44 -- Pain Management/ Pain Management and the Nursing Process

Which class of pain management drugs may interfere with bowel or bladder function? a. anticonvulsants b. opioid analgesics c. nonopijoid analgesics d. non steroidal anti-inflammatory drugs

b. opioid analgesics

Which type of pain management is cold application? a. Relaxation b. Distraction c. Cutaneous stimulation d. Acupressure

c. Cutaneous stimulation

A patient in pain mentions a history of allergy to aspirin. Which drugs might the health care team avoid for this patient? Select all that apply. a. Fentanyl b. Morphine c. Naproxen d. Ibuprofen e. Oxycodone

c. Naproxen d. Ibuprofen

The nursing instructor asks the student nurse to differentiate between A and C peripheral nerve fibers. Which statement made by the student nurse indicates effective learning? a. "the A fibers are myelinated and the C fibers are unmyelinated." b. " the A fibers are smaller in diameter and the C fibers are larger in diameter." c. "the A fibers transmit signals slowly and the C fibers transmit signals rapidly." d. "the A fibers diffuse sensation and the C fibers cause localization sensations."

a. "the A fibers are myelinated and the C fibers are unmyelinated."

A patient is on a lidocaine patch for neuropathic pain. How should the lidocaine be given to the patient to achieve adequate pain control and avoid lidocaine toxicity? a. 12-hours-on, 12 hours-off schedule b. 12-hours on, 6 hours-off schedule c. 48-hours -on, 12 hours-off schedule d. 24-hours-on, 12 hours-off schedule

a. 12-hours-on, 12 hours-off schedule

A primary health care provider prescribes 10 mg of codeine every 4 hours to a patient who has chronic pain from cancer. However, after taking a second dose of the prescribed drug, the nurse notices that the patient is very drowsy and nauseous. Which dose alteration may provide effective pain relief while improving the drowsiness and nausea? a. 5 mg codeine every 4 hours b. 10 mg codeine every 8 hours c. 20 mg codeine every 8 hours d. 5 mg codeine every 12 hours

a. 5 mg codeine every 4 hours

A patient is in the first postoperative day following a nephrectomy. The patient is receiving morphine through a patient-controlled analgesia (PCA) device for management of pain. The nurse decides to use the ABCDE approach while assessing and managing pain for this patient. What are the correct components of the ABCDE approach? Select all that apply. a. A: ask regularly about the pain b. A: assess the pain once a week c. B: believe the patient about the pain d. C: choose pain control options appropriate to the patient e. D: deny the use of painkillers and encourage the patient to bear the pain naturally

a. A: ask regularly about the pain c. B: believe the patient about the pain d. C: choose pain control options appropriate to the patient

The nurse is caring for a patient who is on opioid therapy. For which findings is the nurse carefully observing the patient? Select all that apply. a. Decreased pulse rate b. Increased respiratory rate c. Decreased blood pressure d. Pupil dilatation e. Peripheral edema

a. Decreased pulse rate c. Decreased blood pressure e. Peripheral edema

The nurse is learning about the effects of pain on the sympathetic system. What are the manifestations of sympathetic stimulation in response to the pain? Select all that apply. a. Increased heart rate b. rapid, irregular breathing c. Increased glucose level d. Decreased blood pressure e. Decreased gastrointestinal motility

a. Increased heart rate c. Increased glucose level e. Decreased gastrointestinal motility

The nurse is caring for a patient on pain management therapy. Which types of therapy cause a release of endorphins that can block the transmission of painful stimuli? Select all that apply. a. Massage b. opioid analgesics c. cold application d. non-steroidal anti-inflammatory drugs (NSAIDs) e. Transcutaneous electrical nerve stimulation (TENS)

a. Massage c. cold application e. Transcutaneous electrical nerve stimulation (TENS)

A primary health care provider prescribes medication for a patient in respiratory distress. Shortly after, the patient complains of severe pain. Which medication did the patient likely receive? a. Naloxone b. Capsaicin c. Lidoderm Path d. Acetaminophen

a. Naloxone

Which instructions are crucial for the nurse to give to both family members and the patient who is about to be started on patient-controlled analgesia (PCA) of morphine? a. Only the patient should push the button. b. Do not use the PCA until the pain is severe. c. The PCA prevents constipation. d. Notify the nurse when the button is pushed.

a. Only the patient should push the button.

