Chapter 44 Pain Management Practice Questions

Question 1

A patient has recently had surgery. Which action is best for the nurse to take to assess this patient’s pain?

a. Assess the patient’s body language.
b. Ask the patient to rate the level of pain.
c. Observe the cardiac monitor for increased heart rate.
d. Have the patient describe the effect of pain on the ability to cope.

Answer 1

b. Ask the patient to rate the level of pain.

Question 2

A nurse is caring for a patient who recently had abdominal surgery and is experiencing severe pain. The patient’s blood pressure is 110/60 mm Hg, and heart rate is 60 beats/min. Additionally, the patient does not appear to be in any physical 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. “OK, I will go get you some narcotic pain relievers immediately.”
c. “What would you like to try to alleviate your pain?”
d. “You do not look like you are in pain.”

Answer 2

c. “What would you like to try to alleviate your pain?”

Question 3

A nurse teaches the patient about the gate control theory. Which statement made by a patient reflects a correct understanding about 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 alters the chemical composition of pain neuroregulators, which closes the gate.”
c. “Meditation will help me sleep through the pain because it opens the gate.”
d. “Meditation stops the occurrence of pain stimuli.”

Answer 3

a. “Meditation controls pain by blocking pain impulses from coming through the gate.”

Question 4

A nurse is planning care for an older-adult patient who is experiencing pain. Which statement made by the nurse indicates the supervising nurse needs to follow up?

a. “As adults age, their ability to perceive pain decreases.”
b. “Older patients may have low serum albumin in their blood, causing toxic effects of analgesic drugs.”
c. “Patients who have dementia probably experience pain, and their pain is not always well controlled.”
d. “It is safe to administer opioids to older adults as long as you start with small doses and frequently assess the patient’s response to the medication.”

Answer 4

a. “As adults age, their ability to perceive pain decreases.”

Question 5

The nurse is caring for two patients; both are having a hysterectomy. The first patient is having the hysterectomy after a complicated birth. The second patient has uterine cancer. What will most likely influence the experience of pain for these two patients?

a. Meaning of pain
b. Neurological factors
c. Competency of the surgeon
d. Postoperative support personnel

Answer 5

a. Meaning of pain

Question 6

The nurse is preparing pain medications. To which patient does the nurse anticipate administering an opioid fentanyl patch?

a. A 15-year-old adolescent with a fractured femur
b. A 30-year-old adult with cellulitis
c. A 50-year-old patient with prostate cancer
d. An 80-year-old patient with a broken hip

Answer 6

c. A 50-year-old patient with prostate cancer

Question 7

A patient is receiving opioid medication through an epidural infusion. Which action will the nurse take to protect the patient’s safety?

a. Restrict fluid intake.
b. Label the tubing that leads to the epidural catheter.
c. Apply a gauze dressing to the epidural catheter insertion site.
d. Ask the nursing assistive personnel to check on the patient at least once every 2 hours.

Answer 7

b. Label the tubing that leads to the epidural catheter.

Question 8

A woman is in labor and refuses to receive any sort of anesthesia medication. Which alternative treatment is best for this patient?

a. Transcutaneous electrical nerve stimulation (TENS)
b. Herbal supplements with analgesic effects
c. Pudendal block (regional anesthesia)
d. Relaxation and guided imagery

Answer 8

d. Relaxation and guided imagery

Question 9

A nurse is teaching a patient about patient-controlled analgesia (PCA). Which statement made by the patient indicates to the nurse that teaching is effective?

a. “I will only need to be on this pain medication.”
b. “I feel less anxiety about the possibility of overdosing.”
c. “I can receive the pain medication as frequently as I need to.”
d. “I need the nurse to notify me when it is time for another dose.”

Answer 9

b. “I feel less anxiety about the possibility of overdosing.”

Question 10

A nurse is caring for a patient who is experiencing pain following abdominal surgery. Which information is important for the nurse to share with 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 schedule to provide regular dosing of medication.”
d. “When you experience severe pain, you will need to take oral pain medications.”

Answer 10

c. “We should work together to create a schedule to provide regular dosing of medication.”

Question 11

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 patient’s behavior?

a. The surgery successfully cured the patient’s pain.
b. The patient’s culture is possibly influencing the patient’s experience of pain.
c. The primary health care provider did not prescribe the correct amount of medication.
d. The nurse is allowing personal beliefs about pain to influence pain management at this time.

Answer 11

b. The patient’s culture is possibly influencing the patient’s experience of pain.

Question 12

A nurse is providing discharge teaching for a patient with a fractured humerus. The patient is going home with a prescription for hydrocodone. Which important patient education should the nurse provide?

a. “You need to drink plenty of fluids and eat a diet high in fiber.”
b. “Narcotics can be addictive, so do not take them unless you are in severe pain.”
c. “Be sure to eat a meal high in fat before taking the medication, to avoid a stomach ulcer.”
d. “As your pain severity lessens, you will begin to give yourself once-daily intramuscular injections.”

Answer 12

a. “You need to drink plenty of fluids and eat a diet high in fiber.”

