Funds CH 31 Questions

A client reports taking acetaminophen (Tylenol) to control osteoarthritis. Which instruction should the nurse give the patient requiring long-term acetaminophen use? a) Caution the patient against combining acetaminophen with alcohol. b) Explain that acetaminophen increases the risk for bleeding. c) Advise taking acetaminophen with meals to prevent gastric irritation. d) Explain that physical dependence may occur with long-term oral use.

A

A patient is prescribed morphine sulfate 4.0 mg intravenously for postoperative pain. Which action should the nurse take before administering the medication? a) Monitor the patient's respiratory status. b) Auscultate the patient's heart sounds. c) Check blood pressure in supine and sitting positions. d) Monitor the patient for psychological drug dependence.

A

A patient suddenly develops right lower-quadrant pain, nausea, vomiting, and rebound tenderness. How should the nurse classify this patient's pain? a) Acute b) Chronic c) Intractable d) Neuropathic

A

A patient with a history of mitral valve replacement, hypertension, and type 2 diabetes mellitus undergoes emergency surgery to remove an embolus in her right leg. Which factor contraindicates the use of epidural analgesia in this patient? a) Anticoagulant therapy b) Diabetes mellitus c) Hypertension d) Embolectomy

A

How should the nurse classify pain that a patient with lung cancer is experiencing? a) Radiating b) Deep somatic c) Visceral d) Referred

A

The nurse is assessing an intubated patient who returned from coronary artery bypass surgery 3 hours ago. Which assessment finding might indicate that this patient is experiencing pain? a) Blood pressure 160/82 mm Hg b) Temperature 100.6°F c) Heart rate 80 beats/min d) Oxygen saturation 95%

A

The nurse is caring for an immobile patient with chronic, unrelieved pain that is frequently severe. For what potential complication should the nurse monitor? a) Deep vein thrombosis b) Hypotension c) Dehydration d) Hypoglycemia

A

The nurse plays music for a child with leukemia who is experiencing pain. Which pain management technique is this nurse using? a) Distraction b) Guided imagery c) Sequential muscle relaxation d) Hypnosis

A

To provide the most analgesic effect, a medication should bind with and block the pain impulse especially at which of the following opioid receptor sites? a) Mu b) Delta c) Kappa d) Sigma

A

What is the primary reason the nurse incorporates pain assessment as a part of vital signs measurement? a) Asking about pain may prompt patients to report pain more readily. b) Frequent pain assessment is required by the state's nurse practice act. c) Pain is a vital sign much like blood pressure and heart rate. d) Pain assessment indicates the nurse cares about the patient.

A

What is typically the most reliable indicator of pain? a) Patient's self-report b) Past medical history c) Description by caregiver(s) d) Behavioral cues

A

When should the nurse assess pain? a) Whenever a full set of vital signs is taken b) During the admission interview c) Every 4 hours for the first 2 days after surgery d) Only when the patient reports pain

A

Which action should the nurse take first when the patient has a score of 4 on the sedation rating scale? a) Stimulate the patient. b) Prepare to administer naloxone (Narcan). c) Administer a dose of pain medication. d) Notify the physician immediately.

A

Which drug might the primary care provider prescribe to help facilitate pain management in a client with chronic pain? a) Selective serotonin reuptake inhibitor b) Selective norepinephrine reuptake inhibitor c) Opioid analgesic d) Anti-emetic

A

You are administering acetaminophen to a patient to provide pain relief. Which of the following cautions should you give this patient about this medication? A) Avoid drinking alcohol while taking this medication, as it can lead to severe hepatotoxicity. B) Be aware that you will bruise more easily and will bleed more if cut. C) You will likely experience nausea and vomiting while on this medication. D) Avoid large doses of this medication, as it can lead to respiratory depression.

