Ch.35 Comfort PrepU

A postoperative vaginal hysterectomy client complains of pain that is more intense than this morning. This factor should be explained to the client as

"Acute pain tends to increase during the day and is called a routine pain response"

Pain threshold is the point beyond which a person is no longer willing to endure pain.

False

You have presented an educational inservice about comfort and asks participants to provide examples of effective comfort measures. Which of the following responses by participants indicate a correct understanding of the concept? Select all that apply.

• "Straightening wrinkled bed linens." • "Holding a patient's hand during an invasive procedure or during times of emotional stress." • "Assisting a patient with hygiene needs." • "Keeping the patient's environment free from unpleasant odors." • "Administering prescribed analgesic medications."

Which of the following patient populations are at high risk for inadequate pain management? Select all that apply.

• Patients who have dementia • Young children • Infants • Patients whose primary language is different from that of the healthcare team

After the nurse has instructed a client with low-back pain about the use of a transcutaneous electrical nerve stimulation (TENS) unit for pain management, the nurse determines that the client has a need for further instruction when the client states what?

"I could use the TENS unit if I feel pain somewhere else on my body."

A patient has been reluctant to ask for breakthrough doses of the opioid his physician has prescribed, despite showing signs of pain. The patient tells the nurse that he is afraid of becoming addicted to the drug. How should the nurse respond to the patient's statement?

"There's only an extremely small chance that you will become addicted to this drug."

The nurse has completed a preoperative education session with a client who will receive morphine via a patient-controlled analgesia pump (PCA) after surgery. Which of the following statements by the client indicates the need for further teaching?

"I will remind my family member to push the PCA pump button for me if I doze off during the day."

The nurse talks with a client who states, "My primary care provider wants me to try a TENS unit for my pain. How can electricity decrease my pain?" Which of the following responses is most appropriate?

"The mild electrical impulses block the pain signal before it can reach the brain."

A nurse attempts to arouse a postsurgical client and finds him frequently drowsy and drifting off during conversation; however, he can be aroused. What would be the sedation score for this client?

3

A nurse is caring for a neonate age 2 days in a NICU. What pain assessment scale would best assess the pain for this client?

CRIES Pain Scale

A nurse attempts to relieve the pain of a patient by using cutaneous stimulation. Which of the following accurately describes usage of this technique?

A nurse applies intermittent heat and cold to a patient's leg.

A sudden blow to the head results in pain that is transmitted by which type of fibers?

A-delta

When the male client on his first postoperative day after chest surgery appears stoic and does not ask for any pain medication, the nurse should

Actively solicit information about the client's pain level

A middle-age client tells the nurse that her neck pain reduced considerably after she underwent a treatment in which thin needles were inserted into her skin. What kind of pain relief treatment did the client undergo?

Acupuncture

A nurse observes a posthysterectomy patient who is crying hysterically. What type of pain response is this patient experiencing?

Affective

A child describes intense pain in the chest and head while eating a popsicle. The pain the child is experiencing is termed

Allodynia

During a lecture on pain management, the nursing instructor informs the group of nursing students that the primary treatment measure for pain is which of the following?

Analgesics

Question: You are preparing to apply a transcutaneous electrical nerve stimulation (TENS) unit. Arrange the following steps in the correct order.

Apply electrodes to the prescribed location. Plug electrodes into the TENS unit. Turn on the TENS unit. Assure that patient can feel the tingling sensation. Adjust intensity to prescribed setting. Secure unit to the patient.

Which of the following is the most reliable method for assessing pain?

Asking the patient

The acute care nurse is preparing to care for an 86-year-old patient who just returned to the unit after surgery to repair a fractured hip. The patient has severe dementia. Which of the following pain management strategies would be most appropriate for this patient?

Authorized agent-controlled analgesia (AACA)

A client having acute pain tells the nurse that her pain has gradually reduced, but that she fears it could recur and become chronic. What is a characteristic of chronic pain?

Chronic pain has far-reaching effects on the client.

A patient with chronic pain uses a machine to monitor his physiologic responses to pain. The unit transforms the data into a visual display and through seeing the pain responses, the patient is taught to regulate his physiologic response and control pain through relaxation, imagery, or breathing exercises. What is this technique for pain control known as?

Biofeedback

The nurse identifies the pain described by a client whose back discomfort began after an automobile accident and has persisted for 8 months as

Chronic

A physician has ordered a nurse to perform transcutaneous electrical nerve stimulation (TENS) for a client with back pain. Which of the following candidates is most suitable for TENS?