Question 13

A patient arrives at the emergency department experiencing a headache and rates the pain as 7 on a 0 to 10 pain scale. Which nonpharmacological intervention does the nurse implement for this patient while awaiting orders for pain medication from the health care provider?

a. Reassures the patient that the provider will come to the emergency department soon.
b. Softly plays music that the patient finds relaxing.
c. Frequently reassesses the patient’s pain scores.
d. Teaches the patient how to do yoga.

Answer 13

b. Softly plays music that the patient finds relaxing.

Question 14

A patient diagnosed with type 2 diabetes 26 years ago is beginning to experience peripheral neuropathy in the feet and lower leg. The nurse is providing education to the patient to prevent injury to the feet by wearing shoes or slippers when walking. Which statement 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. “The neurological gates open when wearing shoes, which protects your feet.”
d. “If you step on something without shoes, you might not feel it; this could possibly cause injury to your foot.”

Answer 14

d. “If you step on something without shoes, you might not feel it; this could possibly cause injury to your foot.”

Question 15

A nurse is assessing a patient who began experiencing 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.” Which type of pain does the nurse document the patient is having at this time?

a. Superficial pain
b. Idiopathic pain
c. Chronic pain
d. Visceral pain

Answer 15

d. Visceral pain

Question 16

A patient injured in a motor vehicle crash 2 days ago is experiencing pain and is receiving patient-controlled analgesia (PCA). Which assessment finding indicates effective pain management with the PCA?

a. The patient is sleeping and is difficult to arouse.
b. The patient rates pain at a level of 2 on a 0 to 10 scale.
c. The patient has sufficient medication left in the PCA syringe.
d. The patient presses the control button to deliver pain medication.

Answer 16

b. The patient rates pain at a level of 2 on a 0 to 10 scale.

Question 17

The nurse is caring for a patient and is focusing on modifiable factors that contribute to pain. Which areas does the nurse focus on with this patient?

a. Age and gender
b. Anxiety and fear
c. Culture and ethnicity
d. Previous pain experiences and cognitive abilities

Answer 17

b. Anxiety and fear

Question 18

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 finding best indicates the effectiveness of guided imagery?

a. The patient’s facial expressions are stoic during the procedure.
b. The patient rates pain during the dressing change as a 6 on a scale of 0 to 10.
c. The patient’s need for analgesic medication decreases during the dressing changes.
d. The patient asks for pain medication during the dressing changes only once throughout the procedure.

Answer 18

c. The patient’s need for analgesic medication decreases during the dressing changes.

Question 19

A nurse is providing medication education to a patient who just started been prescribed ibuprofen. Which information will the nurse include in the teaching session?

a. Ibuprofen helps to depress the central nervous system to decrease pain perception.
b. Ibuprofen reduces anxiety, which will help you cope with your pain.
c. Ibuprofen binds with opiate receptors to reduce your pain.
d. Ibuprofen inhibits the development of inflammation.

Answer 19

d. Ibuprofen inhibits the development of inflammation.

Question 20

The nurse has brought a patient the 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 change your dressing.”
c. “Would you like medication to be given for dressing changes in addition to your regularly scheduled medication?”
d. “Your medication is scheduled for this time, and I can’t adjust the time for you. I’m sorry, but you must take your pill right now.”

Answer 20

c. “Would you like medication to be given for dressing changes in addition to your regularly scheduled medication?”

Question 21

A nurse receives an order from a health care provider to administer hydrocodone and acetaminophen 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 nurse’s next best action?

a. Give the medication to the patient immediately because the patient is experiencing severe pain.
b. Ask the health care provider for a nonsteroidal antiinflammatory drug (NSAID) order.
c. Ask the health care provider to verify the dosage and frequency of the medication.
d. Give the medication in addition to playing soothing music for the patient.

Answer 21

c. Ask the health care provider to verify the dosage and frequency of the medication.

Question 22

The nurse is caring for a 4-year-old child who is demonstrating signs of pain. Which technique will the nurse use to best assess pain in this child?

a. Use the FACES scale.
b. Check to see what previous nurses have charted.
c. Ask the parents if they think their child is in pain.
d. Have the child rate the level of pain on a 0 to 10 pain scale.

Answer 22

a. Use the FACES scale.

Question 23

A nurse is caring for a group of patients. Which patient will the nurse see first to best manage patient needs?

a. A patient who received morphine and has a pulse of 62 beats/min, respirations 10
breaths/min, and blood pressure 110/60 mm Hg.
b. A patient lying very still in bed who reports no pain but is pale with warm, dry skin.
c. A patient with severe pain who is nauseated and feels like he or she is about to vomit.
d. A patient writhing and moaning from abdominal pain after abdominal surgery.

Answer 23

a. A patient who received morphine and has a pulse of 62 beats/min, respirations 10

Question 24

A nurse is caring for a patient diagnosed with chronic pain. Which statement by the nurse indicates an understanding of pain management?

a. “This patient says the pain is a 5 but is not acting like it. I am not going to give any pain medication.”
b. “I need to reassess the patient’s pain 1 hour after administering oral pain medication.”
c. “It wasn’t time for the patient’s medication, so when it was requested, I gave a placebo.”
d. “The patient is sleeping, so I pushed the PCA button.”