A patient has had arthritic pain for 8 years and has surgery to remove a buildup of septic fluid. Postoperative, the patient received morphine through a patient-controlled analgesia (PCA) device for the management of pain. What is the advantage of PCA that the nurse should teach the patient? a. PCA allows self-administration of analgesics b. PCA is associated with a risk of overdose c. PCA does not allow administration of opioids d. PCA allows intramuscular administration of medications

a. PCA allows self-administration of analgesics

The nurse works in a postsurgical ward. Which statements by the nurse indicate common misconceptions about pain? Select all that apply. a. Psychogenic pain is not real. b. Chronic pain is not psychological. c. Patients who cannot speak can feel pain. d. Administering analgesics regularly leads to drug addiction. e. Patients who abuse substances overreact to discomfort.

a. Psychogenic pain is not real. d. Administering analgesics regularly leads to drug addiction. e. Patients who abuse substances overreact to discomfort.

The human body has a mechanism to reduce pain perception by inhibitory neurotransmitters. What are the inhibitory neurotransmitters of pain in the brain? Select all that apply. a. Serotonin b. Histamine c. Substance P d. Norepinephrine e. Gamma Aminobutyric acid

a. Serotonin d. Norepinephrine e. Gamma Aminobutyric acid

The nurse explains patient-controlled analgesia to a patient. If the patient has understood this information, what would be the patient's most appropriate statement? a. The device reduces the risk of an overdose of medication. b. The caregivers can operate the device if the patient is unable to do so. c. The patient will be lying in a prone position during the procedure. d. The patient will decide about the loading dose of the analgesic drug.

a. The device reduces the risk of an overdose of medication.

A postoperative patient is currently asleep. Which statement is correct? a. The sedative administered may have helped him sleep, but assessment of pain is still needed. b. The intravenous (IV) pain medication is effectively relieving his pain. c. Pain assessment is not necessary. d. The patient can be switched to the same amount of medication by the oral route.

a. The sedative administered may have helped him sleep, but assessment of pain is still needed.

The nurse has to administer opioids to a female patient after a surgical procedure. Which conditions may require special consideration before administration of opioids? Select all that apply. a. breastfeeding b. dialysis c. respiratory disease d. history of orthopedic surgery e. chronic headache

a. breastfeeding b. dialysis c. respiratory disease

Which adjuvant drug relieves pain caused by inflammation and bone metastasis? a. cotricosteroids b. antidepressants c. opioid analgesics d. non steroidal anti-inflammatory drugs

a. cotricosteroids

Which scales would be most appropriate for assessing pain in children? Select all that apply. a. faces pain scale b. oucher pain scale c. numerical rating scale d. visual analog scale e. Wong-baker faces pain scale

a. faces pain scale b. oucher pain scale e. Wong-baker faces pain scale

The nurse is assessing a patient with appendicitis. Which statement helps the nurse determine the effect of pain on the patient? a. "I have sharp pain in my stomach." b. "I am unable to walk because of this pain." c. "my pain worsens when performing any activity." d. "I have severe pain, which I would rate as 8 out of 10."

b. "I am unable to walk because of this pain."

A patient who underwent abdominal surgery experiences constipation and severe cramping. Which nonpharmacological nursing interventions may provide relief to this patient? Select all that apply. a. helping the patient walk b. increasing the patient's fluid intake c. providing stool softeners to the patient d. planning sleep therapies for the patient e. providing and elevated toilet seat to the patient

a. helping the patient walk b. increasing the patient's fluid intake

The electrocardiogram of an elderly male patient who had chest pain shows signs of myocardial infarction. What are the likely sites for referred pain for a male patient with myocardial infection? Select all that apply. a. jaw b. groin c. left ear d. left arm e. left shoulder

a. jaw d. left arm e. left shoulder

The nurse is planning effective pain management for a patient. What patient barriers prevent pain management? Select all that apply. a. lack of money b. fear of legal repercussions c. difficulty in filling prescriptions d. desire to avoid worrying family and friends e. belief that patient need to learn to live with pain

a. lack of money c. difficulty in filling prescriptions d. desire to avoid worrying family and friends

