Med Surg Chp.12 Prep U
When drafting a nursing care plan for a patient in pain, it is important for the nurse to determine if the pain is acute or chronic. Choose an example of chronic pain.
Intervertebral disk herniation Chapter 12: Pain Management - Page 213-214
A client has been prescribed a fentanyl patch for pain control. The nurse understands that this patch should be replaced every
48-72 hours. Chapter 12: Pain Management - Page 226
Which of the following is the appropriate intervention to avoid physical dependence on drugs in a client?
Discontinue drugs gradually. Chapter 12: Pain Management - Page 225
The client reports chest pain. The nurse uses which of the following questions to assess the pain further. Select all answers that apply.
"How long have you experienced this pain?" "Please point to where you are experiencing pain." "Rate the pain on a scale of 0 to 10, with 10 being the worst possible pain." "What aggravates your chest pain?" Chapter 12: Pain Management - Page 218-220
Carbamazepine (Tegretol) is an example of which medication classification used in analgesia?
Anticonvulsant
When a nurse asks a patient to describe the quality of the pain, what type of descriptive term does the nurse expect the patient to use?
Burning Chapter 12: Pain Management - Page 219
A client is prescribed morphine for a possible ankle fracture. When the nurse brings in a second dose of the medication, the client states, "This medicine made me sick." The nurse replies
"What do you mean by the word sick?" Chapter 12: Pain Management - Page 228-229
Which substance reduces the transmission of pain?
Endorphins Chapter 12: Pain Management - Page 214
A client is receiving morphine through a patient-controlled analgesia (PCA) system following surgery. The nurse states to the client
"Only you are to push the button for medication." Chapter 12: Pain Management - Page 222
A teenage client is undergoing a dressing change to burns on the thigh. The client refuses pain medication and states, "I do not hurt, and I don't need it." He is withdrawn, grimaces, and turns away during the dressing change. He was last medicated 8 hours ago. What is the best statement by the nurse?
"I saw you grimacing during the dressing change. Please explain the reason you refused the pain medication." Chapter 12: Pain Management - Page 218
A client informs the nurse that he has been taking ibuprofen every 6 hours for 3 weeks to help alleviate the pain of arthritis. The client has a history of a gastric ulcer and is taking a proton pump inhibitor for the treatment of this disorder. What should the nurse instruct the client about the use of the ibuprofen?
"It would be best to contact the physician prior to take any over-the-counter medications." Chapter 12: Pain Management - Page 214
Nociception includes four specific processes: transduction, transmission, perception, and modulation. Which action illustrates the nociception process of pain transmission?
A child quickly removing a hand when touching a hot object Chapter 12: Pain Management - Page 214
The client takes naproxen (Aleve) for arthritic pain and is now prescribed warfarin (Coumadin) for persistent atrial fibrillation. Due to the interactions of the medications, the nurse
Assesses the client's stool for color Chapter 12: Pain Management - Page 223
The nurse assessed a patient's pain subsequent to a broken ankle. The nurse documented that the patient's pain was categorized as:
Acute Chapter 12: Pain Management - Page 213
A client with appendicitis has had an appendectomy. After surgery, what type of pain does the nurse anticipate the client will have?
Acute pain Chapter 12: Pain Management - Page 213
How should the administration of analgesics be scheduled to provide a uniform level of pain relief to a client?
Administering the analgesics every three hours Chapter 12: Pain Management - Page 222
When caring for a patient who is deaf, which of the following should be used to elicit information regarding the patient's level of pain?
An outside interpreter should be used. Chapter 12: Pain Management - Page 240
A home health nurse is visiting a client who has been taking the same dose of acetaminophen/hydrocodone for 2 months. To monitor for the presence of expected side effects of this medication, what should the nurse include in the assessment of the client?
Ask about the client's bowel pattern. Chapter 12: Pain Management - Page 228
A patient who is postoperative day 1 following a discectomy has lit his call light and requested a dose of hydromorphone, which he receives on a p.r.n. basis for breakthrough pain. What should the nurse first do in response to the patient's request?
Assess the characteristics of the patient's pain. Chapter 12: Pain Management - Page 220-221
A client recovering from hip surgery is receiving morphine through a patient-controlled analgesia (PCA) infusion pump with a set basal rate. What action is most important for the nurse to implement?
Assess the client's respiratory status Chapter 12: Pain Management - Page 221-222
A preventative approach to pain relief with non-steroidal anti-inflammatory drugs (NSAIDs) means that the medication is given:
Before pain is experienced. Chapter 12: Pain Management - Page 222-223
The nurse is assisting the anesthesiologist with the insertion of an epidural catheter and the administration of an epidural opioid for pain control. What adverse effect of epidural opioids should the nurse monitor for?
Bradypnea Chapter 12: Pain Management - Page 229
When using transdermal Fentanyl, the nurse and patient should be aware of which sign or symptom of Fentanyl overdose?
