Comfort / Rest

Which substance reduces the transmission of pain? Endorphins Substance P Serotonin Acetylcholine

Endorphins

A client who is suspected of having a spinal cord tumor is reporting pain. Upon further assessment, the nurse would anticipate that the client would report that the pain increases when in which position? Supine Prone Semi-Fowler's Side-lying

Prone The nurse is alert for early reports of back pain, which occurs in the region of the tumor. The pain typically increases when the client is in the prone position.

A nurse is teaching a client about pain management after surgery. Which client statement indicates the teaching was effective? "I will need to learn how to give myself pain medication by injection for when I go home." "I will ask for pain medication when the pain becomes unbearable." "I will support my incision with my hands when I cough and do my deep breathing exercises." "The pain from my incision will be very similar to my arthritis pain."

"I will support my incision with my hands when I cough and do my deep breathing exercises."

A client has an initial visit with a chiropractor and states to the nurse, "I am already in pain and am so afraid that the doctor may cause even more." What are therapeutic responses from the nurse? Select all that apply. "The chiropractor may use painless electrical stimulation." "Various relaxation techniques may be used to promote muscle relaxation." "We may use heat or ice on the affected area." "The chiropractor may recommend dietary supplements." "There will be small needles used to reduce pain."

"The chiropractor may use painless electrical stimulation." "We may use heat or ice on the affected area." "Various relaxation techniques may be used to promote muscle relaxation." "The chiropractor may recommend dietary supplements."

A nurse is explaining pain control methods to a patient undergoing a bowel resection. The patient is interested in the PCA pump and asks the nurse to explain how it works. What would be the nurse's correct response? "The pump allows the patient to be completely free of pain during the postoperative period." "The pump allows the patient to take unlimited amounts of medication as needed." "The pump allows the patient to choose the type of medication given postoperatively." "The pump allows the patient to self-administer limited doses of pain medication."

"The pump allows the patient to self-administer limited doses of pain medication." PCA infusion pumps allow patients to self-administer doses of pain-relieving medication within health care provider-prescribed time and dose limits. Patients activate the delivery of the medication by pressing a button on a cord connected to the pump or a button directly on the pump.

A patient is postoperative following an emergency cesarean section birth. The patient asks the nurse about the use of pain medications following surgery. What would be a correct response by the nurse? "It's not a good idea to ask for pain medication regularly as it can be addictive." "It is better to wait until the pain is severe before asking for pain medication." "It's natural to have to put up with pain after surgery and it will lessen in intensity in a few days." "Your doctor has prescribed pain medications for you, which you should request when you have pain."

"Your doctor has prescribed pain medications for you, which you should request when you have pain."

The three types of responses to pain are physiologic, behavioral, and affective. Which are examples of behavioral responses to pain? Select all that apply. A patient cradles a wrist that was injured in a car accident A child is moaning and crying due to a stomachache A patient's pulse is increased following a myocardial infarction A patient in pain strikes out at a nurse who attempts to provide a bath A patient who has chronic cancer pain is depressed and withdrawn A child pulls away from a nurse trying to give an injection

A patient cradles a wrist that was injured in a car accident A child is moaning and crying due to a stomachache A child pulls away from a nurse trying to give an injection

A nurse is monitoring patients in a hospital setting for acute and chronic pain. Which patients would most likely receive analgesics for chronic pain from the nurse? Select all that apply. A patient is receiving chemotherapy for bladder cancer An adolescent is admitted to the hospital for an appendectomy A patient is experiencing a ruptured aneurysm A patient who has fibromyalgia requests pain medication A patient has back pain related to an accident that occurred last year A patient is experiencing pain from second-degree burns

A patient is receiving chemotherapy for bladder cancer A patient who has fibromyalgia requests pain medication A patient has back pain related to an accident that occurred last year

A nurse is assessing a patient receiving a continuous opioid infusion. For which related condition would the nurse immediately notify the primary care provider? A respiratory rate of 10/min with normal depth A sedation level of 4 Mild confusion Reported constipation

A sedation level of 4

The nurse is reviewing a client's electronic medical record and notices that the client has recently experienced dyspareunia. The nurse knows that this is an effect of aging on the female reproductive system. What is the best description of dyspareunia that the nurse can share with the nursing student who is going to see this client with the nurse? The uterus prolapses and falls into the vagina. A woman experiences painful intercourse. A woman experiences female climacteric. Bones become brittle and porous and fracture more easily.

A woman experiences painful intercourse.

