Mod. 3 Pain Flashcards
A patient presents with a crushing injury to the lower extremity. Despite multiple pharmacologic interventions, the pain remains severe and unrelenting. What type of pain is this patient most likely experiencing?
A. Somatic pain
B. Neuropathic pain
C. Intractable pain
D. Visceral pain
C. Intractable pain
Rationale: Intractable pain is a form of chronic, severe pain that does not respond well to standard pharmacologic treatments. It is often seen in patients with severe injuries, including crushing injuries.
A nurse is assessing a patient’s pain and notes that the patient has a low pain threshold. Which statement best describes pain threshold?
A. The maximum amount of pain a person can endure
B. The level at which pain is first perceived
C. A patient’s ability to ignore pain
D. The amount of pain a patient is willing to endure before seeking relief
B. The level at which pain is first perceived
Rationale: Pain threshold is the minimum intensity at which a person begins to perceive pain. Pain tolerance (A & D) refers to the maximum amount of pain a person can endure, while (C) is not a physiological definition of pain.
A patient with acute cholecystitis presents with severe right upper quadrant pain. However, they also report pain in their right shoulder. What is the most likely cause of the shoulder pain?
A. Phantom pain
B. Neuropathic pain
C. Referred pain
D. Somatic pain
C. Referred pain
Rationale: Referred pain occurs when pain is felt in a location different from its source due to shared neural pathways. In this case, gallbladder inflammation (cholecystitis) can cause pain that radiates to the right shoulder due to irritation of the diaphragm, which shares nerve pathways with the shoulder.
Which patient description is most consistent with chronic pain?
A. A patient reports dull lower back pain for over 8 months, along with increased anxiety and difficulty sleeping.
B. A patient reports sharp chest pain that began suddenly and is rated as 10/10 in intensity.
C. A patient presents with severe abdominal pain and reports vomiting and fever over the past 24 hours.
D. A patient reports mild discomfort in the wrist after a recent fall, which has improved with rest and NSAIDs.
A. A patient reports dull lower back pain for over 8 months, along with increased anxiety and difficulty sleeping.
Rationale: Chronic pain is defined as pain lasting longer than 6 months, often accompanied by anxiety, depression, and functional impairment. Acute pain (B, C, D) is typically sudden, short-term, and linked to tissue injury.
A patient with poorly controlled diabetes mellitus reports burning pain, tingling, and numbness in both feet. What type of pain is this?
A. Somatic pain
B. Visceral pain
C. Neuropathic pain
D. Referred pain
C. Neuropathic pain
Rationale: Neuropathic pain occurs due to nerve damage and is common in conditions like diabetes mellitus (diabetic neuropathy). It presents as burning, tingling, or shooting pain, often in the extremities.
A patient who underwent a below-the-knee amputation 2 weeks ago reports sharp, shooting pain in their missing foot. What is the best explanation for this phenomenon?
A. Psychological distress leading to pain perception
B. Activation of severed nerve pathways in the spinal cord
C. A learned pain response from pre-amputation pain
D. Chronic inflammatory response in the residual limb
B. Activation of severed nerve pathways in the spinal cord
Rationale: Phantom pain occurs due to the spontaneous firing of neurons in the spinal cord after the loss of normal sensory input. This pain is real, not psychological (A), and is unrelated to a learned pain response (C) or local inflammation (D).
Which of the following is the most appropriate way to assess a nonverbal patient’s pain?
A. Observe for facial grimacing, restlessness, and changes in vital signs.
B. Assume the patient has no pain if they are not crying.
C. Wait for the patient to communicate pain before administering analgesics.
D. Use only the numerical pain scale for assessment.
A. Observe for facial grimacing, restlessness, and changes in vital signs.
Rationale: Nonverbal patients may show pain through behavioral and physiological indicators such as facial expressions, guarding, increased heart rate, and restlessness. Assuming no pain (B) or waiting for verbal communication (C) can lead to under-treatment. Numerical scales (D) may not be useful in nonverbal patients.
Which of the following patients would likely require opioid analgesia for pain management?
A. A patient with mild lower back strain reporting pain of 3/10 on a numeric scale
B. A patient with post-operative pain from an open abdominal surgery
C. A patient with intermittent headaches relieved by rest and hydration
D. A patient with chronic arthritis pain managed with NSAIDs and physical therapy
B. A patient with post-operative pain from an open abdominal surgery
Rationale: Severe post-operative pain often requires opioid analgesia for adequate control. Mild pain (A), intermittent headaches (C), and chronic arthritis pain (D) are typically managed with NSAIDs, physical therapy, or other non-opioid treatments.
