Chapter 44

Which is the most expected component of an Acute Pain nursing diagnosis? a. Long-bone fracture b. Joint deformity c. Fear of pain d. Inability to sleep

a. Long-bone fracture

Which statement provides an accurate description of pain? A. Pain is subjective. B. Pain is objective. C. Pain is a simple perception. D. Pain is similar among individuals.

A. Pain is subjective

A nurse is talking with a patient regarding the patient's pain. The nurse performed the SOCRATES set of questions. The nurse understands that which additional question would be relevant to the pain assessment? A. "where is the pain located?" B. "what are your past pain experiences?" C. "is the pain stabbing, burning, or aching?" D. "does anything make the pain worse or lessen it?"

B. what are your past pain experiences.

A nurse is assessing pain in a 4-year-old patient who has a femur fracture. Which pain assessment tool would be recommended for this patient? A. 0-10 pain scale B. Moderate pain scale C. neonatal infant pain scale D. universal pain assessment tool

universal pain assessment tool. -The Universal Pain Assessment Tool is a combination of the Verbal Descriptor Scale, Wong-Baker Facial Grimace Scale, and Activity Tolerance Scale, and all three of these tools can be used for children. The Wong-Baker Facial Grimace Scale is most appropriate for a 4-year-old child.

Which is a nursing diagnosis directly associated with pain? a. Anxiety b. Effective Coping c. Delirium d. Readiness for Normal Sleep Patterns

a. Anxiety

Based on the density of nociceptors throughout the body, which condition would the nurse expect to require increased analgesia? a. Burn b. Osteoarthritis c. Blunt abdominal injury d. Low back strain

a. Burn

What type of goal is "reporting a pain of less than 3 of 10 on post-operative day 3"? a. Comfort b. Cognition c. Tolerance d. Readiness

a. Comfort

The nurse is caring for a postoperative patient. Which behavioral manifestations of pain are included in the pain assessment? a. Grimace b. Crying c. Moaning d. Anxiety

a. Grimace

Which theory proposes that pain signals determine if a person feels pain? a. Pattern Theory b. Gate Control Theory c. Melzack Theory d. Neuromatrix Theory

a. Pattern Theory

The nurse is caring for a patient with chronic back pain. The patient feels that he has an increase in back pain when he is experiencing stress. He wishes to practice relaxation techniques to decrease the perception of pain. Which pain theory is this practice associated with? a. Pattern Theory b. Gate Control Theory c. Contemporary Pain Theory d. Neuromatrix Theory

b. Gate Control Theory

Which pain theory proposes that pain is caused by the movement of various substances in and out of the cell? a. Pattern Theory b. Gate Control Theory c. Melzack Theory d. Neuromatrix Theory

b. Gate Control Theory

The nurse is caring for a patient with chronic pain related to fibromyalgia. The patient is in the emergency department for pain control. The patient is complaining of generalized pain at a level of 7 on 1-10 scale. The nurse overhears a primary care provider complaining that this patient is drug-seeking. Which definitions of pain are important for the nurse to keep in mind? a. The patient cannot have pain without an injury. b. Pain is what the patient says it is. c. Pain is measured objectively. d. Pain is a simple perception.

b. Pain is what the patient says it is.

As the nurse conducts a comprehensive pain assessment, the patient is asked to describe the quality of the pain. The patient describes his pain as sharp and acute. Which phase of the nociception process is responsible for the type of pain impulse that is being detected by the patient? a. Transduction b. Transmission c. Perception d. Modulation

b. Transmission

Reporting increased ability to concentrate on a daily activity within two hours of taking morphine sulfate for pain is what type of goal? a. Tolerance b. Readiness c. Cognition d. Comfort

c. Cognition

During the modulation process of nociception, which endogenous opioid has an influence on the emotional perception of pain? a. Dynorphins b. Beta-endorphins c. Enkephalins d. Dopamine

c. Enkephalins

The nurse is conducting a pain assessment on a patient in the oncology unit. The patient is asked to describe the intensity of pain that she is willing to withstand. How is this documented? a. Pain intensity b. Pain scale c. Pain tolerance d. Pain threshold

c. Pain tolerance

What is true regarding pain assessment? a. It is highly objective. b. It is never subjective. c. It is never objective. d. It is highly subjective.

d. It is highly subjective.

Once pain is recognized, which process is responsible for the release of analgesic neurotransmitters? a. Transduction b. Transmission c. Perception d. Modulation

d. Modulation

Which is true regarding ethics and pain management? a. Nurses comply with the American Medical Association. b. A common dilemma is overmedicating for pain. c. The Code of Ethics for nurses has regulatory standards. d. Older adult patients are at risk for under treatment of pain.

d. Older adult patients are at risk for under treatment of pain.

