chapter 6 jensen

A client was administered PO pain medications at 1530. By what time should the nurse re-assess and document the effects of the pain medication? By end of shift. 1630. 1930. 2130.

1630

The nurse should assess for which pain complaints from a client diagnosed with Type II Diabetes Mellitus? Sharp, stabbing Aching, gnawing Burning, tingling Pain only on movement

Burning, tingling

The nurse is preparing a presentation about cancer pain for a group of caregivers of clients with cancer. Which of the following would the nurse expect to include in the description of this type of pain? Cancer pain is usually acute severe pain. Clients often experience brief severe pain despite medication. Surgery is the primary cause of pain secondary to cancer. Cancer pain is typically treated aggressively.

Clients often experience brief severe pain despite medication.

All the following are signs or symptoms reported by clients with chronic pain except: Apathy Confusion Depression Lethargy

Confusion

The nurse is caring for a child with pain. Which is a consequence of pain in children? Select all that apply. Depressive symptoms Lack of appetite Disruption of family functioning Increased restorative sleep Increased levels of play

Depressive symptoms Lack of appetite Disruption of family functioning

A nurse is providing care for an 84-year-old client who has diagnoses of middle-stage Alzheimer disease and a femoral head fracture. What assessment tool should the nurse use to assess the client's pain? Graphic Rating Scale Numeric Rating Scale (NRS) Verbal Descriptor Scale Faces Pain Scale-Revised (FPS-R)

Faces Pain Scale-Revised (FPS-R)

The nursing student asks the nurse what would be an example of visceral pain. What would be the correct response by the nurse? Gallbladder pain Burn pain Cardiac pain Arthritic pain

Gallbladder pain

A client complains of pain in several areas of the body. How should the nurse assess this client's pain? Ask the client to rate the area with the highest pain level. Mark each site on the client's body with a marker. If pain does not radiate, there is no need to rate that area. Have the client rate each location separately.

Have the client rate each location separately.

The nurse understands the importance of performing an accurate pain assessment. In addition to having the patient rate the pain on a pain scale, other things to assess are the following: (Check all that apply.) Location and duration Quality and description Diet and allergies Alleviating and aggravating factors Urine output and pulse oximetry value

Location and duration Quality and description Alleviating and aggravating factors

The nurse is using a multidimensional pain assessment tool that combines indices measuring pain intensity, mood, pain location (via body diagram), and verbal descriptors, and which includes questions about medication efficacy. Which of these tools is a multidimensional pain assessment tool? McGill Pain Questionnaire Visual Analog Scale Numeric Pain Intensity Scale Combined Thermometer Scale

McGill Pain Questionnaire

The patient comes to the emergency department reporting indigestion and left arm pain. The physician orders an EKG along with drawing of cardiac enzymes. When the results are back, the patient is informed of the diagnosis of heart attack. The indigestion and arm pain are examples of which of the following? Visceral pain Referred pain Cutaneous pain Somatic pain

Referred pain

An elderly farmer has sustained severe injuries after a serious accident involving a combine harvester. At the hospital, he tells the nurse that he thinks the pain he is feeling now is "payback" for living a "mean, selfish life." The nurse recognizes that this response by the man indicates which dimension of pain? Cognitive dimension Sociocultural dimension Affective dimension Spiritual dimension

Spiritual dimension

The patient asks the nurse about possible causes of neuropathic pain. Which is the best response by the nurse? "Patients with diabetes often develop neuropathic." "Surgical procedures can cause neuropathic pain." "Sickle cell pain is a type of neuropathic pain." "Orthopedic trauma is an example of neuropathic pain."

"Patients with diabetes often develop neuropathic."

Which of the following is not released during the stress response? Epinephrine Norepinephrine Dopamine Cortisol

dopamine

Which statement by the patient would the nurse consider to be an alleviating factor? Select all that apply. "Elevating my leg makes the swelling go down in my foot." "I picture myself on the beach listening to the waves." "Listening to music makes my pain much more tolerable." "Lack of sleep makes it harder for me to deal with the pain." "Being on my feet all day makes the swelling in my feet increase."

"Elevating my leg makes the swelling go down in my foot." "I picture myself on the beach listening to the waves." "Listening to music makes my pain much more tolerable."

