Chapter 5 Practice Questions - Assessment and Care of Patients With Pain

Question 1

A new nurse asks the precepting nurse “What is the best way to assess a client’s pain?” Which response by the nurse is best?

a. Numeric pain scale
b. Behavioral assessment
c. Client’s self-report
d. Objective observation

Answer 1

c. Client’s self-report

Question 2

A new nurse reports to the nurse preceptor that a client requested pain medication, and when the nurse brought it, the client was sound asleep. The nurse states the client cannot possibly sleep with the severe pain the client described. Which response by the experienced nurse is best?

a. “Being able to sleep doesn’t mean pain doesn’t exist.”
b. “Have you ever experienced any type of pain?”
c. “The client should be assessed for drug addiction.”
d. “You’re right; I would put the medication back.”

Answer 2

a. “Being able to sleep doesn’t mean pain doesn’t exist.”

Question 3

The nurse in the outpatient surgery clinic is discussing an upcoming surgical procedure with a client. Which information provided by the nurse is most appropriate for the client’s long-term outcome?

a. “At least you know that the pain after surgery will diminish quickly.”
b. “Discuss acceptable pain control after your operation with the surgeon.”
c. “Opioids often cause nausea but you won’t have to take them for long.”
d. “The nursing staff will give you pain medication when you ask them for it.”

Answer 3

b. “Discuss acceptable pain control after your operation with the surgeon.”

Question 4

A nurse is assessing pain on a confused older client who has difficulty with verbal expression. Which pain assessment tool would the nurse choose for this assessment?

a. Numeric rating scale
b. Verbal Descriptor Scale
c. FACES Pain Scale-Revised
d. Wong-Baker FACES Pain Scale

Answer 4

c. FACES Pain Scale-Revised

Question 5

The nurse is assessing a client’s pain and has elicited information on the location, quality, intensity, effect on functioning, aggravating and relieving factors, and onset and duration. Which question by the nurse would be best to ask the client for completing a comprehensive pain assessment?

a. “Are you worried about addiction to pain pills?”
b. “Do you attach any spiritual meaning to pain?”
c. “How high would you say your pain tolerance is?”
d. “What pain rating would be acceptable to you?”

Answer 5

d. “What pain rating would be acceptable to you?”

Question 6

A nurse is assessing pain in an older adult. Which action by the nurse is best?

a. Ask only “yes-or-no” questions so the client doesn’t get too tired.
b. Give the client a picture of the pain scale and come back later.
c. Question the client about new pain only, not normal pain from aging.
d. Sit down, ask one question at a time, and allow the client to answer.

Answer 6

d. Sit down, ask one question at a time, and allow the client to answer.

Question 7

The nurse receives a hand-off report. One client is described as a drug seeker who is obsessed with even tiny changes in physical condition and is “on the light constantly” asking for more pain medication. When assessing this client’s pain, which statement or question by the nurse is most appropriate?

a. “Help me understand how pain is affecting you right now.”
b. “I wish I could do more; is there anything I can get for you?”
c. “You cannot have more pain medication for 3 hours.”
d. “Why do you think the medication is not helping your pain?”

Answer 7

a. “Help me understand how pain is affecting you right now.”

Question 8

A nurse on the medical-surgical unit has received a hand-off report. Which client would the nurse see first?

a. Client being discharged later on a complicated analgesia regimen.
b. Client with new-onset abdominal pain, rated as an 8 on a 0-10 scale.
c. Postoperative client who received oral opioid analgesia 45 minutes ago.
d. Client who has returned from physical therapy and is resting in the recliner.

Answer 8

b. Client with new-onset abdominal pain, rated as an 8 on a 0-10 scale.

Question 9

A nurse uses the Checklist of Nonverbal Pain Indicators to assess pain in a nonverbal client with advanced dementia but no other medical history except well-controlled hypertension and high cholesterol. The client scores a zero. Which action by the nurse is best?

a. Assess physiologic indicators and vital signs.
b. Do not give pain medication as no pain is indicated.
c. Document the findings and continue to monitor.
d. Try a small dose of analgesic medication for pain.

Answer 9

a. Assess physiologic indicators and vital signs.

