Evolve - pain treatment/management

How are health care organizations changing practice to address a patient's pain? Multiple choice question

Adopting the Joint Commission's guideline on pain

A postoperative patient has a prescription to receive morphine sulfate 4 mg intramuscularly (IM) every three to four hours as needed for pain. On hand are prefilled syringes labeled morphine sulfate 10 mg/mL. How many mL should the nurse administer? Include a leading zero if applicable. Record your answer using one decimal place. mL

0.4

A nursing student working on a pain-control unit is discussing gender differences concerning pain with the nursing instructor. Which statement by the nursing student requires clarification? Multiple choice question "Men use alternative treatments for their pain less often than women." "Women generally report that they can control their pain better than men." "Men are less likely than women to complain of pain when they experience it." "Women are more likely to receive a diagnosis of nonspecific somatic disorder as an explanation for their pain."

"Women generally report that they can control their pain better than men."

A female patient's medication is being changed from patient-controlled analgesia with meperidine to morphine sulfate after the patient experiences restlessness and agitation. The patient's daughter asks why the change has been made. Which response by the nurse is most appropriate? Multiple choice question

"Your mother is experiencing side effects of meperidine; she may do better with morphine."

The patient has a prescription to receive meperidine 50 to 75 mg intravenous push (IVP) q3-4hr as needed (PRN) for pain. On hand are prefilled syringes labeled "50 mg/mL." How many mL should the nurse administer to give a 75-mg dose? Multiple choice question

1.5 mL

A patient has a temperature of 101.6º F. There is a prescription for ibuprofen 600 mg by mouth (PO) for fever. Available are 200-mg tablets. How many tablets should the nurse administer? Multiple choice question

3 tablets

Which nursing interventions, according to the Pasero Opioid-Induced Sedation Scale (POSS) with Interventions, are beneficial to the patient who is drowsy and drifts to sleep during conversation following opioid therapy? Multiple selection question

Decreasing opioid dose 25% to 50% Administering opioid-sparing nonopioid to the patient Monitoring the patient's respiratory status continuously

A patient has been prescribed fentanyl patches for the treatment of severe chronic pain. The nurse should instruct the patient to immediately report which signs of drug overdose? Multiple selection question

Difficulty breathing Excessive sleepiness

The nurse is reviewing the prescriptions for a patient who is experiencing mild pain. Which of these are appropriate nonopioid analgesics for mild pain? Multiple selection question

Ibuprofen Acetaminophen

A nursing student is learning about pain medications. What does the term "analgesic ceiling" relating to nonsteroidal antiinflammatory drugs (NSAIDs) mean? Multiple selection question

Increasing the dose of the drug will not provide greater analgesia. Increasing the dose will produce deleterious effects on body systems.

A nurse is preparing a teaching plan about pain management for a cancer patient. What information should be included in the teaching plan? Multiple selection question Nonpharmacologic pain relief therapies Mechanism of action of the pain medications Pathophysiology of the development of pain in cancer Side effects and complications associated with medications Adjustments in drug dosages that may be required over a period of time

Nonpharmacologic pain relief therapies Side effects and complications associated with medications Adjustments in drug dosages that may be required over a period of time

To reduce the risk of adverse effects, what should the nurse do when caring for a patient receiving morphine sulfate via patient-controlled analgesia (PCA)? Multiple choice question

Teach the caregiver not to push the button for the patient.

A nurse is caring for a patient with severe chronic pain. The patient has been administered morphine via the intraspinal route of drug delivery. What is the most appropriate reason for administering morphine via this route? Multiple choice question

To prevent nausea and vomiting

A postoperative patient has been started on patient-controlled analgesia with morphine sulfate intravenously (IV). The nurse would re-evaluate the pain-management plan if the patient required more than how many rescue doses in a 24-hour period? Multiple choice question One Two Three Four

two

The patient is experiencing breakthrough pain and a dose of hydromorphone 2 mg intravenous (IV) is prescribed. Available is a vial containing 5 mg/mL of solution. How many mL should be drawn up to give the dose? Multiple choice question

0.4 mL

A nurse explains cold therapy to a patient. Which statements would be appropriate for the nurse to include? . Multiple selection question

"Ice should not be applied over irradiated skin." "Ice should always be applied in circular motions over the affected area." "Ice can be applied on the contralateral side of the body over the same area."

The nurse is reviewing instructions for application of the prescribed fentanyl patch. Which statement by the patient indicates the need for additional instruction? Multiple choice question

"If the patch falls off, I will put a new one on."