The nurse is planning effective pain management for a patient. What patient barriers prevent pain management? Select all that apply. a. lack of money b. fear of legal repercussions c. difficulty in filling prescriptions d. desire to avoid worrying family and friends e. belief that patients need to learn to live with pain

a. lack of money c. difficulty in filling prescriptions d. desire to avoid worrying family and friends

Which interventions does the nurse implement if a patient who is on a patient-controlled analgesia (PCA) pump does not easily awaken? Select all that apply. a. notify the primary health care provider (PHP) b. prepare to administer an opioid-reversing agent c. inspect the intravenous (IV) site for possible catheter occlusion or infiltration d. Discuss a possible basal (continuous) dose with the PHP e. Consult with the PHP regarding an alternative medication route

a. notify the primary health care provider (PHP) b. prepare to administer an opioid-reversing agent

The nurse is teaching a group of caregivers about the concept of pain in older adults. What should the nurse include in the teachings? Select all that apply. a. older patient underreport pain b. sleeping indicated pain relief c. opioids are safe to use in older patients d. older adults tend to perceive more pain e. older adults with cognitive impairment do not experience less pain

a. older patient underreport pain c. opioids are safe to use in older patients e. older adults with cognitive impairment do not experience less pain

Which instructions are crucial for the nurse to give to both family members and the patient who is about to be started on patient-controlled analgesia (PCA) of morphine? a. only the patient should push the button b. do not use the PCA until the pain is severe c. the PCA prevents constipation d. Notify the nurse when the button is pushed

a. only the patient should push the button

Which instructions are crucial for the nurse to give to both family members and the patient who is about to be started on patient-controlled analgesia (PCA) of morphine? a. only the patient should push the button b. do not use the PCE until the pain is severe c. the PCA prevents consitpation d. Notify the nurse when the button is pushed

a. only the patient should push the button

Which statements about opioid analgesics for pain management are correct? Select all that apply. a. opioid analgesics act on higher centers fo the brain b. use of opioid analgesics will increase libido in male patients c. opioid analgesics are prescribed for relieving mild forms of pain d. the short-acting forms of opioids provide pain relief for approximately 4 hours e. prolonged use of opioid analgesics will increase patient tolerance to depression of the central nervous system

a. opioid analgesics act on higher centers fo the brain d. the short-acting forms of opioids provide pain relief for approximately 4 hours

A patient with bronchial carcinoma reports constipation for the past 2 months. The patient has been on meperidine and ibuprofen for pain relief for the past 6 months. The patient has also been taking metformin and captopril for the past 10 years. What could be the most probable reason for constipation in the patient? a. side effects of the opioid b. side effects of the captopril c. interaction of metformin and captopril d. metastasis of cancer to other organs

a. side effects of the opioid (meperidine is opioid)

A health care provider writes the order for an opioid-naïve patient who returned from the operating room following a total hip replacement. The order states, "Fentanyl patch 100 mcg, change every 3 days." Based on this order, the nurse plans to implement which actions? a. the nurse calls the health care provider and questions the order b. the nurse applies the patch on the third postoperative day c. the nurse applies the patch as soon as the patient reports pain d. the nurse places the patch as close to the hip dressing as possible

a. the nurse calls the health care provider and questions the order

During the subjective data collection for pain assessment, the nurse asks the patient, "Can you tell me what your discomfort feels like?" What is the reason for this question? a. the nurse wants the patient to identify the quality of pain b. the nurse wants the patient to identify the severity of pain c. the nurse wants the patient to identify the duration of pain e. the nurse wants the patient to identify the intensity of pain

a. the nurse wants the patient to identify the quality of pain

What is recommended on the World Health Organization (WHO) analgesic ladder while caring for a patient with cancer pain? a. transitioning use of adjuvants with noneseroidal anti-inflammatory drugs (NSAIDs) to opioids b. Using acetaminophen for refractory pain c. Limiting the use of opioids because of the likelihood of side effects d. Avoiding total sedation regardless of how severe the pain is

a. transitioning use of adjuvants with noneseroidal anti-inflammatory drugs (NSAIDs) to opioids

