NUR 3114: Pain Quiz #1

A nurse is caring for a client is receiving hydromorphone HCL via PCA pump and reports continuous pain of 6 on ascale from 0 to 10. Which of the following actions should the nurse take first?

Check the display on the PCA pump.

Which assessment is of highest priority for the nurse to complete before administration of morphine?

Respiratory rate

The nurse teaches a student nurse about managing chronic pain when caring for older patients. Which statement, if made by the student nurse, indicates an understanding of the teaching?

"Chronic pain is not an inevitable part of aging."

A patient asks the nurse why a dose of hydromorphone (Dilaudid) by IV push is given before starting the medication via PCA. Which response is most appropriate?

"The IV push dose will provide for immediate pain relief, which can be maintained by using the PCA."

A nurse is teaching a client who has a new prescription for codeine. Which of the following instructions should the nurse include in the teaching?

"You should change positions slowly."

The nurse should teach a patient to avoid which medication while taking ibuprofen?

Aspirin

The postoperative patient is receiving epidural fentanyl for pain relief. For which common side effects should the nurse monitor the patient (select all that apply.)?

Nausea Itching Urinary Retention

The nurse should question an order written for acetaminophen with oxycodone (Percocet) for a patient exhibiting which clinical manifestation?

Severe jaundice

A nurse is caring for a client who is to start therapy with ibuprofen for hip pain. Which of the following information should the nurse provide about ibuprofen?

Take the medication with food.

A patient is receiving morphine sulfate via patient-controlled analgesia (PCA). What nursing action is most effective to reduce the risk of adverse effects?

Teach the caregiver not to push the button for the patient.

A hospice nurse is caring for a client who has terminal cancer and takes PO morphine for pain relief. The client reports that he had to increase the dose of morphine this week to obtain pain relief. Which of the following scenarios should the nurse document as the explanation for this situation?

The client developed a tolerance to the medication.

Your patient has a favorite television show that she watches every afternoon. She is comfortable during this show and seldom has a need for pain medication when she is watching it. The nurse's assessment of this phenomenon is that:

distraction is an effective modifier of pain for this patient.

Patients who state that they are not in pain, but are grimacing whenever you move or touch them are experiencing:

objective pain.

When assessing a patient receiving morphine sulfate 2 mg every 10 minutes via PCA pump, the nurse should take action as soon as the patient's respiratory rate drops down to or below which parameter?

< 12bpm

A patient with osteoarthritis has been taking ibuprofen 400 mg every 8 hours. The patient states that the drug does not seem to work as well as it used to in controlling the pain. The most appropriate response to the patient is based on what knowledge?

Another NSAID may be indicated because of individual variations in response to drug therapy.

The nurse is preparing to administer celecoxib to a patient. What medication taken by the patient should the nurse monitor for increasing the risk of adverse effects?

Aspirin

A patient has been prescribed a nonsteroidal anti-inflammatory medication (NSAID). Which effect should the nurse instruct the patient to immediately report?

Black or tarry stools

A patient who has had good control for chronic pain using a fentanyl (Duragesic) patch reports rapid onset pain at a level 9 (0 to 10 scale) and requests "something for pain that will work quickly." How will the nurse document the type of pain reported by this patient?

Breakthrough pain

A patient admitted with metastatic lung cancer is ordered to receive morphine sulfate for pain. Which side effect of this medication should the nurse try to prevent with oral intake and medication?

Constipation

Which nursing intervention is most appropriate when preparing to administer an opioid analgesic agent to a patient in pain?

Count the number of doses on hand before administration.

The patient is receiving fentanyl patch for control of chronic cancer pain. What should the nurse observe for in the patient as a potential life-threatening adverse effect of this medication?

Decreased respiratory rate

The nurse is caring for a patient after abdominal surgery. Which action by the nurse is most appropriate for analgesic titration of the prescribed pain medication?

Determine with the patient the analgesic dosage required for pain relief.

After administering acetaminophen with oxycodone (Percocet) for pain, which intervention would be of highest priority for the nurse to complete before leaving the patient's room?

Ensure that the side rails are raised.

The nurse is caring for a patient receiving morphine sulfate 10 mg IV push when necessary for pain. Upon assessment, the nurse finds the patient obtunded with a respiratory rate of 8/minute. Which medication would the nurse prepare to administer to treat these symptoms?

Naloxone

Which clinical manifestation should the nurse attribute to adverse effects of morphine sulfate administered via PCA?

Nausea and vomiting

A patient who has been treated with morphine by patient-controlled analgesia (PCA) is discharged from the hospital with instructions that all of the following medications may be used for pain. Which medication will the nurse instruct the patient to use first?

Oxycodone/acetaminophen (Percocet)

The nurse is caring for a patient receiving morphine sulfate via PCA. Which patient assessment data demonstrate the most therapeutic effect of this medication?

Pain rating 2/10, awake and alert, respirations 18

A nurse is reviewing the assessment data from the admission assessment of a patient admitted from the emergency department. What specific element of a pain assessment is missing from the documentation? General Survey Subjective information abdominal assessment: Trembling Doubled over Right upper quadrant "belly pain." Pain radiates to back. More comfortable bent forward than in bed. Similar pain in the past but only for 2 hours. "This is the worst pain ever!, like a 10/10" Pain started after eating fish and chips at a fast food restaurant 4 hours ago. Abdomen bloated and tender on examination Skin warm and moist

Quality

A nurse is monitoring a client who is postoperative and unable to respond to questions. Which of the followingnonverbal behaviors should the nurse identify as an indication that the client has pain? (Select all that apply.)

Restlessness Grimacing Clenching Furrowed Brow

Acetaminophen and oxycodone are the ingredients in Percocet. Because acetaminophen is metabolized in the liver, the patient could develop acetaminophen toxicity in the presence of severe liver disease (evidenced by jaundice). The prudent nurse would question the order before administration.

This patient has the right to appropriate assessment and management of pain.