When the nurse assists a patient recovering from abdominal surgery to walk, the nurse observes that the patient grimaces, moves stiffly, and becomes pale. The nurse is aware that the patient has consistently refused pain medication. What would be a priority nursing diagnosis for this patient? Acute Pain related to fear of taking prescribed postoperative medications Impaired Physical Mobility related to surgical procedure Anxiety related to outcome of surgery Risk for Infection related to surgical incision

Acute Pain related to fear of taking prescribed postoperative medications

The nurse is preparing to send a child with cancer for a radiation treatment. Which medication should the nurse provide to premedicate the child for this procedure? Analgesic Antiemetic Antineoplastic Antipyretic

Antiemetic Radiation therapy causes nausea because it destroys rapid-growing cells. Among these are the cells of the stomach lining, the reason that nausea occurs.

Applying the gate control theory of pain, what would be an effective nursing intervention for a patient with lower back pain? Encouraging regular use of analgesics Applying a moist heating pad to the area at prescribed intervals Reviewing the pain experience with the patient Ambulating the patient after administering medication

Applying a moist heating pad to the area at prescribed intervals

A client has a transurethral resection of the prostate to treat benign prostatic hyperplasia. The client returns to the room with continuous bladder irrigation and reports bladder pain. What is the priority nursing action? Calculate the client's recent intake and output. Notify the healthcare provider immediately. Assess irrigation catheter for patency and drainage. Administer morphine sulfate 2 mg IV, as prescribed.

Assess irrigation catheter for patency and drainage.

A patient tells the nurse she is having pain in her right lower leg. How does the nurse determine if the patient has developed a deep vein thrombosis (DVT)? By palpating the skin over the tibia and fibula By documenting daily calf circumference measurements By recording vital signs obtained four times a day By noting difficulty with ambulation

By documenting daily calf circumference measurements

The nurse is assessing the pain of a neonate who is admitted to the NICU with a heart defect. Which pain assessment scale would be the best tool to use with this patient? CRIES scale COMFORT scale FLACC scale FACES scale

CRIES scale The CRIES Pain Scale is a tool intended for use with neonates and infants from 0 to 6 months. The COMFORT Scale, used to assess pain and distress in critically ill pediatric patients, relies on six behavioral and two physiologic factors that determine the level of analgesia needed to adequately relieve pain in these children. The FLACC Scale (F—Faces, L—Legs, A—Activity, C—Cry, C—Consolability) was designed for infants and children from age 2 months to 7 years who are unable to validate the presence or severity of pain. The FACES Scale is used for children who can compare their pain to the faces depicted on the scale.

A gravida 4 para 4 mother calls the nurse's station reporting uterine pain following delivery. When the nurse responds to the call, the mother reports that she is having what feels like labor pains again off and on. What would be the nurse's response? Encourage the mother to breast-feed to help relax the uterus. Explain to her that women who have had several babies prior to this delivery often experience afterpains, which is where the uterus is contracting and relaxing at intervals. Recommend that the client ambulate more to help relieve the pain. Tell her that you will notify the doctor of the unusual pain and see what he wants to do.

Explain to her that women who have had several babies prior to this delivery often experience afterpains, which is where the uterus is contracting and relaxing at intervals.

Which option should the nurse encourage to replace fluid and electrolyte losses in a client with AIDS? Gluten Iron and zinc Sucrose Liquids

Liquids

What relaxation technique does the nurse teach the client with obsessive-compulsive disorder (OCD)? Scheduling a timetable Writing a diary Listening to music Practicing deep breathing

Practicing deep breathing

A client with a disorder of the oral cavity cannot tolerate tooth brushing or flossing. Which strategy should the nurse use to assist the client? Regularly wipe the outside of the client's mouth to prevent germs from entering. Provide the client with an irrigating solution of baking soda and warm water. Recommend that the client drink a small glass of alcohol at the end of the day to kill germs. Urge the client to regularly rinse the mouth with tap water.

Provide the client with an irrigating solution of baking soda and warm water.

