ATI Pain
Correct terms: -stress -culture -social support -disease severity
A charge nurse is reviewing factors that can affect a client's perception of pain with a newly licensed nurse. Which of the following should the charge nurse include? (SATA)
a client who had surgery 3 hours ago and is receiving IV hydromorphone PRN
A nurse is reviewing information for several clients on the unit. The nurse should recognize that which of the following clients is at greatest risk for respiratory depression?
Correct terms: -consider each client's cultural preferences -determine the effectiveness of nonpharmacological strategies -use a pain scale specific to each client's cognitive abilities
A nurse is reviewing the plan of care for several clients who are receiving tx for pain. Which of the following actions should the nurse plan to take to evaluate the clients' pain control? (SATA)
Correct terms: -respiratory rate -capnography -oxygen saturation
a nurse is monitoring a client who is 2 hours postoperative and is receiving morphine via PCA pump. Which of the following findings should the nurse plan to monitor to detect opioid-induced ventilatory impairment (OIVI)? (SATA)
correct terms: -grimacing -restlessness -increased diaphoresis
A nurse is assessing a client who is nonverbal for the presence of pain. Which of the following findings indicate an increased level of discomfort? (SATA)
Correct terms: -"a client's religious beliefs might affect the way they respond to pain" -"the client's past pain experiences are not related to their current pain and pain management" -"pain control might be harder to achieve if the nurse and client speak different primary languages"
A nurse is assisting with a staff in-service regarding pain control. Which of the following statements by a staff member indicates an understanding of the information? (SATA)
20 minutes (followed by at least a 20. min break after usage)
A nurse is caring for a client who has a prescription for heat therapy for knee pain. The nurse should apply heat therapy to the client's knee for how long?
Administer 1 mg IM (the nurse should administer the lowest dose when there is a range and the pt has never taken that med before. If ineffective, the nurse can increase the dosage up to the max amount of range prescribed)
A nurse is caring for a client who has a prescription for hydromorphone 1 to 2 mg IM every 4 hours as needed for a pain rating of 4 to 6 on a 0 to 10 scale. The client has never taken hydromorphone before. Which of the following actions should the nurse plan to take?
Offer to assist the client with nonpharmacological relief strategies.
A nurse is caring for a client who has a prescription for oxycodone 5 to 10 mg PO every 4 to 6 hours as needed for pain rating 7 to 10 on a 0 to 10 scale. Fifteen minutes after receiving the dose, the client reports to the nurse their pain is still a 7 and has not changed. Which of the following actions should the nurse take?
the client is diaphoretic
A nurse is caring for a client who has kidney stones. Which of the following manifestations is an objective indicator of pain?
Negligence
A nurse is caring for a client who has severe pain and repeatedly asks for pain medication. The nurse is busy and forgets to assess the client's pain and administer prescribed pain medication. Which of the following can the nurse be charged with?
Naloxone (reversal agent for respiratory depression caused by opioids) (lidocaine is a local anesthetic, prednisone is a corticosteroid that is an adjuvant medication to assist with pain relief, amitriptyline is a tricyclic antidepressant that can be used as an adjuvant med to assist with pain releif)
A nurse is caring for a client who is postoperative following abdominal surgery and has a morphine PCA pump. Which of the following medications should the nurse ensure is available in case the client develops respiratory depression?
Chronic pain
A nurse is caring for a client who reports muscle pain to the lower back that has persisted for over a year after a motor-vehicle crash. In which way should the nurse categorize the client's pain?
Correct terms: -a 3 year old toddler who has a fractured femur -a 14 year old client who has a severe cognitive and developmental delay -a 5 year old preschooler who is experiencing pain during a sickle cell crisis (FLACC pain scale is recommended for children 2 months to 7 years)
A nurse is caring for a group of clients on the pediatric unit. For which of the following clients should the nurse use the FLACC pain scale to determine their pain level? (SATA)
Evaluate the client for pain by observing their behavior.
A nurse is caring for an older adult client who has a cognitive impairment and is postoperative. Which of the following actions should the nurse take?
correct terms: -TENS -massage -acupuncture -cold therapy
A nurse is discussing cutaneous stimulation with a client who has back pain. Which of the following methods should the nurse include? (SATA)
Correct terms: -fear of addiction (leads to pain being undertreated or not treated at all) -belief that pain is an expected part of their illness -inadequate pain assessment
A nurse is discussing end of life pain management with a group of coworkers. Which of the following should the nurse include as barriers to end of life pain management? (SATA)
Correct terms: -face -legs -consolability
A nurse is discussing the FLACC scale with a newly licensed nurse. Which of the following categories should the nurse include? (SATA)
correct terms: -muscular pain -backache -menstrual discomfort
A nurse is discussing the use of heat therapy with a newly licensed nurse. The nurse should include that heat therapy is effective for which of the following conditions? (SATA)
Correct terms: -"you can be taught how to use TENS therapy at home" -"the TENS therapy delivers low-voltage electrical impulses to the skin over the painful areas" -"we will adjust the intensity, pulse rate, and duration of the electrical pulses during your therapy"
A nurse is discussing transcutaneous electrical nerve stimulation (TENS) treatment with a client who has chronic lower back pain. Which of the following statements should the nurse include? (SATA)
"can you point to where you are having your pain?"
A nurse is evaluating a client's pain level using the PQRST mnemonic. Which of the following questions should the nurse ask to evaluate the letter "R"?
A client who has diabetes mellitus and reports bilateral burning foot pain without signs of injury
A nurse is evaluating a group of clients who are experiencing pain. Which of the following clients should the nurse identify as experiencing pain. Which of the following clients should the nurse identify as experiencing neuropathic pain?
A nurse provides a client with the opportunity to take an IM injection or oral medication for pain relief
A nurse is planning to teach coworkers about the legal and ethical principles used with pain management. Which of the following examples should the nurse include as an example of autonomy?
"Your family member has the right to receive effective pain management"
A nurse is providing end of life care for a client who is unresponsive and near death. The client's family asks the nurse about managing the client's pain. Which of the following statements should the nurse make to the client's family?
"You should write down the pain interventions you use and your pain rating before and after"
A nurse is reviewing a new prescription with a client who reports difficulty managing their chronic pain. Which of the following statements should the nurse include?
"I will keep the morphine bottle in a locked cabinet in my kitchen"
A nurse is reviewing discharge instructions for a client who has a prescription for morphine oral solution 10 to 20 mg every 4 hours PRN. Which of the following statements by the client indicates an understanding of the instructions?
"Justice allows the client the opportunity to be treated fairly"
A nurse is teaching staff about the ethical principle of justice and how it relates to pain management for clients. Which of the following statements should the nurse make?