The registered nurse is teaching a nursing student about applying transcutaneous electrical nerve stimulation (TENS) to a patient. Which of the nursing student's statements indicate a need for further teaching? Select all that apply. a. "I should set the frequency to no more than 50 Hz." b. "I should use TENS on patients who have chronic cancer pain." c. "I should place TENS electrodes directly over or near the site of pain." d. "I should apply hair or skin preparations before placing TENS electrodes." e. "I should remove TENS electrodes if the patient feels a buzzing or tingling sensation."

b. "I should use TENS on patients who have chronic cancer pain." d. "I should apply hair or skin preparations before placing TENS electrodes." e. "I should remove TENS electrodes if the patient feels a buzzing or tingling sensation."

The nurse is assessing a hospitalized patient with acute pain. Which questions should the nurse ask the patient for an appropriate assessment? Select all that apply. a. "How bad is your pain now?" b. "What makes your pain worse?" c. "Describe your pain." d. "What is the worst pain you have had in past 24 hours?" e. "Show me where you are hurt. Does it stay there or does it spread?"

b. "What makes your pain worse?" c. "Describe your pain." e. "Show me where you are hurt. Does it stay there or does it spread?"

The nurse is teaching a group of nursing students about concepts of pain in infants. Which information should the nurse include in the teaching? Select all that apply. a. Infants cannot express pain b. Absorption of drugs is faster than expected c. infants are less sensitive to pain than adults are d. preterm neonates have greater sensitivity to pain than older children do e. Assessment of pain involves cues and physiological indicators

b. Absorption of drugs is faster than expected d. preterm neonates have greater sensitivity to pain than older children do e. Assessment of pain involves cues and physiological indicators

A group of nursing students is learning about nociceptive and neuropathic pain. What are examples of neuropathic pain? Select all that apply. a. Aching muscles b. Diabetic neuropathy c. Trigeminal neuralgia d. Nerve root compression e. Throbbing pain at knee joint

b. Diabetic neuropathy c. Trigeminal neuralgia d. Nerve root compression

While treating a patient, the primary health care provider encourages the patient to watch funny videos. This is an example of which pain management technique? a. Relaxation b. Distraction c. Acupressure d. Music therapy

b. Distraction

Which analgesic drug depresses the central nervous system? a. Aspirin b. Fentanyl c. Naproxen d. Ibuprofen

b. Fentanyl

Which analgesic drug depresses the central nervous system? a. Aspirin b. Fentanyl c. Naproxen d. Ibuprofen

b. Fentanyl

During a preoperative assessment, a patient reports history of a heart attack and use of anticoagulant medications. If epidural anesthesia is administered to the patient for the surgery, for which possible complication should the nurse look? a. Synergistic effects b. Hematoma c. Allergic reaction d. Respiratory depression

b. Hematoma

A patient with jaundice is diagnosed with liver cirrhosis and has an enlarged abdomen, which is tender on palpation. The patient reports severe pain, has an oral temperature of 98.4' F, and blood pressure 134/84 mm Hg. The patient takes acetaminophen for pain. What should the nurse tell the patient about the use of acetaminophen? a. It helps reduce inflammation. b. It is not safe in patients with liver cirrhosis. c. It helps reduce blood pressure. d. It increases the dose of opioid needed to achieve pain control.

b. It is not safe in patients with liver cirrhosis.

