CH:9 Assessing Pain

A client 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 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 client is admitted with right lower abdominal pain with rebound tenderness. The nurse suspects appendicitis and documents this type of pain as which of the following?

visceral

A nurse is assessing the effect of a client's chronic back pain on his affective dimension. Which question should the nurse ask for this assessment?

How does the pain influence your overall mood?

A nurse is assessing the vital signs of a client who is moaning with pain. What would be the expected findings?

Increased pulse and blood pressure

Beliefs of health care providers can serve as barriers to an accurate assessment of a client's pain. Which of the following beliefs will not be likely to impair the assessment of pain?

Infants can feel pain and may respond with crying or agitation.

A client recovering from a stroke complains of pain. The nurse suspects this client is most likely experiencing which type of pain?

Neuropathic

When clients report pain, it is important to find the source. When clients describe pain as "burning, painful numbness, or tingling," the source is more than likely:

Neuropathic

A client recovering from abdominal surgery is complaining of pain. The nurse realizes that the client is most likely experiencing which type of pain?

Somatic

A client who suffers from arthritis complains of sharp pain in her knees and elbows. The nurse recognizes this is what type of pain?

Somatic

A nurse enters a client's room to conduct an assessment. The client is crying and states they have so much pain. What is the best response of the nurse?

"Could you tell me more about your pain?"

A middle-aged client is complaining of acute joint pain to a nurse who is assessing the client's pain in a clinic. Which of the following questions related to pain assessment should the nurse ask the client?

"Does your pain level change after taking medications?"

The nurse is explaining the pathophysiology of pain to a nursing student. The nurse determines understanding of the main concepts when the student nurse makes which of the following statements?

"Nociceptors at the peripheral nerve endings transmit pain."

The nursing instructor is teaching a class about how to assess pain in older adults. The teachers tells the students that problems can arise in certain circumstances. The instructor realizes the need for more teaching about pain in the elderly when one of the students replies:

"Pain is a natural part of aging."

Which of the following clients would be classified as having chronic pain?

A client with rheumatoid arthritis

As a nurse is adjusting a client's hospital bed, the nurse accidently pinches a finger between the bed and the wall. Which of the following components is involved in the transduction of the pain the nurse feels?

A-delta and C fibers

A pathophysiology instructor is discussing pain and its treatment across cultures. The instructor points out that clients from racial and ethnic minorities often receive less pain medication compared to Caucasians for what specific conditions?

Acute pain in the ED

A client presents to the health care clinic with reports of a 2-day history of sore throat, ear pressure, fever, and stiff neck. The client states she has taken Tylenol and lozenges without relief. Which nursing diagnosis can be confirmed by this data?

Acute pain related to sore throat

A post-operative client is observed breathing 24 breaths/minute while complaining of 10/10 abdominal pain. The client's oxygen saturation is 90% on 2 liters nasal cannula. What is the nurse's priority action?

Administer prescribed analgesia as ordered.

How may a nurse demonstrate cultural competence when responding to clients in pain?

Avoid stereotyping responses to pain by clients.

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

The nurse is caring for a client who is experiencing visceral pain. What is this client's most likely diagnosis?

Appendicitis

A nurse is caring for a client who has been intubated and is on a mechanical ventilator. Which of the following pain assessment tools should the nurse use to assess the client's pain?

Behavioral Pain Scale (BPS)

A middle aged female client presents to the emergency department complaining of indigestion and left arm pain. What is the nurse's best action?

Check the client's vital signs and connect her to a cardiac monitor.

In preparing a care plan for a client receiving opioid analgesics, the nurse selects which of the following as an applicable nursing diagnosis associated with side effects of opioid use?

Constipation

Which of the following is not released during the stress response?

Dopamine

A nurse assesses a cognitively impaired adult client who grimaces and points to the right knee following a motor vehicle accident. Which pain scale would be most appropriate for the nurse to use to assess the client's pain?

Faces Pain Scale

A client on a medical-surgical unit reports pain of 10 on a scale of 0 to 10 and wants more pain medication. The nurse does not think the pain is as bad as the client says. The physician left orders for prn morphine for breakthrough pain. What is the priority nursing action?

Give the prn morphine

A client complains of pain in several areas of the body. How should the nurse assess this client's pain?

Have the client rate each location separately.

A student nurse learns that especially in the very young and very old pain can be inadequately treated. What else would the student learn about inadequate pain treatment in the very young?

It can lead to neurodevelopmental problems

Which of the following best describes neuropathic pain?

May be labelled as central pain

The client comes to the emergency department reporting indigestion and left arm pain. The physician orders an EKG along with drawing of cardiac enzymes. When the results are back, the client is informed of the diagnosis of heart attack. The indigestion and arm pain are examples of which of the following?

Referred pain

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

Which of the following statements most accurately conveys an aspect of the gate-control theory?

Specialized cells can decrease pain transmission by exciting inhibitory neurons.

An elderly farmer has sustained severe injuries after a serious accident involving a combine harvester. At the hospital, he tells the nurse that he thinks the pain he is feeling now is "payback" for living a "mean, selfish life." The nurse recognizes that this response by the man indicates which dimension of pain?

Spiritual dimension

A nurse is caring for an athlete who was injured during a practice session. There is visible skin impairment, and the client complains of throbbing pain in the leg. What level of pain does the nurse document for this client?

Subcutaneous level

The nurse is assessing a client with a history of drug addiction. What will be helpful in determining interventions that will be most beneficial for providing adequate pain relief to this client?

Using in-depth questions to collect significant data about the client's pain

When assessing the client for pain, the nurse should

When assessing the client for pain, the nurse should

A nurse performs a focused assessment on a client reporting back pain after helping someone move into a new home. The nurse uses COLDSPA to further assess the client's pain. Character: sharp; onset: yesterday; location: lower back; duration: persistent since yesterday; severity: 8 out of 10 (on a scale 0-10, 10 being the worst); pattern: continuous; associated factors: movement. The nurse determines the client is experiencing which of the following classifications of pain?

acute inflammatory pain

A nurse working in a hospital is assessing a 65-year-old female client with a long history of type 2 diabetes who is reporting pain as an 8 out of 10 on a scale of 0 (no pain) to 10 (worst pain) in bilateral feet. The client describes the pain as burning.

burning pain (neuropathic) history of diabetes (neuropathic) pain level 8 out of 10 (inflammatory, neuropathic, visceral) affects bilateral limbs (inflammatory, neuropathic)

A client describes pain in the soles of both feet as constantly burning. Which type of pain should the nurse suspect this client is experiencing?

neuropathic

A nurse is interviewing a client with a long history of a tumor who is receiving chemotherapy and radiation treatment. The nurse expects which of the following findings?

reduction in pain

A client reports pressure in the chest but describes pain in the jaw and right arm. Based on these findings, the nurse determines that the client may be experiencing which of the following types of pain?

referred