Pain EAQ

A patient with bronchial carcinoma reports constipation for the past 2 months. The patient has been on meperidine and ibuprofen for pain relief for the past 6 months. The patient has also been taking metformin and captopril for the past 10 years. Which reason for constipation in the patient is the most probable? 1 Side effect of opioid 2 Side effect of captopril 3 Interaction of metformin and captopril 4 Metastasis of cancer to other organs

1 Text Reference - p. 865

The patient requests that the health care provider suggest a home remedy for constipation. Which herb does the nurse expect the health care provider to recommend? 1 Senna 2 Ginger 3 Rosehips 4 Feverfew

1 Senna Text Reference - p. 863 Senna is an herb that increases gastric motility and can be useful in treating constipation. Ginger, rosehips, and feverfew are useful in treating pain, not constipation.STUDY TIP: To recall that Ginger, Rosehips, and Feverfew are useful in treating pain, consider that many people become grumpy or GRuFf when they are in pain.

An elderly patient complains of severe pain in both lower extremities. The patient becomes tearful when describing the pain and states that it is intolerable. The nurse develops a healing relationship with the patient by incorporating which concepts of healing? Select all that apply. 1 By inquiring how the pain is affecting the patient's daily routine 2 By telling the patient about various pain-relieving interventions 3 By encouraging the patient to be strong and deal with the pain positively 4 By asking the family to help the patient cope with pain and anxiety 5 By administering pain medications and encouraging the patient to exercise

1,2,4 Text Reference - p. 861

A patient has chronic arthritis. Which questions would the nurse ask in order to assess the patient's pain? Select all that apply. 1 "Which factors palliate your pain?" 2 "How would you describe the pain?" 3 "Are you having any trouble passing stools?" 4 "Are you allergic to any food item or medication?" 5 "On a scale of 0-10, how would you rate the pain?"

1,2,5 To assess the pain completely and accurately, the nurse would assess its onset, palliative factors, quality, radiation, severity, and time of pain. Asking about palliative factors helps determine what influences the pain. A description of the pain helps understand the nature and location of the pain. Asking a patient to rate the pain on a pain scale helps assess the intensity of the pain. Asking questions regarding elimination and allergies does not help in pain assessment.STUDY TIP: Use the "OPQRST" mnemonic to recall what should be assessed about pain. Each letter stands for a pain characteristic and follows the sequence in the alphabet. A description of the pain is implied by the Q for quality. R can stand for radiation as well as rating.

The nurse is teaching a group of caregivers about the concept of pain in older adults. Which concepts would the nurse include in the teaching? Select all that apply. 1 Older patients underreport pain. 2 Sleeping is a coping strategy for pain. 3 Opioids are safe to use in older patients. 4 Older adults tend to perceive more pain. 5 Older adults with cognitive impairment do not experience less pain.

1,3,5 Text Reference - p. 857

The nurse is caring for a patient who underwent surgery and has a diagnosis of acute pain. Which clinical manifestations does the nurse expect to find in this patient? Select all that apply. 1Tachycardia 2 Bradycardia 3 Hypertension 4 Hypotension 5 Constipation

1,3,5 Text Reference - pp. 860-861 Surgery may cause acute pain (pain that lasts for less than 6 months). Acute pain causes an increase in the sympathetic nerve activity; thus it causes an increase in heart rate (tachycardia) and an increase in blood pressure (hypertension). Pain normally affects the gastrointestinal tract by decreasing gastric motility and thereby causes constipation. Chronic pain causes a decreased heartbeat (bradycardia) and a decrease in blood pressure (hypotension).

The electrocardiogram of an older adult male patient with chest pain shows signs of myocardial infarction. What are the likely sites for referred pain for a male patient with myocardial infarction? Select all that apply. 1 Jaw 2 Groin 3 Left ear 4 Left arm 5 Right arm

1,4 Text Reference - p. 856 When pathologic changes in one part cause pain at a distant site of the body, then the pain is known as referred pain. Pathologic changes in the heart often cause referred pain in the jaw and left arm. Pathologic changes in the heart do not usually cause pain in the groin, right arm, or left ear.STUDY TIP: Referral pain patterns for myocardial infarction can vary. Consult a textbook for the variations, but know that the jaw, left arm, and shoulder are the most common.

The nurse assesses that a patient is experiencing phantom pain. Which cause of pain is most likely? 1 The patient has a diagnosis of cancer. 2 The patient has an amputated extremity. 3 The patient had a myocardial infarction. 4 The patient has gastroesophageal reflux.