Which information is obtained by referring to the morphine equianalgesic chart? Select all that apply. a. Morphine (oral route) dose equivalent to ibuprofen (oral route) dose b. Morphine (oral route) dose equivalent to hydromorphone (oral route) dose c. Morphine (oral route) dose equivalent fentanyl transdermal patch d. Diclofenac (oral route) dose equivalent to morphine (intravenous route) dose e. Morphine dose equivalent (intravenous route) to fentanyl transdermal patch

b. Morphine (oral route) dose equivalent to hydromorphone (oral route) dose c. Morphine (oral route) dose equivalent fentanyl transdermal patch e. Morphine dose equivalent (intravenous route) to fentanyl transdermal patch

Which class of pain management drugs may interfere with bowel or bladder function? a. Anticonvulsants b. Opioid analgesics c. Nonopioid analgesics d. Nonsteroidal antiinflammatory drugs

b. Opioid analgesics

In which situation would drug administration be considered palliative? a. Thyroid hormone replacement b. Pain management for a patient with terminal cancer c. Antibiotic therapy for a patient with a bacterial infection d. Iron supplements for the treatment of iron-deficiency anemia

b. Pain management for a patient with terminal cancer

A postoperative patient reports pain at the site of surgery. On examination, the nurse finds that the incision is healing well and there are no signs of infection. The nurse instructs a student nurse to give a placebo drug to the patient. Which action would be the most appropriate action for the student nurse to take? a. Follow the instructions given by the nurse. b. Question the action of the placebo prescription. c. Administer another analgesic drug. d. Administer the placebo and inform the primary health care provider immediately.

b. Question the action of the placebo prescription.

Which statement about transcutaneous electrical nerve stimulation (TENS) is incorrect? a. TENS is helpful in reducing pain perception. b. TENS is effective for chronic and post-surgical pain control. c. A TENS unit consists of a battery-powered transmitter, lead wires, and electrodes. d. TENS requires a health care provider's order that identifies the site(s) for electrode placement.

b. TENS is effective for chronic and post-surgical pain control.

The patient rates his pain as a 6 on a scale of 0 to 10, with 0 being no pain and 10 being the worst pain. The patient's wife says that he can't be in that much pain, because he has been sleeping for 30 minutes. Which is the most accurate resource for assessing the pain? a. The patient's wife is the best resource for determining the level of pain, because she has been with him continually for the entire day. b. The patient's report of pain is the best method for assessing the pain. c. The patient's health care provider has the best knowledge of the level of pain that the patient that should be experiencing. d. The nurse is the most experienced at assessing pain.

b. The patient's report of pain is the best method for assessing the pain.

A patient with rheumatoid arthritis reports acute joint pain in the hand. Which intervention is inappropriate for providing pain relief? a. Encouraging the patine to listen to music or watch television b. collaborating with an occupational therapist to provide assertive devices for grooming c. Administering ordered analgesics around the clock for 24 to 48 hours d. applying cool compresses to the patient's joints with the prescriber's approval

b. collaborating with an occupational therapist to provide assertive devices for grooming

The nurse is assessing a patient who had been administered morphine for pain relief. The nurse finds that the patient's respiratory rate is 5 breaths/minute. Which drug would be the most helpful in reversing this adverse effect? a. meperidine b. naloxone c. flumazenil d. metoclopramide

b. naloxone

A patient who is on aspirin therapy for pain relief reports that there has been no change in the pain even after taking the drug. On assessment, the nurse finds that the patient had a history of a bleeding gastric ulcer and obstructive sleep apnea. What immediate action should the nurse take? a. Add an opioid analgesic. b. stop the aspirin administration c. increase the dose of aspirin d. stop the aspirin and give ibuprofen

b. stop the aspirin administration

During emotional pain assessment, the patient reports numbness and tingling sensations interspersed with shooting or electric-like pain. What does the nurse infer from the patient's report? a. the patient is experiencing idiopathic pain b. the patient is experiencing neuropathic pain c. the patient is experiencing nociceptive visceral pain d. the patient is experiencing nociceptive somatic pain

b. the patient is experiencing neuropathic pain

The patient rates his pain as a 6 on a scale of 0 to 10, with 0 being no pain and 10 being the worst pain. The patient's wife says that he can't be in that much pain, because he has been sleeping for 30 minutes. Which is the most accurate resource for assessing the pain? a. the patient's wife is the best resource for determining the level of pain, because she has been with him continually for the entire day. b. the patients report of pain is the best method for assessing the pain c. the patient's heath care provider has the best knowledge of the level of pain that the patient should be experiencing d. the nurse is the most experienced at assessing pain