The nurse is caring for a patient following left hip replacement. Which response by the patient is appropriate when the nurse asks the patient to identify a pain management goal related to the patient's left hip pain? "I want my pain to be 3 or less." "I want to be able to sleep on my left side." "Climbing stairs makes my pain worse." "My pain is a 5 all the time."

"I want my pain to be 3 or less."

A nursing instructor is teaching students how to assess a patient's pain. The instructor emphasizes that there are many misconceptions about pain. The instructor realizes that a student needs further direction when the student states: "Patients with chronic illnessess can have chronic pain." "Nurses are the best authority on pain." "Acute pain can be as intense as chronic pain." "Chronic pain can be referred to as persistent pain."

"Nurses are the best authority on pain."

Recently, lung cancer has metastasized to the bones of a 68-year-old client, precipitating a sudden increase in his pain. The client's wife and daughter are concerned about the consequent increase in the amount of hydromorphone the client requires, citing the risk of addiction. How can the nurse best respond to the family's concern? "Even when he becomes addicted, we can take comfort knowing that his pain is controlled." "It's actually a myth that clients can become addicted to hospital narcotics." "If he ends up needing higher doses to resolve the pain, we will discontinue the drug." "There's a very minimal risk of addiction, and controlling his pain is our first concern."

"There's a very minimal risk of addiction, and controlling his pain is our first concern."

A nurse is performing a detailed pain assessment of a client who has sought care for debilitating migraines. When assessing for precipitating factors, what question should the nurse ask? "Is there anything that's given you relief in the past?" "Have your migraines gotten more severe in the last few months?" "What were you doing immediately before your last migraine?" "How long does a typical migraine last?"

"What were you doing immediately before your last migraine?"

The nurse is assessing a client's pain. Which question would be most appropriate to ask the client to identify precipitating factors that might have exacerbated the pain? "What were you doing when the pain first stated?" "Do concurrent symptoms accompany the pain?" "When did you first notice the pain?" "Is the pain continuous or intermittent?"

"What were you doing when the pain first stated?"

The nurse prepares to update the care plan of a client recovering from abdominal surgery. Which diagnosis should the nurse select that most appropriately addresses the client's pain? Acute pain related to abdominal wound Chronic pain related to surgical procedure Impaired physical mobility related to abdominal pain Ineffective breathing pattern related to abdominal pain

Acute pain related to abdominal wound

A client is diagnosed with chronic non-malignant pain. The nurse understands that this client has experienced this pain for at least how many months? 3 6 9 12

6

A patient is reporting pain and rates it as 7 on a scale of 1 to 10. When the nurse asks him to decribe the pain, he states, "It feels like a knife is stabbing or cutting me." The nurse knows that this type of pain is conducted by which fibers? C fibers A-delta fibers AC fibers P fibers

A-delta fibers

As a nurse is adjusting a client's hospital bed, the nurse accidently pinches a finger between the bed and the wall. Which of the following components is involved in the transduction of the pain the nurse feels? A-delta fibers C-fibers K-fibers L-beta fibers

A-delta fibers

The nurse is attempting to assess pain in a nonverbal, very lethargic client. The client just arrived back to his room after an MRI scan and appears restless. There are no visitors in the room with the client. What is the nurse's best action? Assess pain using the FACES scale. Administer a trial dose of analgesia. Complete the Brief Pain Inventory. Use the FLACC scale to assess pain.

Administer a trial dose of analgesia.

A post-operative client is observed breathing 24 breaths/minute while complaining of 10/10 abdominal pain. The client's oxygen saturation is 90% on 2 liters nasal cannula. What is the nurse's priority action? Administer prescribed analgesia as ordered. Teach and encourage incentive spirometry use. Explain why deep breathing and coughing is important. Manually ventilate client with ambu bag at bedside.

Administer prescribed analgesia as ordered.

A nurse is admitting a client to the postsurgical unit from the postanesthetic care unit. The nurse has transferred the client from the stretcher to a bed and asked the client if he is experiencing pain. The client acknowledges that he is in pain. What would the nurse do next? Ask the client to briefly explain his cultural background. Assess the client's pain by gathering subjective data from the client. Assess the client's self-management skills. Assess the client's pain by obtaining a set of vital signs.

Assess the client's pain by gathering subjective data from the client.