Client involved in sports activities

Endogenous opioids such as endorphins

Contribute to analgesia

A nurse is caring for a client with neck pain. The nurse is explaining neck pain and some basic methods for pain management to the client. Which of the following pain-management facts should the nurse mention to the client and the client's family?

Discuss pain-control methods with the physician.

Which of the following opioid analgesics can be administered through iontophoresis via a patient-controlled transdermal system (PCTS)?

Fentanyl

Before inserting a urinary catheter, a nurse discusses the procedure with the client. When inserting the catheter, the nurse distracts the client by talking to him about his work. The nurse is attempting to relieve the client's procedural pain through which of the following?

Focusing on another stimuli in the environment

Nurse H. prides herself in her sense of humor and recognizes the potential benefits of using humor to help patients deal with pain. What guidelines should Nurse H. follow when using humor to foster pain relief?

Humor should take into account the patient's personality and circumstances.

A nurse is assessing a client's pain. The nurse notes which of the following database findings that is indicative of acute pain?

Increased blood pressure

A nurse asks an adolescent female client to describe her pain using a number between 0 and 10 where 0 means no pain and 10 means severe pain. The nurse is assessing which of the following?

Intensity of pain

The nurse is caring for a client who is receiving morphine via a patient-controlled analgesia (PCA) pump. The nurse notes that the client's respiratory rate is 10 breaths per minute. The client is somnolent, with minimal response to physical stimulation. The nurse should prepare to administer which of the following medications?

Intravenous naloxone (Narcan)

When parents of a preschool child who is experiencing pain from ear surgery inform the nurse that the child is withdrawn from them and acts ambivalent, the nurse responds that the preschooler's behavior

Is a normal response

A nurse is administering prescribed medicine to a client who experienced acute pain in the lower back after a motor vehicle accident. The client tells the nurse that compared to the previous week, his pain had reduced considerably. Which phase of pain is the client experiencing?

Modulation

A postoperative client who has been receiving morphine for pain management is exhibiting a depressed respiratory rate and is not responsive to stimuli. What drug has the potential to reverse the respiratory-depressant effect of an opioid?

Naloxone

When a 17-year-old male athlete injures his knee during basketball practice and refuses to go to the school nurse, he states he does not have pain. The school nurse assesses the student's knee and recognizes that by stating he does not have pain the student is

Not showing weakness to his peers

Which of the following principles should the nurse integrate into the pain assessment and pain management of pediatric clients?

Pain assessment may require multiple methods in order to ensure accurate pain data.

Which of the following guidelines regarding pain should be included in the nurse's education plan for a group of parents with infants and toddlers?

Pain can be a source of fear and threat to the toddler's security.

A middle-aged client with cancer has been prescribed patient-controlled analgesia (PCA) by a physician. Which of the following is an advantage that PCA offers?

Pain can be kept within a constant tolerable level .

A nurse is caring for an elderly client who is unable to walk without a support due to knee pain. During his initial assessment, however, the client does not mention pain. Which of the following beliefs common in elderly clients may cause them to underreport their pain?

Pain is a normal part of aging.

A nurse is assessing a client with arthritis. Which of the following should the nurse consider in the initial assessment of the client?

Pain level

Which of the following is an example of a diffuse pain?

Pain related to stomach cancer

A nurse is caring for a client with an amputated limb. The client tells the nurse that he has a burning sensation in his amputated limb. How should the nurse document this pain?

Phantom pain

As per the physician's orders, a nurse is placing two electrodes on a client's lower back to perform transcutaneous electrical nerve stimulation (TENS). The nurse spaces the electrodes at least the width of one from the other on the client's skin. Which of the following reasons explains the nurse's action?

Prevents the potential for burning the skin

A client has an order for a narcotic analgesic every three to four hours and he received his last dose three hours earlier. Which of the following actions is most appropriate for the nurse to take in response to the client's request for pain medication on his first postoperative day?

Provide the client with pain medication

Based on your knowledge of pain and the body's response, when assessing a client in pain, you would anticipate the

Pupils are dilated

A client tells a nurse, "I feel as if someone is pounding my head with a hammer." The nurs interprets this statement as indicating which of the following about the pain?

Quality

A client describes pain in the lower leg and has been diagnosed with a herniated lumbar disk. The pain in the leg is what type of pain?

Referred pain

A nurse is caring for a client who was administered opioid narcotics. The client complains of constipation. Which of the following is another potential side effect of opioid narcotics?

