PrepU Comfort

Question 1

I am assessing an adult client with right lower quadrant abdominal pain. The client has no history of prior surgeries, has no allergies, and is physically fit. What should I do during the abdominal exam?

Answer 1

Observe the client’s face for signs of discomfort

Question 2

Instructions for client before an abdominal assessment:

Answer 2

1. empty bladder
2. lie supine with arms to the side
3. Distract client with questions or conversation to help avoid tensing of abdominal musculature

Question 3

A male client develops diarrhea secondary to antibiotic therapy. He is to receive two tablets of diphenoxylate HCl with atropine sulfate (Lomotil) orally as needed for each loose stool. What should I inform the ct. that he may experience?

Answer 3

Dizziness: most common adverse effect of diphenoxylate HCl with atropine sulfate:
others are drowsiness, tachycardia
-The drug has chemical similarity to meperidine (an opioid

Question 4

What must be explained when discussing care for clients with inoperable brain tumors?

Answer 4

hospice care and services

Question 5

A client has been prescribed the nitroglycerine patch. What is advantage of this method of administration over the oval administration?

Answer 5

Longer duration of action.

Question 6

Disadvantages of the topical application of nitroglycerin over the oral admin?

Answer 6

-slower action

Question 7

Nociception includes 4 specific processes:

Answer 7

-transduction
-transmission
-perception
-modulation

Question 8

Which action demonstrates nociception process of pain transmission?

Answer 8

A child quickly removing had when touching a hot object.
Nociception is responsible for a rapid reflex withdrawal from painful stimulus and occurs during transmission

Question 9

—— is based on the belief that the brain processes can strongly influence pain perception.

Answer 9

Imagery

Question 10

—— refers to the process by which a noxious stimulus, such as a burn, releases a number of excitatory compound, which moves pain along the pain pathway.

Answer 10

Transduction

Question 11

Which medication is considered a dual-mechanism analgesic agent?

Answer 11

Tramadol: involves many dif. neurochemicals as in the process of modulation

Question 12

Example of a palliative procedure:

Answer 12

reduction of tumor size to relieve pain

Question 13

Which procedure is a type of surgery that is utilized for diagnostic purposes or for repair?

Answer 13

Laparoscopic

Question 14

Excision of a tumor is classified as what type of procedure?

Answer 14

Curative.

Question 15

During labor, a pregnant client’s doula uses therapeutic touch and massage. Which outcome indicates that these approaches have been effective?

Answer 15

The ct. is not requesting pain medication.

Question 16

What alternative “medication” is an antiemetic (helps with nausea/vomiting)

Answer 16

Ginger

Question 17

What type of pain is processed abnormally by the nervous system

Answer 17

neuropathic

Question 18

What is a sitz bath usually prescribed for?

Answer 18

Substitutes for an ice pack to reduce swelling and promote comfort for an episiotomy, perineal trauma, or inflamed hemorrhoids. (third-degree laceration)

Question 19

Oral cefuroxime should be taken with or without food?

Answer 19

With food: decreases nausea/vomiting

Question 20

Instruction for client taking methadone:

Answer 20

Eat small frequent meals if nauseated

Question 21

Which type of client would benefit from a PRN drug regimen as an effective method of pain control?

Answer 21

postoperative stage with occasional pain

Question 22

Which type of client would benefit from dosage of pain medication around the clock?

Answer 22

Early postoperative period, chronic pain, acute pain

Question 23

How is a straight leg test performed?

Answer 23

Ask client to raise leg to point of pain and then dorsiflex foot to check for herniated nucleus pulposus.

Question 24

What is being assessed when asking a ct. to bend forward and touch their toes?

Answer 24

Range of motion of lumbar spine

Question 25

What is assessed when a ct. touches their chin to their chest?

Answer 25

range of motion of cervical spine

Question 26

Lithium toxicity symptoms:

Answer 26

lethargy, fine hand tremor, polydipsia, cardiac arrhythmias, and report food tasting like metal

Question 27

If lithium toxicity is suspected what are the tests that need to be performed?

Answer 27

serum lithium
electrolyte levels
ECG

Question 28

What is the condition characterized by hyperkinetic movement disorder caused by first- and second-generation antipsychotics?

Answer 28

Tardive dyskinesia

Question 29

Neuroleptic malignant syndrome side effects:

Answer 29

elevated temp, unstable pressure, and rigid muscles

Question 30

Symptoms of acute appendicitis:

Answer 30

fever, nausea, vomiting

Question 31

Symptoms of peritonitis:

Answer 31

rigid abdomen with generalized severe abdominal pain and fever

Question 32

How does cold therapy relieve pain?

Answer 32

-swelling reduced at injury site = tension is less to suture site and less pain/tenderness to surrounding tissues
-decreases nerve conduction velocity

Question 33

What scale is used to help determine pain in adults with cognitive impairment, such as Alzheimer disease?

Answer 33

Faces Pain Scale-Revised (FPS-R)

Question 34

Survival rate of Guillain-Barre syndrome?

Answer 34

approximately 90%. May make a full recovery or suffer from some residual deficits.

Question 35

Aortic dissection may be mistaken for which disease?

Answer 35

Myocardial infarction (MI)

Question 36

I am caring for a patient with peripheral arterial insufficiency. What can I suggest to help relieve leg pain during rest?

Answer 36

Lower limb so it is dependent. Improves perfusion to distal tissues

Question 37

Persistent pain in the forefoot (anterior portion of foot) when patient is resting indicates what?

Answer 37

severe degree of arterial insufficiency and critical state of ischemia.
-known as “rest pain” = worse at night and may interfere with sleep

Question 38

Which finger is used to facilitate palpation of anus?

Answer 38

lubricated index finger of gloved hand. Ask client to bear down before placing pad of index finger in anal opening.