A

A 73-year-old patient admitted after a stroke has expressive aphasia. Which pain intensity scales would be appropriate to use with this patient? Select all that apply. a) Visual analogue b) Numerical rating c) Wong-Baker face rating d) Simple descriptor e) PAINAD scale

A,B,C

The nurse meets with a patient with chronic pain who has tried a new program to manage pain. On a scale of 1 to 10, she reports pain reduction from an 8 to a 5. What questions would the nurse ask to further evaluate the effectiveness of this program? Select all that apply. a) "Does this reduction in pain allow you to perform daily activities?" b) "Are you satisfied with the degree of pain relief you have achieved?" c) "May I review what you have recorded in your pain journal?" d) "Is the pain less than before you started the program?" e) "How has your family responded to the reduction in your pain?"

A,B,C

You are assessing a client with Alzheimer's disease for pain. This client is not able to communicate effectively verbally. Which of the following are behavioral cues that would likely indicate that this client is experiencing pain? SELECT ALL THAT APPLY. A) Grimacing B) Rapid eye blinking C) Noisy breathing D) Fidgeting E) Increased appetite F) Decreased blood pressure

A,B,C,D

At which of the following points should you routinely perform pain assessments on your clients? SELECT ALL THAT APPLY. A) On admission to the hospital B) Before and after each potentially painful procedure or treatment C) Before administering morphine for pain D) Three hours after administering acetaminophen E) When the patient complains of pain

A,B,C,E

The nurse is caring for a patient in the late stage of Alzheimer's disease who is noncommunicative. The nurse suspects the patient is experiencing pain based on what assessment findings? Select all that apply. a) Rapid blinking b) Labored breathing c) Reduced respiratory rate d) Nighttime wakefulness e) Restlessness

A,B,E

You are delegating pain management tasks to nursing assistive personnel (NAP). Which of the following tasks may you delegate? SELECT ALL THAT APPLY. A) Provide mouth care B) Give a back rub or massage C) Assess pain D) Evaluate the pain management plan E) Provide darkness and quiet in the room for sleep F) Speak with the client to distract from pain

A,B,E,F

You are providing discharge teaching to a patient and family about pain and about pain management. The patient has been prescribed an opioid. Which of the following instructions should you give them? SELECT ALL THAT APPLY. A) How to use a pain scale B) A warning that the risk for addiction is extremely high C) Nonpharmacological ways to treat pain D) The importance of sticking to the prescribed pain management plan even if it doesn't seem to be working E) Side effects to observe for F) The normal duration of the pain

A,C,E,F

A client arrives at your clinic clutching her abdomen and complaining of cramping accompanied by sharp pain. Which of the following types of pain is the client experiencing? A) Cutaneous B) Visceral C) Deep somatic D) Radiating

B

A patient had a bowel resection 5 days ago. Which request by the patient might alert the nurse that the patient has a history of substance abuse? a) Oral pain medication once every 6 to 8 hours b) Patient-controlled analgesic c) Oral pain medication instead of the IV form d) Only nonpharmacological pain measures

B

A patient prescribed an NSAID, naproxen (Aleve, Naprosyn), for treatment of arthritis reports stomach upset. What should the nurse instruct the patient to do? a) Notify the prescriber immediately. b) Take the medication with food. c) Take the medication with 8 ounces of water. d) Take the medication before bedtime.

B

A patient who underwent a left above-the-knee amputation reports pain in his left foot. The nurse should document this finding as what type of pain? a) Psychogenic b) Phantom c) Referred d) Radiating

B

After undergoing dural puncture while receiving epidural pain medication, a patient reports a headache. Which action can help alleviate the patient's pain? a) Encourage the client to ambulate to promote flow of spinal fluid. b) Offer caffeinated beverages to constrict blood vessels in his head. c) Encourage coughing and deep breathing to increase CSF pressure. d) Restrict oral fluid intake to prevent excess spinal pressure.