The prescribed pain medication prescription reads: give hydromorphone 0.6 mg every three hours intravenous (IV) push for severe postoperative pain. The medication injection is available in a 1 mg/mL strength. How much will the nurse draw up for each dose? Multiple choice question

0.6 mL

Which nondrug therapy is the most appropriate option for the nurse to include in the care plan of a Chinese-American patient who prefers nondrug therapies for pain relief? Multiple choice question

Acupuncture

A nurse is caring for a patient who has undergone internal fixation surgery for fracture of the tibial shaft. The patient is on opioid drugs postsurgery to relieve postsurgical pain. On observation, the nurse finds that the patient's respiratory rate is 7 breaths per minute and the patient looks extremely drowsy. Which actions should the nurse take to prevent respiratory failure in this patient? Multiple selection question

Administer oxygen to the patient. Make attempts to arouse the patient. Obtain a prescription to reduce the dosage of opioid medications.

The patient's neuropathic pain is not well controlled with the opioid analgesic prescribed. What medications may be added for a multimodal approach to treat the patient's pain? Multiple selection question

Antiseizure drugs Tricyclic antidepressants

Which substance produced in the human body is capable of producing an analgesic effect similar to that of morphine? Multiple choice question Serotonin Histamine Enkephalin Norepinephrine

Enkephalin

A nurse is caring for a patient who has undergone an appendectomy. Which route of drug delivery should the nurse use to administer the opioid analgesics to treat postoperative pain? Multiple choice question

Intravenous

A patient with pancreatitis and on opioid therapy for pain relief informs the nurse of pain and difficulty in passing stools. A digital rectal examination (DRE) revealed fecal impaction. Which medication does the nurse determine to be beneficial for safe and effective care? Multiple choice question

Methylnaltrexone

The nurse is planning to use distraction as part of a cancer patient's pain management. Which of these is an example of distraction to provide pain relief? Multiple selection question

Playing a game Listening to music Watching a movie

A patient status postabdominal surgery is in pain and has a prescription for hydromorphone 2 mg intravenous (IV) q3hr as needed (PRN). To avoid adverse effects, the nurse injecting the dose at 0800 would finish injecting the medication no earlier than which time?

0803

The patient is due for a scheduled medication of phenytoin 50 mg intravenously (IV). The nurse should administer the dose over a minimum of how many minutes? Multiple choice question

1 minute

The hospice nurse is providing an opioid to a dying patient who is experiencing severe cancer pain. Which of these statements is true? Multiple choice question

Administering opioids in this situation is an appropriate nursing action.

A patient is receiving morphine therapy for the treatment of pain related to cancer treatment. What nursing action is the most beneficial for this patient, who is having the side effect of constipation? Multiple choice question

Advising the patient to use a stool softener

A patient asks the nurse why a dose of hydromorphone administered intravenous (IV) push is given before starting the medication via patient-controlled analgesia (PCA). Which response is most appropriate? Multiple choice question

"The IV push dose will provide for immediate pain relief, which can be maintained by using the PCA."

It is time for a patient's scheduled dose of celecoxib 200 mg by mouth (PO). Available are capsules containing 100 mg. How many capsules should the nurse administer?

2 capsules

A patient is hospitalized with multiple lacerations and four fractured ribs after a fall. The nurse, creating a plan of care, recognizes that which action is the highest priority? Multiple choice question

Administering analgesics and encourage breathing exercises

A patient with osteoarthritis has been taking ibuprofen 400 mg every eight hours. The patient states that the drug does not seem to work as well as it used to in controlling the pain. The most appropriate response to the patient is based on what knowledge? Multiple choice question

Another nonsteroidal antiinflammatory drug (NSAID) may be indicated because of individual variations in response to drug therapy.

A patient requires treatment with an analgesic, antipyretic, and antiinflammatory. Which nonopioid medication administered by the nurse would be of most benefit to the patient? Multiple choice question

Aspirin

Before administering a dose of celecoxib, the nurse would check the medication order sheet for which medication that could place the patient at greater risk for adverse effects? Multiple choice question

Aspirin

Before administering celecoxib, the nurse should assess the patient's medical record for which medication that would increase the risk of adverse effects? Multiple choice question

Aspirin

The nurse should teach a patient to avoid which medication while taking ibuprofen? Multiple choice question

Aspirin

The nurse should instruct a patient receiving nonsteroidal antiinflammatory drugs (NSAIDs) to report which effect? Multiple choice question

Black or tarry stools

Which manifestations would the nurse attribute to adverse effects of morphine sulfate administered by way of patient-controlled analgesia? Multiple selection question

Bradypnea Constipation Urinary retention Nausea and vomiting

A nurse is caring for a patient who has been prescribed ibuprofen to relieve acute back pain. How will this drug be helpful in relieving pain? Multiple choice question

By interfering with the production of prostaglandin

The Joint Commission's guideline on pain requires health care facilities to do what? Multiple selection question

Educate patients and their families about pain management Educate health care providers about pain assessment and management of pain Recognize the patient's right to appropriate assessment and management of pain

A postoperative patient is experiencing unrelieved pain. The nurse will monitor for what possible harmful effects of unrelieved acute pain? Multiple selection question

Confusion Hyperglycemia Increased heart rate

A patient admitted with metastatic lung cancer is prescribed morphine sulfate for pain. Which side effect of this medication should the nurse try to prevent with oral intake and medication? Multiple choice question Diarrhea Agitation Constipation Urinary incontinence

Constipation

The patient is receiving morphine sulfate for pain. Which signs or symptoms should the nurse observe for as side effects of this medication? Multiple selection question

Constipation Urinary retention Decreased respiratory rate

A nurse is teaching a group of patients about the use of heat therapy for relief of arthritis pain. Which of these is a correct statement about heat therapy? Multiple choice question

Do not use menthol-containing products with heat applications.