Question 10

A nurse asks why several clients are getting more than one type of pain medication instead of very high doses of one medication. Which response by the charge nurse is best?

a. “A multimodal approach is the preferred method of control.”
b. “Clients are consumers and they demand lots of pain medicine.”
c. “We are all much more liberal with pain medications now.”
d. “Pain is so complex it takes different approaches to control it.”

Answer 10

d. “Pain is so complex it takes different approaches to control it.”

Question 11

A client who had surgery has extreme postoperative pain that is worsened when trying to participate in physical therapy. Which intervention for pain management does the nurse include in the client’s care plan?

a. As-needed pain medication after therapy
b. Pain medications prior to therapy only
c. Patient-controlled analgesia with a basal rate
d. Round-the-clock analgesia with PRN analgesics

Answer 11

d. Round-the-clock analgesia with PRN analgesics

Question 12

A nurse on the postoperative inpatient unit receives hand-off report on four clients using patient-controlled analgesia (PCA) pumps. Which client would the nurse see first?

a. Client who appears to be sleeping soundly.
b. Client with no bolus request in 6 hours.
c. Client who is pressing the button every 10 minutes.
d. Client with a respiratory rate of 8 breaths/min.

Answer 12

d. Client with a respiratory rate of 8 breaths/min.

Question 13

A registered nurse is caring for a client who is receiving pain medication via patient-controlled analgesia (PCA). Which action by the nurse indicates the need for further education on pain control with PCA?

a. Assesses the client’s pain level per agency policy.
b. Monitors the client’s respiratory rate and sedation.
c. Presses the button when the client cannot reach it.
d. Reinforces client teaching about using the PCA pump.

Answer 13

c. Presses the button when the client cannot reach it.

Question 14

A client is put on twice-daily acetaminophen for osteoarthritis. Which finding in the client’s health history would lead the nurse to consult with the primary health care provider over the choice of medication?

a. 25–pack-year smoking history
b. Drinking 3 to 5 beers a day
c. Previous peptic ulcer
d. Taking warfarin

Answer 14

b. Drinking 3 to 5 beers a day

Question 15

A nurse is preparing to give a client ketorolac intravenously for pain. Which assessment findings would lead the nurse to consult with the primary health care provider?

a. Bilateral lung crackles
b. Hypoactive bowel sounds
c. Self-reported pain of 3/10
d. Urine output of 20 mL/2 hr

Answer 15

d. Urine output of 20 mL/2 hr

Question 16

A hospitalized client has a history of depression for which sertraline is prescribed. The client also has a morphine allergy and a history of alcoholism. After surgery, several opioid analgesics are prescribed. Which one would the nurse choose?

a. Hydrocodone and acetaminophen
b. Hydromorphone
c. Meperidine
d. Tramadol

Answer 16

b. Hydromorphone

Question 17

A client has received an opioid analgesic for pain. The nurse assesses that the client has a Pasero Scale score of 3 and a respiratory rate of 7 shallow breaths/min. The client’s oxygen saturation is 87%. Which action would the nurse perform first?

a. Apply oxygen at 4 L/min.
b. Attempt to arouse the client.
c. Give naloxone (Narcan).
d. Notify the Rapid Response Team

Answer 17

b. Attempt to arouse the client.

Question 18

An older adult has diabetic neuropathy and often reports unbearable foot pain. About which medication would the nurse plan to educate the client?

a. Desipramine
b. Duloxetine
c. Morphine sulfate
d. Nortriptyline

Answer 18

b. Duloxetine

Question 19

A nurse is caring for four clients receiving pain medication. After the hand-off report, which client would the nurse see first?

a. Client who is crying and agitated
b. Client with a heart rate of 104 beats/min
c. Client with a Pasero Scale score of 4
d. Client with a verbal pain report of 9

Answer 19

c. Client with a Pasero Scale score of 4

Question 20

A nurse is caring for a client who received intraspinal analgesia. Which action by the nurse is most important to ensure client safety?

a. Assess and record vital signs every 4 hours.
b. Instruct the client to report any unrelieved pain.
c. Monitor for numbness and tingling in the legs.
d. Perform frequent neurologic assessments.

Answer 20

b. Instruct the client to report any unrelieved pain.