A patient with Alzheimer's disease is being cared for in the medical-surgical unit. As pain assessments are conducted on a patient with a cognitive disorder, what is the nurse mindful of? A. patient may not be able to express the location of pain B. patient is able to perform behaviors to alleviate pain. C. patient is unable to perceive pain D. patient is able to report pain status E. patient is able to experience pain

A, E. -patients with Alzheimer's disease or other cognitive disorders may not be able to express the location of pain -patient is able to experience pain

Which are verbal manifestations of the presence of pain? Select all that apply. -Clenching teeth -Crying -Anger -Moaning -Screaming

-Crying -moaning -screaming

Which are psychological manifestations of the presence of pain? Select all that apply. -Hopelessness -Grimacing -Anger -Irritability -Anxiety

-Hopelessness -Anger -Irritability -Anxiety

Which of these statements about the heart are true? Select all that apply. -It has two atrial and two ventricular chambers. -The average adult heart is approximately 4 cm wide and 6 cm long. -It pumps oxygenated blood to all parts of the body. -It is part of the respiratory system. -It plays a role in tissue oxygenation.

-It has two atrial and two ventricular chambers. -It pumps oxygenated blood to all parts of the body. -It plays a role in tissue oxygenation.

Order the four steps in the nociception process. 1. The brain translates nerve signals as pain. 2. Pain signals are transmitted through afferent nerve fibers to the spinal cord and brain. 3. Nociceptors identify painful stimuli and convert it into an electrical impulse. 4. The brain changes the perception of pain by sending inhibitory signals via the spinal cord.

1. Nociceptors identify painful stimuli and convert it into an electrical impulse. 2. Pain signals are transmitted through afferent nerve fibers to the spinal cord and brain. 3. The brain translates nerve signals as pain. 4. The brain changes the perception of pain by sending inhibitory signals via the spinal cord.

A new nurse is trying to do a pain assessment. The charge nurse reminds the new nurse to use SOCRATES. The new nurse understands that the "T" in SOCRATES stands for what? A. Time course B. Type of pain C. temperature D. Time of onset

A. Time course -determining whether there is a patter of the pain, such as if the pain occurs after a specific activity or after meals.

A patient has suffered burn injuries related to a house fire, and is in the burn center for pain control and dressing changes. What function does pain serve when it is associated with a thermal injury? A. response B. Warning C. Malfunction D. protective

A. response- pain occurs as a response to an injury

Which stimuli relates to a postoperative incision? A-Thermal B-mechanical C-chemical D-central

B. Mechanical- post op pain associated with an incision is related to mechanical stimuli

A patient with diabetes is being seen in the emergency department for a broken arm. He states that he is in a lot of pain. The nurse understands that pain could have which effect on the patient's blood sugar? A. no effect on blood sugar B. increased blood sugar C. decreased blood sugar D. Varying levels of blood sugar based on time of day.

B. increased blood sugar -likely to be found in a patient with diabetes who is experiencing pain. Blood sugar would increase due to the body's ineffective use of glucose during pain and stress.

A nurse is performing a pain assessment on a patient who is complaining of chest pain. The nurse understands that which question is appropriate to ask the patient? A. "when did you eat last?" B. "where is the pain located?" C. "were you sweaty when the pain began?" D. "were you upset when the pain started?"

B. "where is the pain located?"

Which aspect of the brain helps a person localize where on the body the injury has occurred? A. cortical brain regions B. Sensory-discriminative aspect C. Affective-motivational aspec D. cognitive-evaluative aspect

B. sensory-discriminative aspect -The sensory-discriminative aspect of the brain helps the person localize where on the body injury occurred

A nurse is caring for a patient with a burn. when conducting the pain assessment, which action should the nurse perform first? A. perform comfort measures B. take the patient's vitals C. take the patient's meal order D. remove the burn dressings and ask the patient if the burn site hurts.

B. take the patients vital signs -the first step in performing a pain assessment is to obtain the patient's vital signs.

Which neurotransmitters are involved in controlling the inflammatory response? Select all that apply. Serotonin Bradykinin Histamine Prostaglandin Cytokines

Bradykinin Histamine Cytokines

A nurse asks a patient what makes the patient's shoulder pain worse. This question supports which description of the "E" in the acronym SOCRATES? A. Energy of the pain B. Elements of the pain C. Exacerbating factors of the pain D. Elevation of the pain from 1 to 10

C. Exacerbating factors of the pain

Why are postoperative patients who are in pain at increased risk for pneumonia? A. Pain increases the immune response and causes pneumonia. B. Pain causes crying, which increases mucus production within the lungs. C. Pain causes reluctance to breathe deeply, increasing the risk for atelectasis and pneumonia. D. Pain releases insulin, which causes diabetes and increases the patient's risk of pneumonia.

C. Pain causes reluctance to breathe deeply, increasing the risk for atelectasis and pneumonia.

Which definition accurately depicts pain? A. Pain exists only in the presence of injury. B. Pain is similar among individuals. C. Pain is whatever the individual says it is. D. Pain is not an emotional experience.

