PAIN MANAGEMENT

Question 1

The nurse is caring for client with acute pain. Which of the following should the nurse recognize as objective signs of pain?

Answer 1

• Pulse rate 104

- increased respiratory depth and frequency

Question 2

The length of time that a nurse should leave heat to an injured hip of a patient is no longer than:

Answer 2

30 minutes

Question 3

To perform a nursing assessment correctly, a nurse must remember that pain perception involves several central nervous system processes. Which are examples of CNS processes?

Answer 3

Efferent pathways stimulate the spinal cord to recognize the location of the pain.

Question 4

A nurse is teaching a patient how to use a transcutaneous electrical nerve stimulation (TENS) unit and how it works. What is the most appropriate information for the nurse to relay?

Answer 4

“This unit stimulates both the skin and the underlying tissues to decrease the intensity of the pain.”

Question 5

What is the advantage of taking a nonsteroidal anti-inflammatory drug (NSAID) that is a COX 2 inhibitor?

Answer 5

There are fewer adverse GI effects.

Question 6

A pt experiencing chronic pain as a result of metastatic cancer has a new order of Fentanyl transdermal patch. The initial patch was applied at 0800 on Monday. At 2000 on Monday, the patient reports a pain level of 8 out of 10. The nurse’s best response is to:

Answer 6

Provide a PRN analgesic medication as ordered.

Question 7

Which additional nursing interventions would be effective with pain management in the pediatric population? (select all that apply)

Answer 7

Provide diversional activities such as coloring, puzzles, and games.
Allow uninterrupted sleep and rest.
Encourage parental participation with caregiving to diminish the child’s anxiety.
Perform hand hygiene measures.

Question 8

The nurse is completing an assessment on a nonverbal adult patient. Which type of pain scale assessment tool is the most accurate to use?

Answer 8

FLACC

Question 9

A patient continues to report pain after the administration of the prescribed analgesic. Why should the nurse change the nursing care plan?

Answer 9

The patient’s pain threshold has lowered.

Question 10

The length of time that a nurse should leave heat to an injured hip of a patient is no longer than:

Answer 10

30 minutes

Question 11

A nurse administers nalbuphine (Nubain), an opioid agonist-antagonist, to a 78-year-old patient. The family is worried about the patient and thinks that this drug is too strong and will cause harm. What should the nurse assure the family regarding this drug?

Answer 11

Blocks the side effects observed in opioid agonists.

Question 12

A patient who is obviously in pain refuses the morphine that has been prescribed for pain control because of a fear of addiction. What should the nurse explain is the estimated percentage of patients taking prescribed pain protocols who become addicted?

Answer 12

Less than 1%

Question 13

Which patient assessment would indicate to the nurse that salicylate toxicity is occurring?

Answer 13

Tinnitus

Question 14

Which sign or symptom displayed by a patient would be indicative of opiate withdrawal?

Answer 14

Muscle cramps

Question 15

Two patients are hospitalized with the same diagnosis, but one is 23 years old, with acute recent pain from an injury, and the other is 64 years old, with the pain of a long-standing duration of several years. What is the difference in the anticipated assessments?

Answer 15

Older adult patients with chronic pain usually report lower levels of pain much less severe than they really are.

Question 16

A patient is taking meperidine (Demerol) as needed for moderate to severe pain following an open appendectomy. The nurse assesses the following: current pain level 2, temperature 99° F, BP 130/76, respirations 10, lung sounds clear, abdomen soft and tender, bowel sounds present. Based on this assessment information, the priority nursing diagnosis is:

Answer 16

“Altered Breathing Pattern”

Question 17

Which common adverse effects are associated with opiate agonists? (Select all that apply.)

Answer 17

Dizziness
Orthostatic hypotension
Respiratory depression

Question 18

Which medication used for pain is contraindicated when a patient is taking warfarin (Coumadin)?

Answer 18

Hint: it’s an NSAID, and it decreases the effects of Coumadin. (ibuprofen)

Question 19

A nurse is notified when a patient, newly admitted with liver and gallbladder disease, complains of pain in the right middle back and asks for some pain medication. What is the best interpretation of this reported assessment by the nurse?

Answer 19

The patient has referred pain sensations. The nurse should follow orders for administering pain medication.

Question 20

A nurse is administering morphine IM, which was prescribed for a patient reporting severe pain. What should be the nurse’s primary assessment focus on to evaluate the patient’s response to this drug?

Answer 20

Lowered pain threshold.

Question 21

What are the standards for pain management published by The Joint Commission (TJC)? (Select all that apply.)

Answer 21

Record results of analgesia
Give adequate discharge instruction about pain relief
Educate patients about pain control methods

Question 22

A patient with an extensive abdominal surgical procedure is assessed by the nurse as having predictable pain. How often should the nurse administer analgesics to this patient to be most effective?

Answer 22

Around the clock.

Question 23

What intervention of pain control exemplifies the gate control methods of pain relief?

Answer 23

Giving a massage

Question 24

A patient who had a myocardial infarction 2 days earlier has been eating well, is ambulating with assistance, and is receiving antibiotics and morphine by intravenous (IV) drip. The patient complains of constipation this morning. What should the nurse assess as the probable cause of constipation?

Answer 24

Administration of analgesic medication

Question 25

What assessment should a nurse make to evaluate the presence of pain in a patient who is cognitively impaired?

Answer 25

Increasing confusion