Sedation

A cyclist reports to the nurse that he is experiencing pain in the tendons and ligaments of his left leg, and the pain is worse with ambulation. The nurse will document this type of pain as which of the following?

Somatic pain

A client has required frequent scheduled and breakthrough doses of opioid analgesics in the six days since admission to the hospital. The client's medication regimen may necessitate which of the following interventions?

Stool softeners and increased fluid intake

When assessing a patient on PCA therapy, the nurse finds the patient to be somnolent, with minimal or no response to physical stimulation, scoring a 4 on the sedation scale. What is the recommended intervention in this situation?

Stop the medication infusion immediately and notify the primary care provider; prepare to administer oxygen and a narcotic antagonist, such as naloxone (Narcan).

Pet therapy is commonly used in long-term facilities for distraction. If a client is experiencing pain and the pain is temporarily decreased while petting a visiting dog or cat, this is an example of which type of distraction technique?

Tactile kinesthetic distraction

A client has been admitted to a post-surgical unit with a patient-controlled analgesia (PCA) system. Which of the following statements is true of this medication delivery system?

The dose that is delivered when the client activates the machine is preset.

Which of the following statements accurately represents a consideration when using an epidural analgesia for patient pain management?

The anesthesiologist/pain management team should be notified immediately if the patient exhibits a respiratory rate below 10 breaths/minute.

A middle-aged client with cancer has been prescribed patient-controlled analgesia (PCA). The nurse caring for the client explains the functioning of PCA. What is the main advantage of PCA?

The client is actively involved in pain management.

A nurse is caring for a client with cancer who is experiencing pain. Which of the following would be the most appropriate assessment of the client's pain?

The client's pain based on a pain rating

After the nurse has instructed a client with low-back pain about the use of a transcutaneous electrical nerve stimulation (TENS) unit for pain management, the nurse determines that the client has a need for further instruction when the client states what?

The client's pain based on a pain rating

Who is the authority on the presence and extent of pain experienced by a patient?

The patient

Which of the following statements accurately describes a consideration when using a patient-controlled analgesia (PCA) pump to relieve client pain?

The pump mechanism can be programmed to deliver a specified amount of analgesic within a given time interval.

A nurse is caring for a middle-aged client with acute abdominal pain at a health care facility. The physician has asked the nurse to administer a prescribed dosage of narcotics to the client to relieve the pain. The client has a throat infection and is unable to take the medication orally. What other delivery route might the physician prescribe?

Transdermal route

A patient reports after a back massage that his lower back pain has decreased from 8 to 3 on the pain scale. What opioid neuromodulator may be responsible for this increased level of comfort?

The release of endorphins

A nurse observes that a client who underwent knee surgery two weeks ago needs progressively larger doses of analgesics to get relief from pain. The nurse interprets this as which of the following?

Tolerance

The wife of a patient with cancer is concerned that her husband's breakthrough doses of morphine have recently needed to be larger and more frequent in order for him to achieve pain relief. The nurse would recognize that the patient is likely showing the effects of which of the following?

Tolerance.

A nurse is caring for a client whose injured cells are releasing chemicals such as substance P, prostaglandins, bradykinin, histamine, and glutamate. Which phase of pain is the client experiencing?

Transduction

Epidural analgesia is appropriate for postoperative analgesia and can be administered via continuous infusion pump, or by a patient-controlled epidural analgesia pump (PCEA).

True

Besides controlling pain of the post-abdominal surgery client with narcotics, the nurse suggests to the client that he ...

Use Distraction

Which of the following is an accurate step in the procedure for giving a patient a back massage?

Using a light, gliding stroke, apply lotion to the patient's shoulders, back, and sacral area.

A male college student age 20 years has been experiencing increasingly sharp pain in the right, lower quadrant of his abdomen over the last 12 hours. A visit to the emergency department and subsequent diagnostic testing have resulted in a diagnosis of appendicitis. What category of pain is the client most likely experiencing?

Visceral Pain

A nurse is caring for a client with dull ache in her abdomen. On the way to the health care facility, the client vomits and shows symptoms of pallor. What kind of pain is the client experiencing?

Visceral pain

A nurse is caring for a client with acute back pain. When should the nurse assess the client's pain?

Whenever the vital signs are measured and documented

A client with recurrent episodes of migraine headaches tells the nurse, "I am not comfortable taking medication for my pain." Which of the following are behavioral pain relief techniques that the nurse can use to help the client? Select all that apply.

• Relaxation • Meditation • Biofeedback