C. Pain is whatever the individual says it is. -There is no right or wrong answer when a patient is describing his or her pain

which nursing practice may be influenced by expectations of behaviors that indicate pain? A. prescribing practices B. Pain assessment C. administration of pain medication D. documentation

C. administration of pain medication -expectations of certain behaviors can influence the administration of pain meds.

When would a nurse perform a focused pain assessment on a patient? A. Anytime a patient is at high risk for pain B. After taking vital signs and the patient reports the pain is mild C. After taking vital signs and the patient reports the pain is severe D. Before taking vital signs

C. after taking vital signs and the patient reports the pain is severe

The nurse is working in an urgent care office. A patient comes in with a possible broken ankle, experiencing a lot of pain. The nurse obtains his vital signs and watches him grimace every time his foot is moved. The ankle is edematous. When asked, the patient says his pain is a 9 out of a 10-point scale. The nurse understands that which piece of information is considered subjective data? A. vitals B. edematous ankle C. pain scale 9 out of 10 D. weak pulse in the foot

C. pain scale 9 out of 10

The nurse is describing effects of pain to a patient who is getting ready for surgery. Which statement made by the nurse indicates proper understanding of the effects of pain? A. "you may get a fever from the pain" B. "you may notice redness at the site of incision" C. "you may experience increased blood pressure" D. "you may experience drainage from the surgical site"

C. you may experience increased blood pressure.

The nurse is teaching a patient's family about the effects of pain. Which statement made by the nurse indicates proper teaching? A. "the only body system that responds to pain is the nervous system" B. "when a patient is in chronic pain, the sympathetic nervous system responds" C. "when a patient is in acute pain, the parasympathetic nervous system responds" D. "when a patient is in chronic pain, the parasympathetic nervous system responds."

D. "when a patient is in chronic pain, the parasympathetic nervous system responds" -the parasympathetic nervous system responds, causing responses such as decreased heart rate and blood pressure.

The nurse completed a pain assessment on a 16-year-old teen that was hospitalized post-op for open-heart surgery. The patient describes the pain as "constant aching" and is rated 8 on the 0-10 pain scale. Which action made by the nurse indicates proper understanding of pain assessment? A. opening the dressing to see if there is something wrong with the patient's incision B. obtaining pain inhibitors from the medication dispenser by overriding the need for an order. C. Distracting the patient by offering to get child development to the patient's room to set up an x-box for the patient to play. D. looking in the patient's chart for pain medication that was ordered, and obtaining an order for pain medication from the provider if none has been prescribed.

D. looking in the patient's chart for pain medication that was ordered, and obtaining an order for pain medication from the provider if none has been prescribed.

Through which vessel does oxygenated blood enter the heart? A. Aorta B. Inferior vena cava C. Pulmonary artery D. Pulmonary vein

D. pulmonary vein -oxygenated blood moves from the lungs back to the heart though the pulmonary vein

A nurse is caring for a patient on the oncology floor. The nurse understands that which observation indicates the patient is in pain? A. the patient is hypoglycemic B. the patient is sleeping soundly C. the patient is having normal bowel movements. D. The patient's urine output has decreased from its normal baseline

D. the patient's urine output has decreased from its normal baseline -The release of certain hormones in response to pain causes urine output to decrease.

What is a clinical sign of acute pain seen in the cardiovascular system? A. Decreased heart rate B. Varying cardiac murmur C. Increased systolic blood pressure D. Decreased systolic blood pressure

Increased systolic blood pressure

What term has been given to describe pain assessment in nursing? a. Five rights b. Fifth vital sign c. Fifth element d. Fifth sense

Fifth Vital sign

Which collaborative team members may be involved in providing care to a patient with pain? Select all that apply. Massage therapist Art therapist Physical therapist Pain management specialists Muscle manipulation specialist

Massage therapist Physical therapist Pain management specialists Muscle manipulation specialist

Which pain management activities may be delegated to unlicensed assistive personnel (UAP)? Select all that apply. Providing back rubs Administering pain medication Asking the patient direct yes or no questions Changing the linens Performing oral hygiene

Providing back rubs Asking the patient direct yes or no questions Changing the linens Performing oral hygiene

Which are example components of an Anxiety nursing diagnosis for a patient in pain? Select all that apply. Restlessness Limited mobility Decreased appetite Quivering voice

Restlessness Quivering voice

What should be determined immediately following pain assessment? a. Pain scale preference b. Anxiety level c. Comfort preference d. Pain type

d. Pain type

A patient with diabetes develops an infected wound on the plantar aspect of the foot. The patient reports that he never felt any pain or discomfort related to the wound. Which pain response is lacking in this type of injury? a. Cognitive b. Affective c. Behavioral d. Sensory

d. Sensory

The Neuromatrix Theory proposes that pain is controlled by which factor? a. The medication b. Endorphins c. Pain signals d. The person

d. The person

Which body part is least sensitive to pain? a. Skin b. Joint c. Tissues d. Internal organs

internal organs

A nurse is caring for a patient with kidney stones. The nurse asks the patient to describe the pain on a scale of 0-10.The patient rates the pain a 5. How would the nurse classify this pain? Mild pain Severe pain Average pain Moderate pain

moderate pain between 4-7

Which body part is the most sensitive to pain? a. Skin b. Joint c. Tissues d. Internal organs

skin

Which physiologic process occurs when painful stimuli are first identified and converted into an electrical impulse? Transduction Transmission Perception Modulation

transduction

Which physiologic process occurs when pain signals travel through pathways to the brain and spinal cord? Transduction Transmission Perception Modulation

transmssion