b. the patients report of pain is the best method for assessing the pain

A patient with cancer is administered 60 mg oral morphine per day for chronic pain. The response to this dose is decreasing after repeated administration. The patient now needs to increase the dose of the morphine to achieve adequate pain control. What is this phenomenon called? a. addiction b. tolerance c. pseudoaddiction d. physical dependence

b. tolerance

Which type of pain management therapy is preferred for relieving chronic cancer pain? a. Local Anesthesia b. Topical Analgesic c. Epidural Analgesia d. perineurial Local Anesthetic Infusion

c. Epidural Analgesia

A patient is in the first postoperative day following a nephrectomy. The patient is receiving morphine through a patient-controlled analgesia (PCA) device for management of pain. The patient complains of pain in the shoulders. The nurse understands that it is a referred pain. What explanation should the nurse give to the patient regarding the referred pain? a. It is a pain that occurs sporadically over time. b. It is a moderate pain that occurs for more than 6 months constantly. c. It is a pain that is sensed at a site away from its actual origin or pathology. d. It is neuropathic pain that is caused generally after cancer or a tumor

c. It is a pain that is sensed at a site away from its actual origin or pathology.

Which topical analgesic is effective for relieving postherpetic neuralgia in adults? a. Capsaicin b. ELA-Max/LMX c. Lidoderm patch d. Eutectic mixture of local anesthetics (EMLA)

c. Lidoderm patch

A physician put a postoperative patient on a patient-controlled opioid analgesic pump to be used around the clock for a week. Which assessment should the nurse make at regular intervals? a. Liver Enzymes b. Blood Pressure c. Respiratory Rate d. Body Temperature

c. Respiratory Rate

The nurse is assessing a patient who complains of pain in the abdomen. What is the most appropriate method to assess the intensity of pain? a. asking the patient to describe the pain b. asking the patient about he location of pain c. asking the patient to describe the pain using a pain scale d. asking the patient about the precipitating factors of the pain

c. asking the patient to describe the pain using a pain scale

Which nursing process step is involved when the nurse is reviewing the patient controlled analgesia (PCA) information in the drug reference manual? a. planning b. evaluation c. assessment d. implementation

c. assessment

The nursing instructor is teaching a student nurse about using a patient-controlled analgesia (PCA) pump. Which intervention does the student nurse follow to establish the route of medication and rapid administration of the medication? a. administer the loading dose of analgesia as prescribed b. attach the drug reservoir to the infusion device and prime the tubing c. insert and secure a needless adapter into the injection port nearest the patient d. attach a needless adapter to the tubing adapter of the patient-controlled module

c. insert and secure a needless adapter into the injection port nearest the patient

The nurse plans to give a massage to a patient who has body aches. The patient has a history of angina and deep vein thrombosis. Which area, if massaged, can lead to complications in the patient? a. back b. shoulders c. leg muscles d. thigh muscles

c. leg muscles

A physician put a postoperative patient on a patient-controlled opioid analgesic pump to be used around the clock for a week. Which assessment should the nurse make at regular intervals? a. liver enzymes b. blood pressure c. respiratory rate d. body temperature

c. respiratory rate

A patient is under preoperative care for an elective surgery. After understanding the explanation given by the nurse about spinal anesthesia, the patient expresses fear of becoming paralyzed due to spinal anesthesia. How should the nurse respond in this situation? a. Send the patient home, because it is not a surgical emergency. b. Ask the health care provider to postpone the surgery without patient's permission. c. Arrange an appointment with a surgical counselor as soon as possible. d. Reassure the patient and explain that numbness, tingling, and coldness are common symptoms.

d. Reassure the patient and explain that numbness, tingling, and coldness are common symptoms.

