NUR202 Evolve: Introductory Quiz - Pain Management

The nurse is performing a comprehensive pain assessment. Which statement by the nurse will be most useful in helping to differentiate between nociceptive and neuropathic pain?

"Please describe what your pain feels like."

The nurse preceptor asks the nursing student to explain principles of postoperative pain management. Which statement by the nursing student is correct?

"Poorly managed pain in the postoperative period is a risk factor for long-term postsurgical pain."

The nurse preceptor is educating the novice nurse about the use of McCaffery and Pasero's Hierarchy of Pain Measures. Which statement by the nurse preceptor accurately describes this tool?

"The Hierarchy of Pain Measures includes behavioral pain assessment."

When assessing a patient for pain, acute or chronic, what question does the nurse ask the patient to obtain the most data?

"When does it hurt."

The nurse is preparing a patient for an appendectomy in the emergency department. How does the nurse classify the patient's pain?

-Acute. -Visceral.

The nurse is caring for a patient who reports unrelieved pain despite scheduled administration of opioid analgesic medication. When the nurse attempts to conduct a pain assessment, the patient becomes angry and states, "This is the worst care I have ever received." Which issues are appropriate for the nurse to consider as possible motivations for the patient's behavior?

-Anxiety. -Desperation. -Powerlessness.

Neuropathic pain is most likely to develop following which procedures?

-Bilateral mastectomy. -Leg amputation.

Which conditions produce visceral pain?

-Bladder spasms. -Intestinal distention.

Which objectives are accomplished by conducting an analgesic trial for a cognitively impaired patient?

-Confirming the presence of pain. -Establishing a basis for a pain treatment plan.

Which assessment data is most consistent with chronic pain?

-Depression. -Gradual onset of discomfort. (pain that has lasted for MORE than 3 months).

The nurse is planning nonpharmacologic strategies to alter the patient's pain perception. Which interventions are appropriate for the nurse to include in the patient's plan of care?

-Imagery. -Distraction. -Cognitive behavioral therapy.

The nursing student is giving a classroom presentation about neuropathic pain. Which information is appropriate for the nursing student to include in the presentation?

-Neuropathic pain involves the abdominal processing of stimuli. -Neuropathic pain may occur in the absence of tissue damage or inflammation.

Which individuals may serve as the newly admitted patient's surrogate for the purpose of behavioral pain assessment?

-Parent. -Spouse. -Personal caregiver.

The nurse educator is teaching the nursing student about nociception. When identifying chemicals that are responsible for activating nociceptors during the transduction process, which substances are correct for the nurse educator to include in the discussion?

-Serotonin. -Bradykinin. -Substance P. -Prostaglandins.

The nursing student is designing a poster about nociception. Which substances should be included when listing excitatory compounds that activate nociceptors?

-Substance P. -Histamine. -Prostaglandins. -Bradykinin.

Which question is most effective for assessing the psychosocial impact of chronic pain?

"How has chronic pain affected your professional life?"

Which term is used to describe pain quality?

Cramping.

What does the nurse infer if a patient scores a 2 on the Wong-Baker FACES pain rating scale?

Hurts a little bit.

Which patients are generally incapable of reporting their pain using self-report assessment tools?

Imminently dying patients.

Which condition is most commonly associated with acute pain?

Ischemia.

Which term is the patient most likely to use when describing neuropathic pain?

Shooting.

Which data is most reliable for use in assessment of a patient's pain?

Subjective patient reports.

Which factor contributes to the development of acute pain for the patient with cancer?

Surgical procedures.

An older patient with advanced dementia is brought to the hospital. The nurse uses the Pain Assessment in Advanced Dementia (PAINAD) scale. Which statement made by the nurse will help the primary health care provider make a diagnosis?

"I observed that the patient was moaning or groaning."

A postoperative patient is requesting medication for pain every 4 hours. In planning effective pain management, what assessment question does the nurse ask the patient before administering the medication?

"Is your pain controlled between doses?"

The nurse preceptor is evaluating a novice nurse's understanding of pain management for patients with cancer pain. Which statements by the novice nurse are correct?

-"Cancer treatments are associated with acute pain." -"Cancer pain is usually present in two or more areas of the body." -"The majority of cancer pain is the result of tumor growth."

A patient is brought to the hospital in a state of delirium. Which indicators on the Checklist of Nonverbal Pain Indicators (CNPI) does the nurse use to assess this patient's level of pain?

-Facial expression. -Mental status changes. -Changes in interpersonal interactions.

What are the common side effects of non-steroidal anti-inflammatory drugs (NSAIDs) when they are used in older adults?

-Gastrointestinal problems. -Bleeding episodes. -Sodium retention. -Renal toxicity.

Effective pain assessment requires the nurse to understand which principles related to pain perception among older adults?

-The incidence of pain is higher in older adults. -Older adults may be reluctant to report pain.

The primary health care provider instructs the nurse to obtain the patient's pain level every four hours. Which actions by the nurse help facilitate the pain assessment?

-Use a standard pain assessment tool. -Increase features of the scale, such as the font size. -Repeat the instructions and questions more than once.

Which patient does the RN arriving for duty assess first?

56-year-old with acute pancreatitis who reports increasing abdominal pain.

In the role of patient advocate, what does the nurse do first for a patient who reports pain?

Believes the patient's report of pain.

The nurse is performing a pain assessment on an alert, mechanically ventilated patient. Which patient behavior has the potential to provide the most useful assessment data for determining pain intensity?