Question 21

Nurses at a conference learn the process by which pain is perceived by the client. Which processes are included in the discussion? (Select all that apply.)

a. Induction
b. Modulation
c. Sensory perception
d. Transduction
e. Transmission
f. Transition

Answer 21

b. Modulation
c. Sensory perception
d. Transduction
e. Transmission

Question 22

A nurse learns the concepts of addiction, tolerance, and dependence. Which information is accurate? (Select all that apply.)

a. Addiction is a chronic physiologic disease process.
b. Physical dependence and addiction are the same thing.
c. Pseudoaddiction can result in withdrawal symptoms.
d. Tolerance is a normal response to regular opioid use.
e. Tolerance is said to occur when opioid effects decrease.
f. Physical dependence occurs after repeated doses of an opioid.

Answer 22

a. Addiction is a chronic physiologic disease process.
d. Tolerance is a normal response to regular opioid use.
e. Tolerance is said to occur when opioid effects decrease.
f. Physical dependence occurs after repeated doses of an opioid.

Question 23

A postoperative client has an epidural infusion of morphine and bupivacaine. Which actions does the nurse delegate to the assistive personnel (AP)? (Select all that apply.)

a. Ask the client to point out any areas of numbness or tingling.
b. Determine how many people are needed to ambulate the client.
c. Perform a bladder scan if the client is unable to void after 4 hours.
d. Remind the client to use the incentive spirometer every hour.
e. Take and record the client’s vital signs per agency protocol

Answer 23

c. Perform a bladder scan if the client is unable to void after 4 hours.
d. Remind the client to use the incentive spirometer every hour.
e. Take and record the client’s vital signs per agency protocol

Question 24

A client with a broken arm had ice placed on it for 20 minutes. A short time after the ice was removed, the client reports that the effect has worn off and requests pain medication, which cannot be given yet. Which actions by the nurse are most appropriate? (Select all that apply.)

a. Ask for a physical therapy consult.
b. Educate the client on cold therapy.
c. Offer to provide a heating pad.
d. Repeat the ice application.
e. Teach the client relaxation techniques.
f. Offer the client headphones with music.

Answer 24

b. Educate the client on cold therapy.
d. Repeat the ice application.
e. Teach the client relaxation techniques.

Question 25

A nurse learns that there are physical consequences to unrelieved pain. Which factors are included in this problem? (Select all that apply.)

a. Decreased immune response
b. Development of chronic pain
c. Increased gastrointestinal (GI) motility
d. Possible immobility
e. Slower healing
f. Negative quality of life

Answer 25

a. Decreased immune response
b. Development of chronic pain
d. Possible immobility
e. Slower healing
f. Negative quality of life

Question 26

A nurse is studying pain sources. Which statements accurately describe different types of pain? (Select all that apply.)

a. Neuropathic pain sometimes accompanies amputation.
b. Nociceptive pain originates from abnormal pain processing.
c. Deep somatic pain is pain arising from bone and connective tissues.
d. Somatic pain originates from skin and subcutaneous tissues.
e. Visceral pain is often diffuse and poorly localized.

Answer 26

a. Neuropathic pain sometimes accompanies amputation.
c. Deep somatic pain is pain arising from bone and connective tissues.
d. Somatic pain originates from skin and subcutaneous tissues.
e. Visceral pain is often diffuse and poorly localized.

Question 27

A nurse on the postoperative unit administers many opioid analgesics. Which actions by the nurse are best to prevent unwanted sedation as a complication of these medications? (Select all that apply.)

a. Avoid using other medications that cause sedation.
b. Delay giving medication if the client is sleeping.
c. Give the lowest dose that produces good control.
d. Identify clients at high risk for unwanted sedation.
e. Use an oximeter to monitor clients receiving analgesia.

Answer 27

a. Avoid using other medications that cause sedation.
c. Give the lowest dose that produces good control.
d. Identify clients at high risk for unwanted sedation.
e. Use an oximeter to monitor clients receiving analgesia.

Question 28

A client reports a great deal of pain following a fairly minor operation. The surgeon leaves a prescription for the nurse to administer a placebo instead of pain medication. Which actions by the nurse are most appropriate? (Select all that apply.)

a. Consult with the surgeon and voice objections.
b. Delegate administration of the placebo to another nurse.
c. Give the placebo and reassess the client’s pain.
d. Notify the nurse manager of the placebo prescription.
e. Tell the client what medications were prescribed.

Answer 28

a. Consult with the surgeon and voice objections.
d. Notify the nurse manager of the placebo prescription.