B

An older adult receiving hospice care has dementia as a result of metastasis to the brain. His bone cancer has progressed to an advanced stage. Why might the client fail to request pain medication as needed? The client: a) Experiences less pain than in earlier stages of cancer b) Cannot communicate the character of his pain effectively c) Knowledges pain at a later time than when it occurs d) Relies on caregiver to provide pain relief without asking

B

In which process do peripheral nerves carry the pain message to the dorsal horn of the spinal cord? a) Transduction b) Transmission c) Perception d) Modulation

B

The nurse administers acetaminophen 325 mg and codeine 30 mg orally to a patient reporting a severe headache. When should the nurse reassess the patient's pain? a) 15 minutes after administration b) 60 minutes after administration c) 90 minutes after administration d) Immediately before the next dose is due

B

Which action should the nurse take when preparing patient-controlled analgesia for a postoperative patient? A) Caution the patient to limit the number of times he presses the dosing button. B) Ask another nurse to double-check the setup before patient use. C) Instruct the patient to administer a dose only when experiencing pain. D) Provide clear, simple instructions for dosing if the patient is cognitively impaired.

B

Which characteristic about pain would the nurse most consider when developing a pain management plan for a patient with chronic lower back pain? a) An objective experience that disrupts daily living that can be measured with altered vital signs b) An unpleasant sensory and emotional experience association with actual or potential tissue damage, or described in terms of such damage c) A generalized response of the body as a result of trauma or damage to the tissues resulting in discomfort d) An emotional response to tissue damage that differs significantly from one individual to another

B

Which nursing diagnosis is most appropriate for the patient who returns from the postanesthesia care unit after undergoing right hemicolectomy surgery for colon cancer? a) Acute Pain secondary to surgery b) Acute Pain (abdominal) secondary to surgery for colon cancer c) Chronic Pain secondary to cancer diagnosis d) Chronic Pain (abdominal) secondary to abdominal surgery

B

Which of the following actions would the nurse prioritize for the patient who is experiencing chronic back pain that interferes with activities of daily living (ADLs)? a) Maintain a pain journal to document quality of his pain experience. b) Meet with the healthcare team to discuss a pain management plan. c) Attempt to take only analgesic medication when absolutely needed. d) Suggest use of a deep-pressure back massage with effleurage technique.

B

Which side effects associated with opioid use may improve after taking a few doses of the drug? a) Constipation b) Drowsiness c) Dry mouth d) Difficulty with urination

B

You are caring for a client who has severe burns on her right arm and is in extreme pain, despite receiving a strong analgesic. You decide to rub the client's uninjured left arm to relieve pain in the right. This approach is known as which of the following? A) Massage B) Contralateral stimulation C) TENS D) Acupressure

B

A 64-year-old patient just returned from surgery. She is breathing rapidly and moving constantly in bed. She states, "I am scared and I hurt so much." What would be an appropriate intervention? Select all that apply. a) Immediately notify the surgeon of these data (physical symptoms and patient's statement). b) State calmly, "I am going to do everything I can to make you more comfortable." c) Tell the patient you would like to help her calm down and take some deep breaths. d) Ask the nursing assistive personnel to stay with the patient while you get an analgesic for her. e) Turn on the television to distract her from the pain and anxiety.

B,C,D

You have decided to use cutaneous stimulation to diminish a patient's perception of pain by blocking the transmission of pain impulses. Which of the following are examples of cutaneous stimulation that you could use? SELECT ALL THAT APPLY. A) Diaphragmatic breathing B) TENS unit C) Acupuncture D) Therapeutic touch E) Massage F) Application of an ice pack

B,C,E,F

A 70-year-old male with diabetic peripheral neuropathy reports a burning sensation in his feet. He also states, "Those pain pills make me feel funny and they don't help my pain, so I don't take them." Which of the following is likely to be most beneficial for treating this patient's neuropathic pain? a) Opioid analgesic (morphine) b) NSAID (ibuprofen) c) Antiepileptic drug (gabapentin) d) Narcotic analgesic with acetaminophen (hydrocodone)