A pregnant woman is receiving an epidural analgesic prior to delivery. The nurse provides vigilant monitoring of this patient to prevent the occurrence of what side effect? Pruritus Urinary retention Vomiting Respiratory depression

Respiratory depression

When developing the care plan for a patient with chronic pain, the nurse plans interventions based on the knowledge that chronic pain not related to cancer or palliative/end-of-life care is most effectively relieved through which method? Using the highest effective dose of an opioid on a PRN (as needed) basis Using nonopioid drugs conservatively Using consistent nonpharmacologic and nonopioid pharmacologic therapies Administering a continuous intravenous infusion on a regular basis

Using consistent nonpharmacologic and nonopioid pharmacologic therapies

A patient reports abdominal pain that is difficult to localize. The nurse documents this as which type of pain? Cutaneous Visceral Superficial Somatic

Visceral

Which is not one of the general nursing measures employed when caring for the client with a fracture? providing comfort measures cranial nerve assessment administering analgesics assisting with ADLs (-activities of daily living)

cranial nerve assessment

A nurse is assessing a client's pain. The nurse notes which database finding that is indicative of acute pain? decreased respiratory rate increased blood pressure pupil constriction decreased pulse rate

increased blood pressure

Nursing care for the client with fibromyalgia should be guided by the assumption that patients with fibromyalgia rarely respond to treatment. will eventually lose their ability to walk. all have the same type of symptoms. may feel as if their symptoms are not taken seriously.

may feel as if their symptoms are not taken seriously.

To meet the sensory needs of a client with viral meningitis, the nurse should: avoid physical contact between the client and family members. increase environmental stimuli. minimize exposure to bright lights and noise. promote an active range of motion.

minimize exposure to bright lights and noise.

A client is admitted with generalized abdominal pain, nausea, vomiting, and hypotension. The client has not passed stool in over 1 week and has been in pain for the past 4 days. Which type of pain would you expect the client to be experiencing? chronic visceral deeper somatic neuropathic

visceral Visceral pain arises from internal organs such as the heart, kidneys, and intestine that are diseased or injured. Visceral pain usually is diffuse, poorly localized, and accompanied by autonomic nervous system symptoms such as nausea, vomiting, pallor, hypotension, and sweating. Neuropathic pain is pain that is processed abnormally by the nervous system. Deeper somatic pain such as that caused by trauma produces localized sensations that are sharp, throbbing, and intense. Chronic pain has a duration longer than 6 months.

A nurse uses a whirlpool to relax a patient following intense physical therapy to restore movement in the patient's legs. What is a potent pain-blocking neuromodulator, released through relaxation techniques? Prostaglandins Substance P Endorphins Serotonin

Endorphins

The nurse is preparing a 6-year-old for a venipuncture. The boy appears anxious and is crying. How can the nurse foster feelings of control to help minimize his anxiety about the procedure? "Pick your favorite Band-Aid and show me which arm to use." "What questions do you have about what I am doing?" "Mrs. Jones, why don't you have him sit on your lap?" "See how fast you can make this pinwheel whirl."

"Pick your favorite Band-Aid and show me which arm to use."

The nurse is caring for a 7-year-old child who has just returned from the postoperative unit after surgery. The child is playing in bed with toys. The child's parents are smiling and state, "Isn't it great that our child does not have any pain?" What is the best response by the nurse? "Some children distract themselves with play while in pain." "A child who resumes usual play is not experiencing pain." "Children don't experience as much pain after surgery as adults." "The child's activity level is the best indicator of pain."

"Some children distract themselves with play while in pain." Some children distract themselves with play or music while in pain and may sleep as a result of exhaustion.

A client complains of leg pain shortly after being admitted with a fractured tibia sustained in a fall. When the nurse assesses the pain, the client states, "My pain is a 7 out of 10." What action by the nurse would be most appropriate? Provide diversional activities to distract the client. Administer pain medication as ordered. The nurse doesn't need to do anything for this pain level. Ask the client what makes the pain better.

Administer pain medication as ordered.

A nurse is caring for patients in a hospital setting. Which patient would the nurse place at risk for pain related to the mechanical activation of pain receptors? An older adult on bedrest following cervical spine surgery A patient with a severe sunburn being treated for dehydration An industrial worker who has burns caused by a caustic acid A patient experiencing cardiac disturbances from an electrical shock

An older adult on bedrest following cervical spine surgery

A client rings the call bell to request pain medication. On performing the pain assessment, the nurse informs the client that the nurse will return with the pain medication. After a few moments, the nurse returns with the pain medication. The nurse's returning with the pain medication is an example of which principle of bioethics? Fidelity Autonomy Nonmaleficence Justice

Fidelity

Postoperatively, a client with a radical neck dissection should be placed in which position? Prone Supine Side-lying Fowler

Fowler

When assessing pain in a child, the nurse needs to be aware of what considerations? Immature neurologic development results in reduced sensation of pain Inadequate or inconsistent relief of pain is widespread Reliable assessment tools are currently unavailable Narcotic analgesic use should be avoided