Confusion Chapter 12: Pain Management - Page 251
A client receives hydromorphone 2 mg intravenously for report of postoperative pain. Fifteen minutes later, the nurse notes respirations are 6 breaths/minute and the client is nonresponsive. The nurse administers prescribed naloxone. The next time the client reports pain, the best nursing action is:
Consult with the healthcare provider to reduce the dose. Chapter 12: Pain Management - Page 222
According to the Joint Commission, which of the following is a focus of assessment related to quality of pain?
Description in the client's own words
The nurse is assessing a patient complaining of severe pain. What physiologic indicator does the nurse recognize as significant of acute pain?
Diaphoresis Chapter 12: Pain Management - Page 220
About which issue should the nurse inform clients who use pain medications on a regular basis?
Inform the primary health care provider about the use of salicylates before any procedure, and avoid over-the-counter analgesics consistently without consulting a physician. Chapter 12: Pain Management - Page 214
The nurse is visiting a client at home with intractable cancer pain. The client has a transdermal fentanyl patch on her right chest area. It is most important for the nurse to
Remove the heating pad present on the chest area. Chapter 12: Pain Management - Page 227
Regarding tolerance and addiction, the nurse understands that
although clients may need increasing levels of opioids, they are not addicted. Chapter 12: Pain Management - Page 225
A client who has undergone extensive fracture repair continues to request opioid pain medication with increasing frequency. The initial surgeries occurred more than 2 months ago, and the nurse is concerned about the repeated requests. What does the nurse suspect to be the cause of the client's frequent appeals for pain medication?
tolerance Chapter 12: Pain Management - Page 225
A client is admitted with generalized abdominal pain, nausea, vomiting, and hypotension. The client has not passed stool in over 1 week and has been in pain for the past 4 days. Which type of pain would you expect the client to be experiencing?
visceral Chapter 12: Pain Management - Page 215
A client arrives in the orthopedic clinic with complaints of twisting the right ankle while playing softball. The nurse collects data including complaints of pain and swelling in the right ankle. What intervention will the nurse provide that will decrease vasodilation and reduce localized swelling?
Ice bag Chapter 12: Pain Management - Page 232
About which issue should the nurse inform clients who use pain medications on a regular basis?
Inform the primary health care provider about the use of salicylates before any procedure, and avoid over-the-counter analgesics consistently without consulting a physician. Chapter 12: Pain Management - Page 222
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?
Gabapentin Chapter 12: Pain Management - Page 231
When taking a client history, the nurse notes that the client is taking herbal remedies in addition to acetaminophen. Which herb, when taken in conjunction with acetaminophen, enhances the risk of bleeding?
Gingko Chapter 12: Pain Management - Page 223
A client is recovering from abdominal surgery and sleeping. The client had received an opioid medication 3 hours ago. The client's son requests pain medication for the client, stating "I do not want her to wake up in pain." The first nursing action is
Instruct the son about lack of client consent. Chapter 12: Pain Management - Page 222
The patient develops respiratory depression after the nurse administers fentanyl for pain. What medication can the nurse anticipate administering to counteract the effects of the fentanyl?
Narcan Chapter 12: Pain Management - Page 224
A client is being treated in a substance abuse unit of a local hospital. The nurse understands that when this client has compulsive behavior to use a drug for its psychic effect, the client needs to be monitored for which effect?
Addiction Chapter 12: Pain Management - Page 225
A client, who had an above the knee amputation of the left leg related to peripheral vascular disease from uncontrolled diabetes, complains of pain in the left lower extremity. What type of pain is the client experiencing?
Neuropathic pain Chapter 12: Pain Management - Page 215
A client is reporting her pain as "8" on a 0-to-10 pain intensity scale. Then, the client states the pain is "3." Before the nurse leaves the room, the client states her pain is "6." The best action of the nurse is to
Obtain a pain scale with faces for the client to measure her pain. Chapter 12: Pain Management - Page 218-219
The nurse is assessing an older adult patient just admitted to the hospital. Why is it important that the nurse carefully assess pain in the older adult patient?
Older people experience reduced sensory perception. Chapter 12: Pain Management - Page 213
Which of the following is a physiologic response to pain?
Pallor Chapter 12: Pain Management - Page 218
Which phase of pain transmission occurs when the brain experiences pain at a conscious level?
Perception Chapter 12: Pain Management - Page 215
Which is a true statement regarding placebos?
Placebos should never be used to test a client's truthfulness about pain. Chapter 12: Pain Management - Page 232
A nurse documents the presence of chronic pain on an electronic health record. Choose a description that could be used. The pain can be:
Prolonged in duration. Chapter 12: Pain Management - Page 213
Analgesics can be given through various routes of administration. Which of the following is a gastrointestinal route of administration for analgesics?
Rectal Chapter 12: Pain Management - Page 221
The nurse's major area of assessment for a patient receiving patient-controlled analgesia is assessment of what system?