The nurse attending to a postoperative patient finds that the patient's pain medications have been changed from morphine to ibuprofen. What are the possible reasons for the change in medication by the health care provider? Select all that apply. a. the patient's pain has increased b. morphine is known to cause seizures c. the patient experienced clinical respiratory depression d. ibuprofen does not affect the central nervous system the way morphine does e. ibuprofen does not interfere with bowl and bladder function

c. the patient experienced clinical respiratory depression d. ibuprofen does not affect the central nervous system the way morphine does e. ibuprofen does not interfere with bowl and bladder function

The primary health care provider (PHP) prescribes a patient-controlled analgesia (PCA) pump to a postoperative patient for pain relief. The nurse reviews the PHP's order for the patient's name, the name of the medication, dose, frequency of medication, and lockout period. Why does the nurse perform this review? a. To prevent medication errors b. to ensure that the patient receives the correct medications c. to ensure that the medication is administered safely d. to avoid placing the patient at risk for allergic reactions

c. to ensure that the medication is administered safely

The registered nurse is teaching a patient about the use of cold therapy in acute pain management. Which of the patient's statements indicates a need for further teaching? a. "I will apply ice two to five times a day." b. "I will apply ice with a lightweight cover, with firm pressure to my skin." c. "I will apply ice within a 6-inch circular area near where I have pain." d. " I will place ice between my thumb and index finger if I have shoulder pain."

d. " I will place ice between my thumb and index finger if I have shoulder pain."

The registered nurse is teaching a patient about the use of cold therapy in acute pain management. Which of the patient's statements indicates a need for further teaching? a. "I will apply ice two to five times a day." b. "I will apply ice with a lightweight cover, with firm pressure to my skin." c. "I will apply ice within a 6-inch circular area near where I have pain." d. "I will place ice between my thumb and index finger if I have shoulder pain."

d. "I will place ice between my thumb and index finger if I have shoulder pain."

A patient receiving morphine through a patient-controlled analgesia (PCA) infusion is experiencing respiratory depression. Intravenous naloxone 0.4 mg has been ordered. Once diluted with 9 mL of normal saline, at which rate would the nurse administer the medication via the intravenous push route? a. 1 mL every 1 min b. 1 mL every 2 min c. 0.5 mL every 1 min d. 0.5 mL every 2 min

d. 0.5 mL every 2 min

A 65-year-old patient is experiencing mild musculoskeletal pain. Which drug is the primary health care provider most likely to prescribe? a. Aspirin b. Naproxen c. Ibuprofen d. Acetaminophen

d. Acetaminophen

The physician tells the nurse to administer a second drug to a patient already on oxycodone. Which drug would be safe for this patient? a. Fentanyl b. Morphine c. Codeine d. Acetaminophen

d. Acetaminophen

Which pain management drug is considered the best tolerated and safest analgesic? a. Fentanyl b. Tramadol c. Acetylcysteine d. Acetaminophen

d. Acetaminophen

What is the immediate intervention if a patient on morphine 10 mg/mL infusion therapy experiences severe respiratory depression? a. Administering acetylcysteine b. Change morphine infusion to oral oxycodone c. Decreasing the rate of infusion d. Administering 0.4 mg of naloxone

d. Administering 0.4 mg of naloxone

After having received 0.2 mg of naloxone intravenous push (IVP), a patient's respiratory rate and depth are within normal limits. The nurse now plans to implement which actions? a. Discontinue all ordered opioids. b. Close the room door to allow the patient to recover. c. Administer the remaining naloxone over 4 minutes. d. Assess patient's vital signs every 15 minutes for 2 hours.

d. Assess patient's vital signs every 15 minutes for 2 hours.

A patient returning to the nursing unit after knee surgery is verbalizing pain at the surgical site. What is the nurse's first action? a. Call the patient's health care provider. b. Administer pain medication as ordered. c. Check the patient's vital signs. d. Assess the characteristics of the pain.

d. Assess the characteristics of the pain.

The nurse is assessing a patient who has sustained severe injuries in a motor vehicle accident. The patient is in severe pain and is diaphoretic. On assessment, the patient's heart rate is increased, pupils are dilated, and blood pressure is decreased. Which finding is caused by the stimulation of the parasympathetic nervous system? a. Diaphoresis b. Dilation of pupils c. Increased heart rate d. Decreased in blood pressure

d. Decreased in blood pressure

Which statement is true regarding opioiates for pain management? a. Morphine is available only for oral administration. b. Hydrocodone is only available intravenously. c. Oxycodone is available for both oral and intravenous administration. d. Hydromorphone is available for both oral and intravenous administration.

d. Hydromorphone is available for both oral and intravenous administration.