C

A client who is receiving epidural analgesia complains of nausea and loss of motor function in his legs. The nurse obtains his blood pressure and notes a drop in his blood pressure from the previous reading. Which complication is the patient most likely experiencing? A) Infection at the catheter insertion site B) Side effect of the epidural analgesic C) Epidural catheter migration D) Spinal cord damage

C

A patient develops a respiratory rate 6 breaths/min after receiving IV hydromorphone (Dilaudid) 2.0 mg. Which medication should the nurse anticipate administering to this patient after notifying the prescriber of this side effect? a) Physostigmine (Antilirium) b) Flumazenil (Romazicon) c) Naloxone (Narcan) d) Protamine sulfate

C

A patient who sustained a leg laceration in an industrial accident is brought to the emergency department. The area around the laceration is red, swollen, and tender. Which substance is responsible for causing this response? a) Histamine b) Prostaglandin c) Bradykinin d) Serotonin

C

A patient who sustained rib fractures in a motor vehicle accident is stating that his pain medication is ineffective. Inadequate pain control places this patient at risk for which complication? a) Metabolic alkalosis b) Pneumothorax c) Pneumonia d) Hemothorax

C

The nurse conducting a pain assessment for a patient would recognize deep somatic pain as which of the following? a) Achy b) Superficial c) Radiating d) Crampy

C

The nurse is caring for a patient with chronic low back pain. The patient reports taking 800 mg of ibuprofen tid for the past 12 years. For this patient, which lab result is most important for the nurse to review? a) WBC with differential b) Serum sodium, potassium, chloride, and CO2 c) Hemoglobin and hematocrit d) Platelet count

C

The nurse is talking to a patient with chronic pain secondary to psoriatic arthritis in multiple joints about developing a pain management program. Which goal identified by the patient would be realistic for the program? a) "I would like for all my pain to be gone and not recur in the future." b) "I want to be able to do all the things I used to do before this pain started." c) "I want to control the pain enough to allow me to sleep through the night." d) "My goal is to lead a normal life without experiencing so much pain every day."

C

The nurse is teaching a client who sustained an ankle injury about cold application. Which instruction should the nurse include in the teaching plan? a) Place the cold pack directly on the skin over the ankle. b) Apply the cold pack to the ankle for 30 minutes at a time. c) Check the skin frequently for extreme redness. d) Keep the cold pack in place for at least 24 hours.

C

The nurse uses his hands to direct energy fields surrounding the patient's body. After this intervention, the patient states that his pain has lessened. How should the nurse document the intervention? a) Tactile distraction was performed and appeared effective in reducing pain. b) Guided imagery was effective to relax the patient and reduce the pain. c) Therapeutic touch was performed; patient verbalized lessening of pain after treatment. d) Sequential muscle relaxation was performed; patient states pain is less.

C

The patient reports pain after surgery, ranking it 6 on a scale of 1 to 10. She tells the nurse, "I don't want to be all doped up. My family is coming to visit and I want to be alert enough to visit with them." Which of the following medications would likely be most effective for postoperative pain relief without excessive sedation? a) Fentanyl IV b) Morphine IV c) Ibuprofen PO d) Hydrocodone PO

C

What physiological process causes the severe pain of menstrual cramps? a) Mechanical stimuli b) Thermal stimuli c) Prostaglandin activity d) Histamine activity

C

Which NSAID drug might be administered to inhibit platelet aggregation in a patient at risk for thrombophlebitis? A) Ibuprofen (Motrin) B) Celecoxib (Celebrex) C) Aspirin (Ecotrin) D) Indomethacin (Indocin)

C

Which action should the nurse take before administering morphine 4.0 mg intravenously to a patient complaining of incision pain? A) Assess the patient's incision. B) Clarify the order with the prescriber. C) Assess the patient's respiratory status. D) Monitor the patient's heart rate.