Respiratory Chapter 12: Pain Management - Page 222
The nurse caring for a 74-year-old man who has just returned to the surgical unit following surgery for a total knee replacement received report from the PACU. Part of the report had been passed on from the preoperative assessment, in which the patient stated that he has "gotten confused" in the past when he takes pain medications. The nurse should recognize which of the following principles of pain management among older adults?
The elderly may require lower doses of medication and are easily confused with new medications. Chapter 12: Pain Management - Page 231-232
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?
The pain medication will be administered before the pain is experienced. Chapter 12: Pain Management - Page 222
A client comes to the clinic and informs the nurse that he needs more analgesics for chronic pain. The client states that the medication is not as strong, and he requires more than the prescribed dose. What does the nurse suspect is occurring with the client?
Tolerance Chapter 12: Pain Management - Page 225
The client is taking oxycodone (Oxycontin) for chronic back pain and reports decreased pain relief when he began taking a herb to improve his physical stamina. The nurse asks if the herb is
ginseng Chapter 12: Pain Management - Page 232
A client has a long history of diabetes mellitus and developed diabetic neuropathy more than 25 years ago. The client is without breakthrough pain at this point in time. How would this client's pain be classified?
neuropathic and chronic Chapter 12: Pain Management - Page 213-214
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?
the limits on dose and frequency that are programmed into the PCA Chapter 12: Pain Management - Page 222
The nurse is obtaining data regarding the medication that the client is taking on a regular basis. The client states he is taking duloxetine (Cymbalta), an antidepressant for the treatment of neuropathic pain. What type of therapy does the nurse understand the client is receiving?
Adjuvant drug therapy Chapter 12: Pain Management - Page 231
A client is receiving morphine sulfate intravenously (IV) every 4 hours as needed for the relief of pain related to a surgical procedure the client had 3 days previously. The physician is discontinuing the IV and will be starting the client on oral pain medication. What would provide the client with optimal pain relief when discontinuing the IV dose?
Administer an equianalgesic dose. Chapter 12: Pain Management - Page 224
When administering a fentanyl patch, the last dose of sustained-release morphine should be administered at what point?
At the same time the first patch is applied Chapter 12: Pain Management - Page 227
The client is scheduled for surgery. The nurse is reviewing with the client about postoperative pain management. The client states her goal after receiving treatment is "0." The first action of the nurse is to
Educate the client that this goal may not be achievable. Chapter 12: Pain Management - Page 219
A client being treated for rheumatoid arthritis has been prescribed a glucocorticosteroid. How should the nurse best ensure this client's safety during treatment?
Ensure the client knows to taper down the dose if it is discontinued by the care provider. Chapter 12: Pain Management - Page 1061
The nurse needs to carefully monitor a client with traumatic injuries. How often should the nurse check and document the client's pain?
Every time the client's vital signs are assessed Chapter 12: Pain Management - Page 220
The physician has ordered a mu opioid analgesic for a patient with pain. What drug does the nurse anticipate administering?
Fentanyl Chapter 12: Pain Management - Page 224
The nurse is administering a narcotic analgesic for the control of a newly postoperative client's pain. What medication will the nurse administer to this client?
Fentanyl (Duragesic) Chapter 12: Pain Management - Page 221
An older adult is being treated with opioids for pain relief. Which of the following should the nurse strongly recommend to this client?
Follow a bowel regimen. Chapter 12: Pain Management - Page 228
Which of the following is the most important potential nursing diagnosis for the client receiving opiate therapy?
Risk for impaired gas exchange Chapter 12: Pain Management - Page 228
Which of the following nursing interventions contributes to achieving a client's goal for pain relief?
Collaborate with the client about his or her goal for a level of pain relief. Chapter 12: Pain Management - Page 233
Which nursing intervention should a nurse perform when caring for a client who is prescribed opiate therapy for pain?
Do not administer if respirations are Chapter 12: Pain Management - Page 224
The nurse, as a member of the patient's health care team, obtains pain assessment information to identify goals for pain management. Select the most important factor that the nurse would use for goal setting:
Severity of the pain as judged by the patient Chapter 12: Pain Management - Page 218-219
A client is scheduled for abdominal surgery and states that he is afraid of postoperative pain. The best nursing action is to inform the client
That medication will be prescribed for pain relief Chapter 12: Pain Management - Page 233-234
A preschool-age child is admitted for complaints of abdominal pain and vomiting. What is the best method for the nurse to collect data about the pain level of the child?
The Wong-Baker FACES scale Chapter 12: Pain Management - Page 218
Which of the following is a reliable source for quantifying pain?
The client's description of the pain Chapter 12: Pain Management - Page 213
A 19-year-old woman had a mandibular osteotomy (jaw surgery) performed early this morning and is being assessed by the nurse after being transferred from the PACU. The nurse has asked the patient about her pain, to which the patient has responded, "I'm not really having any pain, but I've got a dull ache all around my jaw that's really bad." How should the nurse best interpret this patient's statement?
The patient is experiencing pain but is describing it in different terms. Chapter 12: Pain Management - Page 218