Answer 24

b. “I need to reassess the patient’s pain 1 hour after administering oral pain medication.”

Question 25

The nurse is assessing how a patient’s 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 0 to 10 for me?”
d. “When does your pain medication typically take effect on your pain?”

Answer 25

b. “What activities, if any, has your pain prevented you from doing?”

Question 26

The nurse is teaching a student nurse about pain assessment scales. Which statement by the student indicates effective teaching?

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 don’t need pain medication, they aren’t in pain.”
c. “A patient’s behavior is more reliable than the patient’s report of pain.”
d. “Pain assessment scales determine the quality of a patient’s pain.”

Answer 26

a. “You cannot use a pain scale to compare the pain of my patient with the pain of your patient.”

Question 27

The nurse is administering pain medication for several patients. Which patient does the nurse administer medication to first?

a. The patient who needs to be premedicated before walking.
b. The patient who has a PCA running that needs the syringe replaced.
c. The patient who needs to take a scheduled dose of maintenance pain medication.
d. The patient who is experiencing 8/10 pain and has an immediate order for pain medication.

Answer 27

d. The patient who is experiencing 8/10 pain and has an immediate order for pain medication.

Question 28

The nurse is assessing a patient for opioid tolerance. Which finding supports the nurse’s assessment?

a. The patient needed a substantial dose of naloxone.
b. The patient needs increasingly higher doses of opioid to control pain.
c. The patient no longer experiences sedation from the usual dose of opioid.
d. The patient asks for pain medication close to the time it is due around the clock.

Answer 28

b. The patient needs increasingly higher doses of opioid to control pain.

Question 29

A nurse is caring for a patient with rheumatoid arthritis who is now going to be taking 2 acetaminophen tablets every 6 hours to control pain. Which part of the patient’s social history is the nurse most concerned about?

a. Patient drinks 1 to 2 glasses of wine every night.
b. Patient smokes 2 packs of cigarettes a day.
c. Patient occasionally uses marijuana.
d. Patient takes antianxiety medications.

Answer 29

a. Patient drinks 1 to 2 glasses of wine every night.

Question 30

The nurse is caring for a patient who suddenly experiences chest pain. What is the nurse’s first priority?

a. Call the rapid response team.
b. Start an intravenous (IV) line.
c. Administer pain-relief medications.
d. Ask the patient to rate and describe the pain.

Answer 30

d. Ask the patient to rate and describe the pain.

Question 31

The nurse is caring for a group of patients. Which task may the nurse delegate to the unlicensed assistive personnel (UAP)?

a. Administer a back massage to a patient with pain.
b. Assessment of pain for a patient reporting abdominal pain.
c. Administer patient-controlled analgesia for a postoperative patient.
d. Assessment of vital signs in a patient receiving epidural analgesia.

Answer 31

a. Administer a back massage to a patient with pain.

Question 32

A nurse is caring for a patient with chronic pain from arthritis. Which action is best for the nurse to take?

a. Give pain medications around the clock.
b. Administer pain medication before any activity.
c. Give pain medication after the pain is a 7/10 on the pain scale.
d. Administer pain medication only when nonpharmacological measures have failed.

Answer 32

a. Give pain medications around the clock.

Question 33

A nurse is caring for a patient who fell on the ice and has connective tissue damage in the wrist and hand. The patient describes the pain as throbbing. Which type of pain does the nurse document in this patient’s medical record?

a. Visceral pain
b. Somatic pain
c. Centrally generated pain
d. Peripherally generated pain

Answer 33

b. Somatic pain

Question 34

The nurse is caring for an infant in the intensive care unit. Which information should the nurse consider when planning care for this patient?

a. Infants cannot be assessed for pain.
b. Infants respond behaviorally and physiologically to painful stimuli.
c. Infants cannot tolerate analgesics owing to an underdeveloped metabolism.
d. Infants have a decreased sensitivity to pain when compared with older children.

Answer 34

b. Infants respond behaviorally and physiologically to painful stimuli.

Question 35

The nurse is administering ibuprofen to an older patient. Which assessment data causes the nurse to hold the medication? (Select all that apply.)

a. Patient states allergy to aspirin.
b. Patient states joint pain is 2/10 and intermittent.
c. Patient reports past medical history of gastric ulcer.
d. Patient reports last bowel movement was 4 days ago.
e. Patient experiences respiratory depression after administration of an opioid medication.

Answer 35

a. Patient states allergy to aspirin.
c. Patient reports past medical history of gastric ulcer.

Question 36

The nurse is assessing the characteristics of a patient’s pain. Match the characteristic to the question a nurse will ask to determine that specific characteristic.

a. Could you rate your pain on a scale of 0 to 10?
b. How often does it recur?
c. Could you point to the area of pain?
d. Do certain activities worsen the pain?
e. What does the pain feel like?

1. Timing
2. Location
3. Severity
4. Quality
5. Aggravating factors

Answer 36

1. B
2. C
3. A
4. E
5. D