for these two patients?
a. Neurological factors
b. Competency of the surgeon
c. Meaning of pain
d. Postoperative support personnel - CORRECT ANSWER C
The nurse anticipates administering an opioid fentanyl patch to which patient?
a. A 15-year-old adolescent with a broken femur
b. A 30-year-old adult with cellulitis
c. A 50-year-old patient with prostate cancer
d. An 80-ycar-old patient with a broken hip - CORRECT ANSWER C
What nursing intervention is most effective in preventing injury to a patient following administration of epidural anesthesia?
a. Keeping the reversal agent in a syringe in the patients bedside table
b. Applying a gauze dressing to the epidural catheter insertion site
c. Label the tubing that leads to the epidural catheter
d. Asking the nursing assistive personnel to check on the patient at least once every 2 hours - CORRECT ANSWER C
A 24-year-old Asian woman is in Jabor and refuses to receive any sort of anesthesia medication. Which alternative treatment is best for this patient?
a. Relaxation and guided imagery
b. Transcutaneous electrical nerve stimulation (TENS)
c. Herbal supplements with analgesic effects
d. Pudendal block - CORRECT ANSWER A
Which of the following statements made by the patient indicates to the nurse that teaching on a patient- controlled analgesia (PCA) device has been effective?
a. This is the only pain medication I will need to be on
b. I can administer the pain medication as frequently as I need to
c. I feel less anxiety about the possibly of overdosing
d. I will need the nurse to notify me when it is time for another dose - CORRECT ANSWER C
A nurse is caring for a patient who is experiencing pain following abdominal surgery. What information is important for the nurse to tell the patient when providing patient education about effective pain management?
a. To prevent overdose, you need to wait to ask for pain medication until you begin to experience pain.
b. You should take your medication after you walk to make sure you do not fall while you are walking.
c. We should work together to create a regular schedule of medications that does not allow for breakthrough pain.
d. You need to take oral pain medications when you experience severe pain. - CORRECT ANSWER C
A nurse is caring for a patient who recently had spinal surgery. The nurse knows that patients usually experience acute pain following this type of surgery. The patient refuses to get up and walk and is not moving around in the bed. However, the patient is stoic and denies experiencing pain at this time. What most likely explains this patients behavior and response to surgery?
a. The surgery successfully cured the patients pain
b. The patienta culture is possibly influencing the patients experience of pain
c. The patient is experiencing urinary retention because of manipulation of the spine during surgery; this is preventing the patient from experiencing pain.
d. The nurse is allowing personal beliefs about pain to influence pain management at this time. - CORRECT ANSWER B
A nurse is providing discharge teaching for a patient with a fractured humerus. The patient is going home with Vicodin (5/325). What important patient education does the nurse provide?
a. Be sure to cat a meal high in fat before taking the medication, to avoid a stomach ulcer.
b. Narcotics can be addictive, so do not take them unless you are in severe pain.
c. You need to drink plenty of fluids and eat a diet high in fiber.
d. As your pain severity lessens, you will begin to give yourself once-daily intramuscular injections. - CORRECT ANSWER C
A patient arrives at the emergency department experiencing a headache and rates the pain as 7 on a 0 to 10 pain scale. What nonpharmacological intervention does the nurse implement for this patient while awaiting orders for pain medication from the health care provider?
a. Frequently reassesses the patients pain scores
b. Reassures the patient that the provider will come to the emergency department soon
c. Softly plays music that the patient finds relaxing
d. Teaches the patient how to do yoga - CORRECT ANSWER C
14. A patient who has had type 2 diabetes for 26 years is beginning to experience peripheral neuropathy in the feet and lower legs, which is causing the patient to have a decreased ability to feel pain in the lower extremities. The nurse is providing education to the patient to prevent injury to the feet. The nurse tells the patient to always wear shoes or slippers when walking. Which of the following statements made by the nurse best explains the rationale for this instruction?
a. Wearing shoes blocks pain perception and helps you adapt to pain, which ends up protecting your feet.
b. Shoes provide nonpharmacological pain relief to people with diabetes and peripheral neuropathy.
c. Since you cannot feel pain as much in your feet, you need to open your neurological gates to allow pain sensationa to come through. Wearing shoes helps to open those gates, which protects your feet.