Blinking.

Pain duration may be described using which term?

Brief.

The theory which suggests that pain is not felt when impulses to the brain are blocked is known as which of the following?

Gate control.

Which condition places the patient at highest risk for undertreatment of pain?

Delirium and other problems of cognition.

Which nursing action reflects correct use of the Wong-Baker FACES Pain Rating Scale?

Encouraging the patient to choose a cartoon face that best represents the pain.

What is the most appropriate statement that describes the gate control theory of pain?

Endorphins are released when large-diameter nerve fibers are stimulated.

A patient with fibromyalgia is scheduled to receive noninvasive, nonpharmacological pain management treatment. The nurse identifies that which substances will be released in the body during treatment?

Endorphins.

The nurse is attending to a patient who is terminally ill with leukemia and in severe pain. What is the realistic outcome for this patient?

Experiencing improved quality of life.

Which strategy represents correct use of behavioral signs as part of pain assessment?

Identifying specific pain behaviors that are unique to the patient.

During which process of pain transmission does an opioid analgesic medication inhibit pain by affecting central mechanisms?

Modulation.

A patient with colon cancer experiences constant, excruciating abdominal pain. What is most likely triggering this patient's pain?

Invasion of tissue.

The registered nurse is working with a student nurse who is trying to help gauge the level of pain in a patient who is unable to use other tools of communication. Which action by the student nurse needs correction?

Misinterpreting lip-reading by eye contact.

Which factor contributes to the development of chronic cancer pain?

Nerve compression.

Which intervention facilitates nursing assessment of the severity of the patient's pain?

Obtaining a self-report.

Which statement is true about assessing pain in an older adult patient?

Older adults are at great risk for under treated pain.

Which statement about opioid addiction is correct?

Opioid addiction is a chronic disease that is a treatable disease.

Which information will the nurse prioritize when analyzing data obtained during a pain assessment?

Pain rating of 6 on a scale of 0 to 10.

The nurse is conducting a pain assessment. Which assessment data is the most reliable indicator of the patient's pain?

Pain rating of a 3 on 0-10 scale.

Which process of pain transmission will be affected by nursing interventions that decrease the patient's conscious awareness of pain?

Perception.

A patient with extensive burn injuries is to be weaned from long-term opioid use. What type of opioid dependence does the nurse expect this patient to have?

Physical dependence.

Which term describes pain produced by inflammation of the trigeminal nerve (trigeminal neuralgia) that is diffuse in nature, extending across the various nerves that innervate the face?

Projected.

The nurse is caring for a patient who is recovering from abdominal surgery. Which nursing intervention has the highest priority?

Providing education about patient-controlled analgesia (PCA) use.

Which component of a comprehensive pain assessment is most helpful for differentiating between nociceptive and neuropathic pain?

Quality.

Which component of pain assessment is addressed by the patient describing his pain as "searing"?

Quality.

During change-of-shift report, the day shift staff learns that a patient who had back surgery has been reporting increasing lower back pain during the night. It is most appropriate for which day staff member to assess the patient's pain?

RN team leader who is responsible for updating the care plan for the patient.

Which pain is felt along a specific nerve or nerves?

Radiating pain.

Which term describes pain that occurs along a specific nerve or nerves?

Radiating.

Which term describes pain that originates at the location of a spinal nerve injury, and then extends down that nerve into both of the patient's legs?

Radiating.

Which condition is associated with neuropathic pain?

Radiculopathy.

A patient who is receiving naproxen for postoperative pain develops gastrointestinal bleeding. The nurse suspects that the change in the patient's health status is caused by what?

Reduced levels of cyclooxygenase-1 (COX-1).

Which term describes back pain caused by pancreatitis?

Referred.

A patient suffering from pain for the past couple of months visits a primary health care provider. Following the initial interview, the primary health care provider concludes that the patient is suffering from neuropathic pain. Which finding in the patient's history supports this conclusion?

Shooting, burning, shock-like sensation with painful numbness.

Which pain rating scale requires the patient to select the phrase that best corresponds with the pain intensity?

The Verbal Descriptor Scale (VDS).

The nurse is attending to an Asian-American patient who cannot communicate in English. What tool does the nurse use when assessing the pain of the patient?

Wong-Baker FACES Pain Rating Scale.

A patient rates their pain at a 2 or 3 on a pain rating scale on a calibrated 0-to-10. How does the nurse interpret this finding?

The patient has mild pain.

After assessing a patient, the nurse concludes that the patient has deep somatic pain. Which findings in the patient support the nurse's conclusion?

The patient has pain due to deep vein thrombosis.

During which process of pain transmission does the initial stimulation of nociceptors occur?

Transduction.

The patient who is recovering from abdominal surgery tells the nurse, "I will not use my incentive spirometer because it hurts when I take a deep breath." Which process of pain transmission is the patient directly avoiding by refraining from taking a deep breath?

Transduction.

Which term is used to describe pain duration?

Transient.

The nurse manager on the surgical unit is making assignments for the day. Who is assigned to check and program the patient-controlled analgesia (PCA) pumps on the unit?

Two registered nurses (RNs).

Which strategy is most useful for pain assessment in the alert patient who is mechanically ventilated?

Using a communication board.

Which pain rating scale makes use of six cartoon faces with word descriptors to depict pain levels in a patient?

Wong-Baker FACES pain rating scale.

Which condition is most likely to lead to the development of somatic pain?

Wound complications.