Which characteristic is more common in neuropathic pain than in nociceptive pain?
A. Sharp and localized pain
B. Pain that worsens with movement
C. Burning or tingling sensations
D. Pain that resolves with anti-inflammatory medications
C. Burning or tingling sensations
Rationale: Neuropathic pain often presents as burning, tingling, or shooting sensations due to nerve damage. Nociceptive pain (A, B) is typically sharp and movement-sensitive, and inflammatory pain (D) responds well to NSAIDs.
A 55-year-old patient reports experiencing pain that has persisted for more than six months, even after their initial injury has healed. The patient also mentions feeling increasingly anxious and depressed. Based on this assessment, what type of pain is the patient most likely experiencing?
A. Acute pain
B. Chronic pain
C. Neuropathic pain
D. Nociceptive pain
B. Chronic pain
Rationale:
Chronic pain is defined as pain that lasts longer than six months, even after the initial injury has healed. Anxiety and depression are commonly associated with chronic pain, as it can significantly affect a person’s emotional health.
A nurse is conducting a pain assessment on a patient. Which of the following questions would be most important to ask in order to assess the frequency and pattern of the patient’s pain?
A. “What activities or movements make your pain better or worse?”
B. “How long have you had the pain?”
C. “Where do you feel the pain?”
D. “How often does your pain occur?”
D. “How often does your pain occur?”
Rationale:
To assess the frequency and pattern of the patient’s pain, it is essential to ask how often the pain occurs. This helps determine if the pain is intermittent or continuous and can guide further treatment options.
Why is it important for nurses to understand and assess pain in their patients?
A. Pain is a minor concern and does not significantly affect the patient’s recovery.
B. Nurses’ perceptions of pain do not impact the nurse-patient relationship.
C. Pain can be detrimental to the body and provide clues about a patient’s emotional health.
D. Pain is irrelevant to physical health outcomes.
C. Pain can be detrimental to the body and provide clues about a patient’s emotional health.
Rationale:
Pain is the 5th vital sign and can significantly affect a patient’s physical and emotional health. Understanding pain is essential not only for effective treatment but also for fostering a positive nurse-patient relationship and identifying potential underlying emotional or psychological issues.
Which of the following is a key feature of chronic pain that differentiates it from acute pain?
A. Occurs suddenly and lasts for a short time
B. Typically resolves within 6 months of the injury healing
C. Leads to significant changes in emotional health, such as anxiety and depression
D. Is always localized to one spot
C. Leads to significant changes in emotional health, such as anxiety and depression
Rationale:
Chronic pain often persists for more than 6 months, even after the original injury has healed. This prolonged pain can lead to emotional changes, including anxiety and depression, which is a significant difference from acute pain.
A nurse is assessing a patient’s pain and wants to understand if the pain is localized or radiating. Which of the following questions would be most appropriate to ask?
A. “Does your pain come and go, or is it constant?”
B. “Where do you feel the pain?”
C. “What brought on your pain?”
D. “How long have you had the pain?”
B. “Where do you feel the pain?”
Rationale:
Asking the patient where they feel the pain is crucial to assess whether the pain is localized or radiating. This can provide important insights into the nature of the pain, such as whether it’s referred or originating from a specific area.
When a nurse recognizes that a patient is experiencing chronic pain, which of the following actions should be prioritized in the care plan?
A. Encouraging the patient to rest in bed for most of the day
B. Recommending that the patient manage the pain without any medication
C. Providing resources for emotional support, such as counseling
D. Ignoring the psychological aspects of the pain
C. Providing resources for emotional support, such as counseling
Rationale:
Chronic pain is often associated with emotional distress, such as anxiety and depression. It is important to address the psychological aspects of pain by providing emotional support and counseling resources to help the patient manage both the physical and emotional impact of their pain.
Which of the following statements about acute pain is true?
A. It can last for more than six months and may lead to depression.
B. It typically occurs suddenly and lasts for a short duration, usually less than 6 months.
C. It is usually not accompanied by any changes in emotional health.
D. It always requires long-term management strategies.
B. It typically occurs suddenly and lasts for a short duration, usually less than 6 months.
Rationale:
Acute pain is characterized by a sudden onset and typically resolves within a few days to months, often lasting less than six months. Unlike chronic pain, it does not typically lead to long-term emotional health changes unless it becomes persistent.
