Pain

A nurse is caring for a client with pain. What should the nurse monitor for when administering intravenous acetaminophen? a) bleeding b) renal toxicity c) hepatotoxicity d) gastrointestinal effects

c) hepatotoxicity

The client reports chest pain. The nurse uses which of the following questions to assess the pain further. Select all answers that apply. a) "How long have you experienced this pain?" b) "You've never had this pain before, have you?" c) "What aggravates your chest pain?" d) "Please point to where you are experiencing pain." e) "Rate the pain on a scale of 0 to 10, with 10 being the worst possible pain."

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

The advance nurse practitioner, who is treating a client diagnosed with neuropathic pain, decides to start adjuvant analgesic agent therapy. Which medication is appropriate for the nurse practitioner to prescribe? a) Gabapentin b) Hydromorphone c) Tramadol d) Ketamine

a) Gabapentin

The nurse is caring for a patient who has been hospitalized on several occasions for lower abdominal pain related to Crohn's disease. How may this chronic pain be described? a) Prolonged in duration b) Attributable to a specific cause c) Rapidly occurring and subsiding with treatment d) Separate from any central or peripheral pathology

a) Prolonged in duration

Regarding tolerance and addiction, the nurse understands that a) although clients may need increasing levels of opioids, they are not addicted. b) the nurse must be primarily concerned about the development of addiction by a client in pain. c) tolerance to opioids is uncommon. d) addiction to opioids often develops.

a) although clients may need increasing levels of opioids, they are not addicted.

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? a) the limits on dose and frequency that are programmed into the PCA b) the fact that naloxone will be kept readily available at all times c) the use of non-pharmacologic pain interventions to minimize use of the PCA d) the importance of limiting the use of the PCA to no more than twice per hour

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

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? a)The pain medication will be administered before the pain is experienced. b) The pain medication will be administered when the level of pain tolerance has been exceeded. c) The pain medication will be administered when the pain is at its peak. d)The pain medication will be administered before the pain becomes severe.

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

The client takes naproxen for arthritic pain and is now prescribed warfarin for persistent atrial fibrillation. Due to the interactions of the medications, what is the nurse's best response? a) Administer both medications with food to increase absorption b) Assess the client's stool for color c) Inform the client to decrease alcohol to one glass each day d) Teach the client to ingest foods high in vitamin K

b) Assess the client's stool for color -------------------------------- Rationale: Clients who take NSAIDs, such as naproxen (Aleve), with warfarin (Coumadin) may experience gastrointestinal bleeding. The nurse will need to monitor for this.

Prostaglandins are chemical substances with what property? a) Inhibit the transmission of pain b) Increase the sensitivity of pain receptors c) Reduce the perception of pain d) Inhibit the transmission of noxious stimuli

b) Increase the sensitivity of pain receptors

Which of the following pain assessment tools is most commonly used in adults? a) FACES scale b) Numeric scale c) Linear scale d) Word scale

b) Numeric scale

A client has been taking opioid analgesics for more than 2 weeks to control post-surgical pain. Although pleased with the client's progress, the surgeon decides to change the analgesic to a non-opioid drug. The surgeon prescribes a gradually lower opioid dose and increasingly larger non-opioid doses. The surgeon is changing medications in this manner to avoid: a) addiction. b) withdrawal symptoms. c) tolerance. d) respiratory depression.

b) withdrawal symptoms.

Which client is most likely to receive opioids for extended periods of time? a) A client with fibromyalgia b) A client with phantom limb pain c) A client with progressive pancreatic cancer d) A client with trigeminal neuralgia

c) A client with progressive pancreatic cancer

In caring for a young child with pain, which assessment tool is the most useful? a) Simple description pain intensity scale b) 0-10 numeric pain scale c) Faces pain-rating scale d) McGill-Melzack pain questionnaire

c) Faces pain-rating scale

In applying the principles of pain treatment, what is the first consideration? a) Treatment is based on client goals. b) A multidisciplinary approach is needed. c) The client must be believed about perceptions of own pain. d) Drug side effects must be prevented and managed.

c) The client must be believed about perceptions of own pain.

The advance practice nurse is treating a client experiencing a neuropathic pain syndrome. Which statements by the client demonstrates an understanding of concepts related to neuropathic pain? a) "Neuropathic pain is the body's normal response to tissue damage that causes pain." b) "Neuropathic pain will only last a few days and is easily treated with COX-2 analgesic agents." c) "When the inflammation in my foot resolves, I will no longer have pain from neuropathy." d) "My phantom limb pain serves no purpose, and I may need to take antidepressants to help."

d) "My phantom limb pain serves no purpose, and I may need to take antidepressants to help." ------------------------------------ Rationale: Neuropathic pain is chronic and not treated with COX-2 analgesics. Neuropathic pain is an abnormal processing of sensory input by the peripheral or central nervous system or both. Neuropathic pain may occur in the absence of tissue damage and inflammation. Neuropathic pain serves no useful purpose. Evidence-based guidelines recommend the tricyclic antidepressants despiramine (Norpramin) and nortriptyline (Aventyl, Pamelor) and the SNRIs duloxetine (Cymbalta) and venlafaxine (Effexor) as first-line options for treatment of neuropathic pain.

The nurse is obtaining data regarding the medication that the client is taking on a regular basis. The client states he is taking duloxetine, an antidepressant for the treatment of neuropathic pain. What type of therapy does the nurse understand the client is receiving? a) Alternate drug therapy b) Withdrawal therapy c) Replacement drug therapy d) Adjuvant drug therapy

d) Adjuvant drug therapy

Which of the following is a physiologic response to pain? a) Dry skin b) Hypotension c) Bradycardia d) Pallor

d) Pallor -------------------------------------- Rationale: Physiologic responses to pain include pallor, tachycardia, diaphoresis, and hypertension.