A nurse is admitting a client to the postsurgical unit from the postanesthetic care unit. The nurse has transferred the client from the stretcher to a bed and asked the client if he is experiencing pain. The client acknowledges that he is in pain. What would the nurse do next? Ask the client to briefly explain his cultural background. Assess the client's pain using a mnemonic device. Assess the client's self-management skills. Assess the client's pain by obtaining a set of vital signs.

Assess the client's pain using a mnemonic device.

pain. The client acknowledges that he is in pain. What would the nurse do next? Ask the client to briefly explain his cultural background. Assess the client's pain using a mnemonic device. Assess the client's self-management skills. Assess the client's pain by obtaining a set of vital signs.

Assess the client's pain using a mnemonic device.

A patient is reporting pain and informs the nurse that it has become unbearable. The first thing the nurse should do is what? Check the patient's record for allergies. Check the physician's orders to see what pain medication to administer. Assess the site and intensity of the pain. Call the physician.

Assess the site and intensity of the pain.

The nurse is working on a pediatric unit caring for a 4-year-old who is recovering from the surgical repair of the pelvis. When assessing the patient's pain, what is the most appropriate pain assessment tool for the nurse to use? Face, Legs, Activity, Cry, Consolability Scale Visual Analog Scale FACES Pain Scale Numeric Pain Intensity Scale

FACES Pain Scale

A nurse is caring for a 4-year-old patient who is crying and appears to be in pain. The nurse begins to assess the pain by showing pictures on a chart and asking the patient to point to the one that best represents the pain he is experiencing. This is an example of which of the following: FLACC scale FACES scale VISUAL analog scale Numeric scale

FACES scale

The nurse is caring for a 4-week-old postoperative patient. The most appropriate pain assessment tool would be the: Face, Legs, Activity, Cry, Consolability Scale FACES Pain Scale Numeric Pain Intensity Scale Combined Thermometer Scale

Face, Legs, Activity, Cry, Consolability Scale

A patient is experiencing acute pain and has asked the nurse for medication. The patient rates the pain as an 8 on a scale of 0 to 10. During assessment, a physiological response from the patient that the nurse can expect is: Decreased pulse Diaphoresis Hypotension Flaccid muscles

Diaphoresis

A nurse is assessing the effect of a client's chronic back pain on his affective dimension. Which question should the nurse ask for this assessment? What medical conditions do you have? Where is the pain located? What is the highest level of education you've completed? How does the pain influence your overall mood?

How does the pain influence your overall mood?

A hospital's protocols for assessment have been modified in light of standards established by the Joint Commission. What change would bring practice into alignment with these standards? Teaching all new clients about the basic pathophysiology of pain Assessing clients' pain objectively rather than subjectively Identifying pain as the fifth vital sign and assessing clients accordingly Triaging clients according to the type of pain that they are experiencing

Identifying pain as the fifth vital sign and assessing clients accordingly

The nurse is teaching the patient about the importance of treating pain and informs the patient that if pain is not treated adequately, it can lead to many different complications. Which of the following are some examples? (Check all that apply.) Impaired pulmonary function Decreased immune response Decreased hematocrit count Longer hospital stays Chronic regional pain syndrome

Impaired pulmonary function Decreased immune response Longer hospital stays Chronic regional pain syndrome

Mrs. D. has presented to the clinic six times over the past 8 weeks with complaints of leg pain that is taking a toll on her activities of daily living and mental health. Some clinic staff members have begun rolling their eyes when they see Mrs. D enter the clinic; there is a consensus that her complaints of pain are an attention-getting strategy. The nurse can find no objective indications for the client's pain, which the client claims is worsening over time. Which of the following actions should the nurse choose? Order diagnostics to confirm or rule out the existence of the pain. Implement treatment that is based on the fact that the pain is real and debilitating. Implement an analgesic regimen that is especially conservative to gauge the client's response. Tactfully inquire whether Mrs. D. is using her complaints of pain to avoid acknowledging other physical or psychosocial problems.

Implement treatment that is based on the fact that the pain is real and debilitating.

