Prep U Pain management

A client has a long history of diabetes mellitus and developed diabetic neuropathy more than 25 years ago. The client is without breakthrough pain at this point in time. How would this client's pain be classified?

neuropathic and chronic

A client is on a second round of radiation therapy for an inoperable tumor, and asks the nurse for medication to help with pain. The nurse suspects that the client's pain is the result of nerve damage from the radiation. Which type of pain is the client likely experiencing?

neuropathic pain

Which nursing intervention should a nurse perform when caring for a client who is prescribed opiate therapy for pain?

Do not administer if respirations are less than 12 breaths per minute

The client is scheduled for surgery. The nurse is reviewing with the client about postoperative pain management. The client states her goal after receiving treatment is "0." The first action of the nurse is to

Educate the client that this goal may not be achievable.

An older adult is being treated with opioids for pain relief. Which of the following should the nurse strongly recommend to this client?

Follow a bowel regimen.

A clinic nurse assesses a client with diabetes who reports taking naproxen (Aleve) and the herb bilberry for osteoarthritis. To assess for an adverse reaction between naproxen and bilberry, the nurse asks the client

"Do you bleed easily?"

Which phase of pain transmission occurs when the one is made aware of pain?

Perception

Which of the following is a disadvantage to using the IV route of administration for analgesics?

Short duration

The client reports chest pain. The nurse uses which of the following questions to assess the pain further. Select all answers that apply.

"What aggravates your chest pain?" "Rate the pain on a scale of 0 to 10, with 10 being the worst possible pain." "How long have you experienced this pain?" "Please point to where you are experiencing pain."

When receiving epidural opioids, respiratory depression generally peaks within which time frame?

6 to 12 hours

Which of the following is a disadvantage of using the transdermal route of opioid administration?

A delay in effect until the dermal layer is saturated

The nurse has assessed a client's pain subsequent to a broken ankle. How would the nurse categorize and document the client's pain?

Acute

How should the administration of analgesics be scheduled to provide a uniform level of pain relief to a client?

Administering the analgesics on a regular basis

The nurse understands that which statement is true about tolerance and addiction?

Although clients may need increasing levels of opioids, they are not addicted.

When a nurse asks a patient to describe the quality of the pain, what type of descriptive term does the nurse expect the patient to use?

Burning

Which of the following should the nurse recommend to a client with a bruised ankle to initially relieve pain associated with the injury and reduce localized swelling?

Applications of heat and cold

A client recovering from hip surgery is receiving morphine through a patient-controlled analgesia (PCA) infusion pump with a set basal rate. What action is most important for the nurse to implement?

Assess the client's respiratory status

The client is prescribed 2 mg of intravenous morphine every 2 hours as needed for pain. The nurse administers the medication. Thirty minutes later, the client reports the pain level remains at a "6" on a pain intensity scale of 0 to 10. The nurse first

Assesses the client's mental status and vital signs

When the nurse is performing an assessment and finds no physical cause for a patient's pain, what should the nurse do when the patient continues to complain of pain?

Believe a patient when he or she states that pain is present.

Which of the following nursing interventions contributes to achieving a client's pain relief?

Collaborate with the client about his or her goal for a level of pain relief.

The nurse is caring for a client in the hospital who has been taking an analgesic for pain related to a chronic illness and has developed a tolerance to the medication. What is the most appropriate action by the nurse?

Consult with the prescriber regarding the need for an increased dose of the drug and not to reduce the frequency of administration.

The nurse is assessing a patient complaining of severe pain. What physiologic indicator does the nurse recognize as significant of acute pain?

Diaphoresis

Which substance reduces the transmission of pain?

Endorphins

The nurse is administering a narcotic analgesic for the control of a newly postoperative client's pain. What medication will the nurse administer to this client?

Fentanyl (Duragesic)

A client has been using nonnarcotic analgesics daily over an extended period. Which of the following effects should the nurse carefully monitor for in this client?

Gastrointestinal bleeding

A client arrives in the orthopedic clinic with complaints of twisting the right ankle while playing softball. The nurse collects data including complaints of pain and swelling in the right ankle. What intervention will the nurse provide that will decrease vasodilation and reduce localized swelling?

Ice bag

The nurse understands that which of the following physiologic changes that influence the pain response occur in the gerontologic population?

Increased sensitivity to medications

A client, who had an above the knee amputation of the left leg related to peripheral vascular disease from uncontrolled diabetes, complains of pain in the left lower extremity. What type of pain is the client experiencing?

Neuropathic pain

A high school football player hurts his foot while playing a game. The client complains of intense pain with muscle spasms and swelling of the toe. Which pain assessment tool will the nurse most likely use to assess the client's pain level?

Numeric Rating Scale (NRS)

Opioid analgesics are effective pain management tools for many clients. A significant portion of a nurse's practice is older adults who suffer from chronic pain. What impact does a client's age have on initial dosing?

Older clients should receive a reduced dose.

Which is a true statement regarding placebos?

Placebos should never be used to test a client's truthfulness about pain.

A client is being taught to self-administer a narcotic analgesic by means of an intravenous PCA pump system. Which of the following would help prevent accidental overdosage?

Programming the dosage and time interval into the device

A nurse documents the presence of chronic pain on an electronic health record. Choose a description that could be used. The pain can be:

Prolonged in duration.

An elderly client has a fractured hip and is in Buck's traction. The client is disoriented and cannot express herself. At 0730 the client was calm. Now, at 0930, the client is restless and agitated. The nurse reviews the medication administration record. The last dose of opioid was at 0330. The nurse assesses the client's agitation may be from

Recurring pain

The nurse's major area of assessment for a patient receiving patient-controlled analgesia is assessment of what system?

Respiratory

A new surgical patient has been prescribed an opioid analgesic intravenously for pain control. The nurse should be aware of which most serious adverse effect of this medication?

Respiratory depression

The nurse, as a member of the patient's health care team, obtains pain assessment information to identify goals for pain management. Select the most important factor that the nurse would use for goal setting:

Severity of the pain as judged by the patient

A client reports abdominal pain as "8" on a pain intensity scale of 0-10 thirty minutes after receiving an opioid intravenously. Her past medical history includes partial-thickness burns to approximately 60% of her body several years ago. The nurse assesses

That the client's past experiences with pain may influence her perception of current pain

Which of the following is a reliable source for quantifying pain?

The client's description of the pain

The nurse informs the patient that a preventive approach for pain relief will be used, involving nonsteroidal anti-inflammatory drugs. What will this mean for the patient?

The pain medication will be administered before the pain is experienced.

The nurse is caring for a client with kidney stones who is complaining of severe pain. What type of pain does the nurse understand this client is experiencing?

Visceral Pain

According to The Joint Commission's pain assessment and management standards, which of the following are essential components of a comprehensive pain assessment?

location, onset, alleviating factors, and aggravating factors

A client reports having joint pain that has gotten worse over the last year despite gradually increasing doses of an OTC pain reliever. Which type of pain will the nurse document as the chief complaint?

chronic pain

The client has suffered an injury to his right leg and is reporting pain at the level of "5" on a scale of 0 to 10. The client has a history of peripheral arterial disease. The client requests nonpharmacologic interventions. What interventions are appropriate for the nurse to perform? Select all that apply.

teaches the client to perform slow, rhythmic breathing massages the client's back and shoulders turns on the television to a show the client asks to watch

A client has been given a patient-controlled analgesia (PCA) device to control postoperative pain. The client expresses concern about administering too much of the analgesic and accidentally overdosing. What topic should the nurse teach the client about?

the limits on dose and frequency that are programmed into the PCA