2 The patient has an amputated extremity. Text Reference - p. 856

The nurse is assessing a patient with acute pain. Which statements are true about acute pain? Select all that apply. 1 Patients with acute pain are more likely to experience depression and fatigue. 2 Acute pain has an identifiable cause. 3 Acute pain lasts less than 6 months. 4 Anxiety increases the severity of acute pain. 5 Patients with acute pain seek numerous health care providers.

2,3,4 Acute pain has an identifiable cause. The duration of acute pain is less than 6 months, whereas chronic pain is longer than 6 months. In acute pain, the presence of anxiety increases the severity of the pain experienced, reduces the individual's tolerance to pain, and decreases the ability to cope with pain. Individuals with chronic pain are more likely to experience depression and fatigue and are more likely to attempt suicide. A patient with chronic pain may seek numerous health care providers if the pain has an unknown cause.

The nurse is caring for a postsurgical patient who underwent nephrectomy. Which observations would suggest to the nurse the patient is in severe pain? Select all that apply. 1 The patient is motionless. 2 The patient has a reduced attention span. 3 The patient is constantly asking for pain relief medication. 4 The patient has clenched teeth and is biting his or her lips. 5 The patient is talking incessantly for a long period of time.

2,3,4 Text Reference - p. 861

A nurse is assessing a hospitalized patient with acute pain. Which question would the nurse ask the patient for an appropriate assessment? Select all that apply. 1 "How bad is your pain now?" 2 "What makes your pain worse?" 3 "Describe your pain." 4 "What is the worst pain you have had in the past 24 hours?" 5 "Show me where you hurt. Does it stay there or does it spread?"

2,3,5 When assessing a patient with acute pain, the questions should be specific. The questions should aim to determine intensity, location, and quality of pain. Ask for provocative factors like what makes the pain worse. Ask about the region of the pain and the radiation of pain. Asking how bad the pain is may not yield specific details. Instead the patient should be asked to rate the pain on a scale of 0 to 10. Other details can be asked about once the patient is comfortable.

Which conditions does the nurse identify as causes of visceral pain? Select all that apply. 1 Arthritis 2 Appendicitis 3 Fibromyalgia 4 Pancreatitis 5 Pyelonephritis

2,4,5 Text Reference - p. 855

A nurse is teaching a group of nursing students about concepts of pain in infants. Which information would the nurse include in the teaching? Select all that apply. 1 Infants cannot express pain. 2 Undertreatment is more prevalent in the pediatric population. 3 Infants are less sensitive to pain than older adults. 4 Preterm infants may display pain behaviors different from those of full-term infants. 5 Assessment of pain involves behavioral cues and physiologic indicators.

2,4,5 Text Reference - p. 858

Which condition leads the nurse to conclude that a patient has referred pain? 1 Bone fracture 2 Bladder distention 3 Myocardial infarction 4 Gastrointestinal reflux disease

3 Text Reference - p. 856

Which pain therapy involves the application of low-intensity current via skin electrodes in order to relieve pain? 1 Cordotomy 2 Sympathectomy 3 Spinal cord stimulation 4 Transcutaneous electrical nerve stimulation (TENS)

4 Transcutaneous electrical nerve stimulation (TENS) Text Reference - p. 864

A nurse is teaching pain management to a group of caregivers. Which information should be included in the teaching? Select all that apply. 1 Chronic pain is often psychological. 2 Only hospitalized patients experience severe pain. 3 Psychogenic pain is not real. 4 Regular administration of analgesics will not lead to addiction. 5 Patients with minor illnesses may also experience severe pain.

4,5 Text Reference - p. 869

The nurse is caring for a neonate who is grimacing, cries vigorously, and has a gagging breath pattern. The nurse also finds rapid extension of the arms and legs, and the infant's state of arousal is fussy. Which pain score would describe the neonatal infant's pain? Record your answer using a whole number. __________

The neonatal infant pain scale is the pain assessment tool used to determine the necessity of administrating pain medication to a neonate. It is calculated by giving scores to the type of facial expression, cry, breathing pattern, movement of the arms and legs, and state of arousal. The score given for grimacing = 1; a vigorous cry = 2; a gagging breath pattern = 1; rapid extension of arms = 1; rapid extension of legs = 1; and a fussy state of arousal = 1. Therefore the neonatal infant pain scale rating for this neonate is 7.