A nurse is assessing the vital signs of a patient who is moaning with pain. What would be the expected findings? Decreased pulse and respirations Increased pulse and blood pressure Increased temperature No change from usual results

Increased pulse and blood pressure

Beliefs of health care providers can serve as barriers to an accurate assessment of a client's pain. Which of the following beliefs will not be likely to impair the assessment of pain? Old people have more pain which is to be expected. Infants can feel pain and may respond with crying or agitation. A sleeping person feels no pain. Persons asking for pain medication but who are showing no other evidence of pain are just addicted to the medication.

Infants can feel pain and may respond with crying or agitation.

Pain affects patients in different ways, with no boundaries. Which of the following are possible causes of pain? (Check all that apply.) Injury Surgery Chronic illnesses Gender No identifiable cause

Injury Surgery Chronic illnesses No identifiable cause

A nurse is assessing the pain of a client who has had major surgery. The client also has been experiencing depression. Which of the following principles should guide the nurse's assessment of a client's pain? The client is likely experiencing less pain than he is reporting. The client's depression exists independently of the level of pain. It is likely that the client's pain rating will be influences by his emotional state. The degree of surgery will be the key indicator for level of pain experienced.

It is likely that the client's pain rating will be influences by his emotional state.

A nurse is creating a concept map of the pathophysiology of pain. The nurse should identify which of the following as being responsible for transmitting pain sensations to the central nervous system? Transduction Modulation Nociceptors Cytokines

Nociceptors

A patient recovering from a stroke complains of pain. The nurse suspects this patient is most likely experiencing which type of pain? Nociceptive Neuropathic Somatic Idiopathic

Neuropathic

A client with an amputated arm tells a nurse that sometimes he experiences throbbing pain or a burning sensation in the amputated arm. What kind of pain is the client experiencing? Cutaneous pain Visceral pain Chronic pain Neuropathic pain

Neuropathic pain

An adolescent client who suffered a crushing leg injury due to an all terrain vehicle (ATV) rollover, complains of painful tingling in the affected leg and inability to bend the knee. The client's leg is swollen. What is the nurse's priority action? Administer the prescribed non-steroid anti-inflammatory medication. Elevate the client's leg on several pillows and apply ice. Raise the head of the bed to High Fowler's position. Notify the healthcare provider immediately.

Notify the healthcare provider immediately.

Which of the following principles should the nurse integrate into the pain assessment and pain management of pediatric patients? Pain assessment may require multiple methods in order to ensure accurate pain data. The developing neurological system children transmits less pain than in older patients. Pharmacologic pain relief should be used only as an intervention of last resort. A numeric scale should be used to assess pain if the child is older than 5 years of age.

Pain assessment may require multiple methods in order to ensure accurate pain data.

A client enters the emergency department moaning and complaining of severe pain in his lower back. Which of the following clinical manifestations should the nurse expect to see in this client as a physiologic response to pain? Select all that apply. Hypoglycemia Perspiration Increased heart rate Increased intestinal motility Sleeplessness

Perspiration Increased heart rate Sleeplessness

When performing a pain assessment the client should be asked to provide all the following information except: Effects of pain on activities of daily living Physiological classification Treatment expectations Effectiveness of treatment

Physiological classification

Patients have different levels of tolerance for pain. Research has proven an increased sensitivity to pain in which of the following groups? Pregnant women Preterm newborns Toddlers School-age children

Preterm newborns

The nurse is assessing hospitalized post-operative pain and has asked the client to rate his pain, describe it, state the location and onset of when it started. What other question should the nurse include in this pain assessment? Provoking and alleviating factors Availability of medication Financial resources to obtain medication Medications taken in the past

Provoking and alleviating factors

The patient with a cognitive impairment sometimes cannot rate pain on a scale of 0 to 10. In such a case, the nurse is aware of other cues to assess the patient's pain. Which of the following is correct? Showing signs of having a difficult personality and yelling Restlessness, guarding Loss of appetite and decreased urine output Decreased blood pressure and pulse rate

Restlessness, guarding

Which of these clinical manifestations are physiologic responses to pain? Select all that apply. Sleeplessness Perspiration Increased heart rate Increased intestinal motility Increased insulin

Sleeplessness Perspiration Increased heart rate

A client who suffers from arthritis complains of sharp pain in her knees and elbows. The nurse recognizes this is what type of pain? Visceral Somatic Cutaneous Referred

Somatic

Which would the nurse recognize as a barrier to assessing pain in the older adult? Select all that apply. The belief that pain is a normal part of the aging process. Older adults may not display an outward reaction to pain. Older adults with pain may fear becoming dependent on others. The unavailability of pain assessment tools for the older adult. Treatment of pain can lead to greater quality of life.