C

Which expected outcome is best for the patient with a nursing diagnosis of Acute Pain related to movement and secondary to surgical resection of a ruptured spleen and possible inadequate analgesia? a) The patient will verbalize a reduction in pain after receiving pain medication and repositioning. b) The patient will rest quietly when undisturbed. c) On a scale of 0 to 10, the patient will rate pain as a 3 while in bed or as a 4 during ambulation. d) The patient will receive pain medication every 2 hours as prescribed.

C

Which pain management task can be safely delegated to nursing assistive personnel? a) Assessing the quality and intensity of the patient's pain b) Evaluating the effectiveness of pain medication c) Providing a therapeutic back massage d) Administering oral dose of acetaminophen

C

You are using a method of pain relief that involves targeting specific nerves that carry pain impulses with electromagnetic waves. Which of the following interventions is this? A) Rhizotomy B) TENS C) Radiofrequency ablation therapy D) PENS

C

You are caring for a patient who is in constant, unrelieved pain from traumatic injuries suffered in a motorcycle accident. You expect this pain to trigger excessive release of which of the following hormones? SELECT ALL THAT APPLY. A) Insulin B) Testosterone C) Adrenocorticotropic hormone (ACTH) D) Cortisol E) Antidiuretic hormone (ADH) F) Growth hormone (GH)

C,D,E,F

A patient receiving an epidural analgesic complains of a headache. Which of the following should the nurse suspect? a) Catheter migration b) Local anesthesia toxicity c) Common side effect of the analgesic d) Dural puncture

D

A patient reports that he uses music therapy to help control his chronic pain. Music therapy works by prompting the release of endogenous opioids during which stage of the pain process? a) Perception b) Transduction c) Transmission d) Modulation

D

A patient with Raynaud's disease receives no symptomatic relief with diltiazem (Cardizem). Which surgical intervention might be a treatment option for this patient to help provide symptomatic relief? a) Cordotomy b) Rhizotomy c) Neurectomy d) Sympathectomy

D

According to Margo McCaffery, pain is ultimately defined by whom? A) American Pain Society B) The physician C) The nurse D) The patient

D

After receiving ibuprofen (Motrin) 800 mg orally for right hip pain, the patient states that his pain is 8 out of 10 on the numerical pain scale. Which action should the nurse take? a) Use nonpharmacological therapy while waiting 3 more hours before next dose. b) Administer an additional 800 mg oral dose of ibuprofen right away. c) Do nothing because the patient's facial expression indicates he is comfortable. d) Notify the prescriber that the current pain management plan is ineffective.

D

The nurse administers codeine sulfate 30 mg orally to a patient who underwent craniotomy 3 days ago for a brain tumor. How soon after administration should the nurse reassess the patient's pain? A) Immediately B) In 10 minutes C) In 20 minutes D) In 60 minutes

D

The pediatric nurse is caring for a 4-year-old child who is experiencing chronic pain secondary to tissue injury from past sickle cell anemia crises. Which of the following nonpharmacological pain reduction interventions might the nurse implement? Have the child: a) Perform vigorous activity b) Practice visualization c) Listen to rap music d) Watch a funny movie

D

You are caring for a patient with Raynaud's disease who has intractable pain. The patient is scheduled to undergo surgical interruption of pain conduction pathways to improve vascular blood supply and to eliminate vasospasm and pain. Which type of surgery is the patient most likely to undergo? A) Cordotomy B) Rhizotomy C) Neurectomy D) Sympathectomy

D

Which factor in the patient's past medical history dictates that the nurse exercise caution when administering acetaminophen (Tylenol)? A) Hepatitis B B) Occasional alcohol use C) Allergy to aspirin D) Gastric irritation with bleeding

a

Which pain management task can the nurse safely delegate to nursing assistive personnel? A) Asking about pain during vital signs B) Evaluating the effectiveness of pain medication C) Developing a plan of care involving nonpharmacological interventions D) Administering over-the-counter pain medications

a

A 73-year-old patient who sustained a right hip fracture in a fall requests pain medication from the nurse. Based on his injury, which type of pain is this patient most likely experiencing? A) Phantom B) Visceral C) Deep somatic D) Referred

c