The registered nurse is evaluating the performance of a student nurse who is performing a back massage for a patient with back pain. Which action by the student nurse needs correction? a. using long, gliding stoked along the muscles of the spine b. beginning at the sacral area and massaging in a circular motion c. kneading the skin by gently grasping tissue between the thumb and fingers d. Kneading downward along one side of the spine from the shoulders to the buttocks

d. Kneading downward along one side of the spine from the shoulders to the buttocks

A new medical resident writes an order for oxycodone SR 10 mg PO q12 hours prn. Which part of the order does the nurse question? a. the drug b. the time interval c. the dose d. PRN

d. PRN (b/c long-acting (SR) formulations NOT ordered pro)

The nurse is teaching pain management to a group of caregivers. Which information should be included? Select all that apply. a. Chronic pain is often psychological. b. Only hospitalized patients experience severe pain. c. Psychogenic pain is not real. d. Regular administration of analgesics will not lead to addiction. e. Patients with minor illnesses may also experience severe pain.

d. Regular administration of analgesics will not lead to addiction. e. Patients with minor illnesses may also experience severe pain.

When teaching a patient about transcutaneous electrical nerve stimulation (TENS), which information should the nurse include? a. TENS works by causing distraction. b. TENS therapy does not require a health care provider's order. c. A TENS unit must remain plugged in at all times d. TENS electrodes are applied near or directly on the site of pain.

d. TENS electrodes are applied near or directly on the site of pain.

A 65-year-old patient is experiencing mild musculoskeletal pain. Which drug is the primary health care provider most likely to prescribe? a. aspirin b. naproxen c. ibuprofen d. acetaminophen

d. acetaminophen

The nurse plans to give a massage to a patient who has body aches. The patient has a history of angina and deep vein thrombosis. Which area, if massaged, can lead to complications in the patient? a. back b. shoulders d. leg muscles e. thigh muscles

d. leg muscles (calf muscles)

A nurse administers epidural anesthesia to a patient in the terminal stages of cancer for pain relief. Which nursing intervention is then necessary? a. administering supplemental doses of opioid b. assessing vitals once every hour after administering the first dose c. administering anticoagulant medications with the epidural d. notifying the health care provider if the patient develops pain at the epidural insertion site

d. notifying the health care provider if the patient develops pain at the epidural insertion site

A patient with chronic low back pain who took an opioid around-the-clock (ATC) for the past year decided to abruptly stop the medication for fear of addiction. He is now experiencing shaking, chills, abdominal cramps, and joint pain. What does the nurse recognize as these symptoms? a. addiction b. tolerance c. pseudoaddiction d. physical dependence

d. physical dependence

A patient is receiving opioid analgesics to treat pain following a knee injury. After assessment, the nurse begins to administer naloxone at a rate of 0.5 mL every 2 minutes. What patient condition is the nurse treating with this intervention? a. sedation b. constipation c. urinary retention d. respiratory depression

d. respiratory depression

The nursing student is providing instructions on patient-controlled analgesia (PCA) to the patient. Which action if made by the nursing student requires correction? a. instructing the patient about the purpose of PCA b. explaining that the pump reduces the risk of overdose c. teaching the patient how to use the PCA before the procedure d. telling the family members to operate the PCA device for the patient

d. telling the family members to operate the PCA device for the patient

After assessing pain in a 9-year-old child using a numeric rating scale (NRS), the nurse documents the score as 5. What does the nurse interpret from this score? a. the child has no pain b. the child has mild pain c. the child has severe pain d. the child has moderate pain

d. the child has moderate pain

Which pain management method is considered a non-pharmacological complementary and alternative intervention? a. distraction b. biofeedback c. guided imagery d. therapeutic touch

d. therapeutic touch

The nurse administers 250 mg of acetaminophen along with 5 mg of hydrocodone to a patient in pain. Why is acetaminophen part of this protocol? a. to reduce the risk of hepatotoxicity b. to prevent the risk of over sedation c. to prevent the occurrence of respiratory depression d. to decrease the dose of opioid required for pain control

d. to decrease the dose of opioid required for pain control