The belief that pain is a normal part of the aging process. Older adults may not display an outward reaction to pain. Older adults with pain may fear becoming dependent on others.

The nurse is explaining the difference between acute pain and chronic pain to the patient. Which should the nurse include in the explanation? The cause of acute pain can be identified. The duration of chronic pain is short. Chronic pain is caused by damage to nerves. Acute pain lasts longer than 3 to 6 months.

The cause of acute pain can be identified.

A nurse is meeting for the first time a 42-year-old client whose visit to the clinic has been prompted by her chief complaint of ongoing lower back pain. Which of the following approaches to pain assessment should the nurse use when assessing the client's pain? The nurse should implement a pain assessment tool that is as detailed as possible. The nurse should allow the client to guide the direction and character of assessment to identify her priorities. The nurse should prioritize objective data to quantify and validate the client's pain. The nurse should use a pain assessment tool that is simple but still addresses the major parameters of pain.

The nurse should use a pain assessment tool that is simple but still addresses the major parameters of pain.

Who is the authority on the presence and extent of pain experienced by a patient? The patient An anesthesiologist A nurse A surgeon

The patient

The nurse recognizes that a barrier to successful pain management for the patient with opioid tolerance is: The patient does not experience pain relief with usual doses of opioids. The patient has the normal physiologic response to painful stimuli. The repeated use of opioids causes their bodies to become less sensitive to pain. Appropriate pain assessment tools are unavailable for this type of patient.

The patient does not experience pain relief with usual doses of opioids.

A patient reports after a back massage that his lower back pain has decreased from 8 to 3 on the pain scale. What opioid neuromodulator may be responsible for this increased level of comfort? The release of endorphins The release of insulin The release of melatonin The release of dopamine

The release of endorphins

A nurse is caring for a client who was administered opioid narcotics. The client complains of constipation. Which of the following is another potential side effect of opioid narcotics? Sedation Anxiety Diarrhea Insomnia

sedation

The nurse is assessing the client's perception of pain and its intensity and quality. Which dimension is the nurse evaluating? Physical Sensory Behavioral Cognitive

sensory

When assessing the client for pain, the nurse should doubt the client when he or she describes the pain. assess for underlying causes of pain, then believe the client. believe the client when he or she claims to be in pain. assess for the presence of physiologic indicators (such as diaphoresis, tachycardia, etc.), then believe the client.

believe the client when he or she claims to be in pain.

The nursing class is learning about pain assessment. Which of the following is a manifestation of pain? Confusion Bracing Pressured speech Apathy

bracing

A client who has fractured her arm is describing her pain as "excruciating." The nurse determines that the client is experiencing what type of pain? Cutaneous Visceral Deep somatic Radiating

deep somatic

A patient who was in an automobile accident a week ago is at home recovering from her injuries. She contacts her primary care provider's office to report that she still has severe pain in her back, resulting from an injury to that region, that has not been lessened by two different pain relievers that the physician had prescribed for her. The nurse recognizes this as which type of pain? Intractable Chronic Visceral Referred

intractable

A nurse is using the FLACC (Face, Legs, Activity, Cry, Consolability) scale for pediatric pain assessment to assess for pain in a 6-month-old client. Which of the following findings on this assessment tool would indicate the strongest pain in the client? Occasional grimace or frown Whimpering Lying quietly Kicking

kicking

A client describes pain in the soles of both feet as constantly burning. Which type of pain should the nurse suspect this client is experiencing? somatic referred visceral neuropathic

neuropathic

In addition to pain intensity, what is another basic element of a pain assessment? Quality Focused goal History Preferred assessment tool

quality

A group of students is reviewing information about pain transmission and the fibers involved. The students demonstrate understanding when they state that A-delta primary afferent fibers transmit pain that is felt as which of the following? Burning Throbbing Sharp Aching

sharp

Which of the following would the nurse use as the primary assessment for a client's pain? The client's spiritual view of the pain Current pain therapies used The client's report of the pain Psychosocial questions related to perceptions

the clients report of the pain