Inadequate or inconsistent relief of pain is widespread

A nurse instructor is teaching a class of student nurses about the nature of pain. Which statements accurately describe this phenomenon? Select all that apply. Pain is whatever the health care provider treating the pain says it is Pain exists whenever the person experiencing it says it exists Pain is an emotional and sensory reaction to tissue damage Pain is a simple, universal, and easy-to-describe phenomenon Pain that occurs without a known cause is psychological in nature Pain is classified by duration, location, source, transmission, and etiology

Pain exists whenever the person experiencing it says it exists Pain is an emotional and sensory reaction to tissue damage Pain is classified by duration, location, source, transmission, and etiology

A nurse administered oral pain medication 1 hour ago. Which documentation by the nurse best reflects the effectiveness of the pain medication? Rates pain higher on pain scale, notified physician. Rates pain 8/10, states nauseated for last 30 minutes. States pain is not relieved, talking with family on phone. Vital signs within normal limits, sleeping.

Rates pain 8/10, states nauseated for last 30 minutes.

A client comes into the emergency department with severe back pain radiating to the left lower groin. The healthcare provider prescribes morphine sulfate 5-10 mg IV every 2 hours. One hour after receiving 10 mg of morphine, the client is restless and distressed, reporting the pain is still at 8 of 10. What action will the nurse take? Review the client's medical record for evidence of past opioid misuse or drug-seeking behavior to help direct the best course of action. Reassess the client's pain and associated symptoms, and report findings to the healthcare provider to advocate for better pain control. Explain that a high dose of the pain medication has been administered and that taking more too soon can lead to respiratory depression. Tell the client that the order is for every 2 hours, and explain that an additional dose cannot be given for at least one more hour.

Reassess the client's pain and associated symptoms, and report findings to the healthcare provider to advocate for better pain control.

A patient who is having a myocardial infarction reports pain that is situated in the neck. The nurse documents this as what type of pain? Transient pain Superficial pain Phantom pain Referred pain

Referred pain

A nurse is providing instructions for the client with chronic rhinosinusitis. The nurse accurately tells the client: You may drink 1 glass of alcohol daily. Sleep with the head of bed elevated. Do not perform saline irrigations to the nares. Caffeinated beverages are allowed.

Sleep with the head of bed elevated.

A middle-age client with cancer has been prescribed patient-controlled analgesia (PCA). The nurse caring for the client explains the functioning of PCA. What is the main advantage of PCA? The client requires less nursing care. The client obtains pain relief slowly and steadily. The client is able to have long hours of rest. The client is actively involved in pain management.

The client is actively involved in pain management.

Which client outcome during active and transitional labor is best? The client will practice breathing techniques during contractions. The client will tolerate 8 oz (224 g) of clear liquids during labor process. The client will walk in the hall for 15 minutes every 2 hours. The client will state a pain level of 7 and under during contractions.

The client will practice breathing techniques during contractions.

Which statement accurately describes a consideration when using a patient-controlled analgesia (PCA) pump to relieve client pain? The PCA pump is not effective for chronic pain. The pump mechanism can be programmed to deliver a specified amount of analgesic within a given time interval. A PCA pump must be used and monitored in a health care facility. This approach can only be used with oral analgesics.

The pump mechanism can be programmed to deliver a specified amount of analgesic within a given time interval.

The nurse instructs the client about skin massage and the gate control theory of pain. Which statement would be appropriate for the nurse to include for client understanding of the nonpharmacologic pain relief methods? The gating mechanism is located at the pain site. The gating mechanism opens so all the stimuli pass through to the brain. Pain perception is decreased if anxiety is present. These methods are a technique to prevent the painful stimuli from entering the brain.

These methods are a technique to prevent the painful stimuli from entering the brain.

A nurse providing teaching on ways to promote skin hydration for the parents of an infant with atopic dermatitis. Which response indicates a need for further teaching? "We should use soap to clean only dirty areas." "We should bathe our child in hot water, twice a day." "We should use a mild soap for sensitive skin." "We need to avoid any skin product containing perfumes, dyes, or fragrances."

We should bathe our child in hot water, twice a day.

The nurse caring for a client with bilateral rib fractures explains to the client that the pain causes him to take more shallow respirations, which will contribute to feeling short of breath due to a: decreased residual volume. increased vital capacity. decreased tidal volume. increased total lung capacity.

decreased tidal volume.