The nurse is preparing to administer medications to a patient for the management of chronic nonmalignant and cancer pain. What medications does the nurse anticipate administering? Multiple selection question

Duloxetine Venlafaxine Amitriptyline

A patient is receiving a patient-controlled analgesia (PCA) opioid infusion after back surgery. The patient is sleeping but awakens when the nurse speaks to the patient in a normal tone of voice. However, during the conversation, the patient drifts back to sleep. Respirations are 8 breaths/minute. What is the most appropriate nursing action in this situation? Multiple choice question

If prescribed, decrease the opioid dose 25% to 50%

Which therapies will the nurse instruct the patient to follow if a primary health care provider suggests relaxation strategies in order to enhance the quality of life for a patient with chronic pain? Multiple selection question

Imagery Meditation Art therapy

A patient is prescribed a patient-controlled analgesia (PCA) delivery system for pain secondary to renal cancer. Which instruction would be correct for the nurse to include when educating the patient about the PCA system? Multiple choice question

It uses an infusion system controlled by the patient.

A nurse is caring for a patient with bone cancer. The patient reports intolerable pain in the thigh. Which drug would be most effective for the severe musculoskeletal pain related to cancer? Multiple choice question

Morphine

A patient has a prescription to receive oxycodone for pain. Before administering this medication, the nurse would check for which allergy that could pose a risk to the patient?

Morphine

The nurse should prepare to administer which medication for the patient experiencing respiratory depression following intravenous administration of morphine? Multiple choice question

Naloxone

Which pain assessment technique should the nurse use when caring for a patient with advanced dementia? Multiple choice question

Observe for patient behaviors that indicate pain.

Which drugs will the nurse administer to prevent pain transmission from the abdomen to other parts of the body in a patient with liver disease who has severe abdominal pain? Multiple choice question

Opioid analgesics

Which statement should the nurse include in information used to teach a patient about pain management? Multiple choice question

Pain needs to be reported if it is not relieved to tolerable levels.

The nurse is caring for four different patients who are receiving analgesia through different routes in a health care setting. Which patient will have excellent steady-state analgesia levels in the blood?

Patient 4 (IV)

Following a bowel resection, the patient is able to receive morphine sulfate 1 mg every 10 minutes by patient-controlled analgesia (PCA) pump. What assessment data would require the nurse to take immediate action? Multiple choice question

Respiratory rate 8 breaths/min, pupillary constriction

The nurse should question a prescription written for acetaminophen and oxycodone for a patient exhibiting which clinical manifestation?

Severe jaundice

A nurse provides education for a group of healthy patients who are receiving acupuncture. Which statement made by the patients indicates that the teaching is understood? Multiple choice question

Sterile, disposable fine needles are inserted into the skin's surface at specific points.

A patient who has had surgery for breast cancer reports ongoing, constant moderate pain with short periods of severe pain during dressing changes. Which of these statements is true? Multiple choice question

The pain is best treated by receiving both a long-acting and a short-acting opioid.

The patient with pneumonia has a temperature of 101º F. There is a prescription to administer ibuprofen 600 mg by mouth (PO) for a temperature greater than 100º F. Available are 200-mg tablets. How many tablets should the nurse administer? Multiple choice question

Three tablets

A nurse is caring for a patient with a tension headache. After taking aspirin the patient reports feeling nauseated. The nurse should contact the primary health care provider to obtain a prescription for what change in medication? Multiple choice question

To decrease the dosage of aspirin

A nurse finds that a patient with severe chronic pain has received two prescriptions: methadone, an opioid, and ibuprofen, a nonsteroidal antiiflammatory drug (NSAID). What is the likely rationale for prescribing two analgesic drugs to this patient? Multiple choice question

To prevent the side effects of the opioid drug

The family member of a patient with a heroin addiction is taught how to use Evzio in the event of opioid overdose. What is the purpose of Evzio? Multiple choice question

To reverse the effects of opioids in the event of an overdose

The nurse is preparing to administer celecoxib 200 mg orally for pain relief. Available are capsules containing 100 mg. How many capsules should the nurse administer? Record your answer using a whole number. capsules.

2