d. You have lost the ability to wit - CORRECT ANSWER D
A nurse is assessing a patient who started to have severe pain 3 days ago. When the nurse asks the patient to describe the pain, the patient states, The pain feels like it is in my stomach. It is a burning pain, and it spreads out in a circle around the spot where it hurts the most What type of pain does the nurse document that the patient is having at this time?
a. Superficial pain
b. Idiopathic pain
c. Chronic pain
d. Visceral pain - CORRECT ANSWER D
1A patient who had a motor vehicle accident 2 days ago is experiencing pain and is receiving patient- controlled analgesia (PCA). How does the nurse know that the patient is experiencing effective pain management with the PCA?
a. The patient is sleeping and is difficult to arouse.
b. The patient rates pain at an acceptable level of 3 on a 0 to 10 scale.
c. Sufficient medication is left in the PCA syringe.
d. The patient presses the control button to deliver pain medication. - CORRECT ANSWER B
The nurse recognizes that which of the following is a modifiable contributor to a patients perception of pain?
a. Age and gender
b. Anxiety and fear
c. Culture
d. Previous pain experience - CORRECT ANSWER B
The nurse is evaluating the effectiveness of guided imagery for pain management as used for a patient who has second- and third-degree burns and needs extensive dressing changes. Which statement best describes that guided imagery is effectively controlling the patients pain during dressing changes?
a. The patients need for analgesic medication decreases during the dressing changes.
b. The patient rates pain during the dressing change as a 6 on a scale of 0 to 10.
c. The patients facial expressions are stoic during the procedure.
d. The patient can tolerate more pain, so dressing changes can be performed more frequently. - CORRECT ANSWER A
A nurse is providing medication education to a patient who just started taking ibuprofen, a nonselective nonsteriodal antiinfammatory drug (NSAID). Which statement made by the nurse best indicates how ibuprofen works?
a. Ibuprofen helps to remove factors that cause or stimulate pain.
b. Ibuprofen reduces anxiety, which will help you better cope with your pain.
c. Ibuprofen helps to decrease the production of prostaglandins.
d. Ibuprofen binds with opiate receptors to reduce your pain - CORRECT ANSWER C
A nurse has brought the patient his scheduled pain medication. The patient asks the nurse to wait to give pain medication until the time for the dressing change, which is 2 hours away. Which response by the nurse is most therapeutic?
a. This medication will still be providing you relief at the time of your dressing change.
b. OK, swallow this pain pill, and I will return in a minute to fill your wound.
c. Would you like medication to be given for dressing changes on top of your regularly scheduled medication?
d. Your medication is scheduled for this time, and I cant adjust the time for you. Im sorry, but you must take your pill right now. - CORRECT ANSWER C
A nurse receives an order from a health care provider you administer Vicodin ES, which contains 750mg acetaminophen and 7.5 mg hydrocodone, to a patient who is experiencing 8/10 postsurgical pain. The order is to give 2 tablets every 6 hours by mouth as needed for pain. What is the nurses best next action?
a. Give the Vicodin ES to the patient immediately because the patient is experiencing severe pain.
b. Ask the health care provider to verify the dosage and frequency of the medication.
c. Ask the health care provider for an order for a nonsteroidal antiinflammatory drug (NSAID).
d. Ask the health care provider for an order to play music for the patient, in addition to providing the pain medication. - CORRECT ANSWER B
The nurse knows that which technique is best for assessing pain in a child who is 4 years of age?
a. Ask the parents if they think their child is in pain.
b. Use the FACES scale.
c. Ask the child to rate the level of pain on a 0 to 10 pain scale.
d. Check to see what previous nurses have charted. - CORRECT ANSWER B
Which statement made by a nursing educator best explains why it is important for nurses to determine a patients medical history and recent drug use?
a. Health care providers have a responsibility to prevent drug seekers from gaining access to drugs.
b. This providing pain relief. miormiation is useful in determining what tyne of pain interventions will most likely be effective in
c. Some recreational drugs have pharmaceutical countemarts that may be more effective in managing pain.
d. Getting this information gives the nurse an onnortunity to provide patient teaching about drug abstinence. - CORRECT ANSWER B
A nurse is supervising a student who is caring for a patient with chronic pain. Which statement by the student indicates an understanding of pain management?
a. This patient says her pain is a 5, but she is not acting like it. I am not going to give her any pain medication.
b. The patient is sleeping, so I pushed her PCA button for her.
c. I need to reassess the patients pain 1 hour after administering oral pain medication.
d. It wasnt time for the patients medication, so when she requested it, I gave her a placebo. - CORRECT ANSWER C
The nurse is assessing how a patients pain is affecting mobility. Which assessment question is most appropriate?
a. Have you considered working with a physical therapist?
b. What activities, if any, has your pain prevented you from doing?
c. Would you please rate your pain on a scale from 1 to 10 for me?
d. What effect does your pain medication typically have on your pain? - CORRECT ANSWER B
The nurse is teaching a student nurse about pain assessment scales. Which statement by the student indicates correct understanding?
a. You cannot use a pain scale to compare the pain of my patient with the pain of your patient.
b. When patients say they dont need pain medication, they arent in pain.
c. Pain assessment scales determine the quality of a patients pain.
d. A patients behavior is more reliable than the patients report of pain. - CORRECT ANSWER C
The nurse is administering pain medication for several patients. Which patient does the nurse administer medication to first?
a. The patient who needs to take a scheduled dose of maintenance pain medication
b. The patient who needs to be premedicated before walking
c. The patient with a PCA running who needs to have the syringe replaced
d. The patient who is experiencing 8/10 pain and has a STAT order for pain medication - CORRECT ANSWER D
The nurse is assessing a patient for opioid tolerance, Which finding supports the nurses assessment?
a. Increasingly higher doses of opioid are needed to control pain.
b. The patient needed a substantial dose of naloxone (Narcan).
c. The patient asks for pain medication close to the time it is due around the clock.
d. The patient no longer experiences sedation from the usual dose of opioid. - CORRECT ANSWER A
A nurse is caring for a patient with rheumatoid arthritis who is now going to be taking 2 acetaminophen (Tylenol) tablets every 6 hours to control pain. Which part of the patients social history is the nurse most concerned about?
a. Patient drinks 1 to 2 glasses of wine every night.
b. Patient smokes 2 packa of cigarettes a day
c. Patient occasionally smokes marijuana
d. Patient takes antianxiety medications - CORRECT ANSWER A
The nurse is caring for a patient who suddenly experiences chest pain. What is the nurses first priority?
a. Call the rapid response team.
b. Ask the patient to rate and describe the pain.
c. Raise the head of the bed.
d. Administer pain relief medications. - CORRECT ANSWER B
The nurse is caring for a patient who recently had surgery to repair a hernia. The patients pain was 7 out of 10 before receiving pain medication. One hour after receiving an oral opiod, the patient ranks his pain at 3 out of 10. The patient asks the nurse why he isnt receiving more pain medication. Which is the nurses besr response?
a. This medication can be given only every 4 hours. It is not time for you to have any other pain medication right now.
b. I will notify the health care provider to come perform an assessment if your pain doesnt improve in 30 minutes
c. If the pain becomes severe, we may need to transfer you to an intensive carw unit
d. It can take 2 hours for oral pain medication to work, and your pain is going down. Lets try boosting you up in bed and putting an ice pack on the incision to see if that helps - CORRECT ANSWER D
Which of the following is the best way for the nurse to manage pain for a patient with chronic pain from arthritis?
a. Administer pain medication before any activity.
b. Provide intravascular bolus as needed for breakthrough pain.
c. Give medications around-the-clock.
d. Administer pain medication only when nonpharmacological measures have failed. - CORRECT ANSWER C
A nurse is caring for a patient who fell on the ice and has connective tissue damage in the wrist and hand. What does type of pain does the nurse document that the patient has?
a. Visceral pain
b. Somatic pain
c. Peripherally generated pain
d. Centrally generated pain - CORRECT ANSWER B
The nurse is caring for an infant in the intensive care unit. Which of the following is the most accurate description of factors that will influence the perception and management of pain for this patient?
a. Infants cannot tolerate analgesics owing to an underdeveloped metabolism.
b. Infants have an increased sensitivity to pain when compared with older children.
c. Pain cannot be accurately assessed in infants.
d. Infants respond behaviorally and physiologically to painful stimuli. - CORRECT ANSWER D
The nurse is administering ibuprofen (Advil) to an older patient. Which of the following assessment data causes the nurse to hold the medication? (Select all that apply.)
a. Past medical history of gastric ulcer
b. Patient states last bowel movement was 4 days ago
c. Stated allergy to aspirin
d. Patient states has 2/10 intermittent joint pain
e. Patient expeeienced respiratory depression after administration of an opiod medication - CORRECT ANSWER A, C [Show Less]