Pain Management-2
The nurse is teaching a student nurse about pain assessment scales. Which statement by the student indicates correct understanding?
"Pain assessment scales determine the quality of a patient's pain."
A 24-year-old Asian woman is in labor and refuses to receive any sort of anesthesia medication. Which alternative treatment is best for this patient?
Relaxation and guided imagery
A postoperative patient is currently asleep. Therefore the nurse knows that:
The sedative administered may have helped him sleep, but assessment of pain is still needed
When using ice massage for pain relief you should:
apply ice using firm pressure over the skin, apply ice until numbness occurs and remove for 5-10 minutes
A patient returning to the nursing unit after knee surgery is verbalizing pain at the surgical site. The nurse's first action is to:
assess the characteristics of the pain
Which of the following statements made by the patient indicates to the nurse that teaching on a patient-controlled analgesia (PCA) device has been effective?
"I feel less anxiety about the possibility of overdosing."
A nurse is supervising a student who is caring for a patient with chronic pain. Which statement by the student indicates an understanding of pain management?
"I need to reassess the patient's pain 1 hour after administering oral pain medication."
A nurse is providing medication education to a patient who just started taking ibuprofen, a nonselective nonsteroidal antiinflammatory drug (NSAID). Which statement made by the nurse best indicates how ibuprofen works?
"Ibuprofen helps to decrease the production of prostaglandins."
The nurse is caring for a patient who recently had surgery to repair a hernia. The patient's pain was 7 out of 10 beforereceiving pain medication. One hour after receiving an oral opioid, the patient ranks his pain at 3 out of 10. The patient asks the nurse why he isn't receiving more pain medication. Which is the nurse's best response?
"It can take 2 hours for oral pain medication to work, and your pain is going down. Let's try boosting you up in bed and putting an ice pack on the incision to see if that helps."
A nursing student is planning care for an elderly patient who is experiencing pain. Which of the following statements made by the nursing student indicates the need for the nursing professor to clarify the nursing student's knowledge?
"It is safe to administer opioids to older adults as long as you start with small doses and frequently assess the patient's response to the medication."
Which of the following statements made by a patient reflects that the patient understands the relationship between the gate control theory of pain and the use of meditation to relieve pain?
"Meditation controls pain by blocking pain impulses from coming through the gate."
Which statement made by a nursing educator best explains why it is important for nurses to determine a patient's medical history and recent drug use?
"This information is useful in determining what type of pain interventions will most likely be effective in providing pain relief."
A nurse is caring for a patient who is experiencing pain following abdominal surgery. What information is important for the nurse to tell the patient when providing patient education about effective pain management?
"We should work together to create a regular schedule of medications that does not allow for breakthrough pain."
The nurse is assessing how a patient's pain is affecting mobility. Which assessment question is most appropriate?
"What activities, if any, has your pain prevented you from doing?"
A nurse is caring for a patient who recently had an abdominal hysterectomy and states that she is experiencing severe pain. The patient's blood pressure is 110/60, and her heart rate is 60. Additionally, the patient does not appear to be in any distress. Which response by the nurse is most therapeutic?
"What would you like to try to alleviate your pain?"
A nurse has brought the patient his scheduled pain medication. The patient asks the nurse to wait to give pain medication until the time for the dressing change, which is 2 hours away. Which response by the nurse is most therapeutic?
"Would you like medication to be given for dressing changes on top of your regularly scheduled medication?"
A patient who has had type 2 diabetes for 26 years is beginning to experience peripheral neuropathy in the feet and lower legs, which is causing the patient to have a decreased ability to feel pain in the lower extremities. The nurse is providing education to the patient to prevent injury to the feet. The nurse tells the patient to always wear shoes or slippers when walking. Which of the following statements made by the nurse best explains the rationale for this instruction?
"You have lost the ability to withdraw from pain because of your peripheral neuropathy. If you step on something and are not wearing shoes, you will not feel it; this could possibly cause injury to your foot."
A nurse is providing discharge teaching for a patient with a fractured humerus. The patient is going home with Vicodin (5/325). What important patient education does the nurse provide?
"You need to drink plenty of fluids and eat a diet high in fiber."
The nurse anticipates administering an opioid fentanyl patch to which patient?
A 50-year-old patient with prostate cancer
A new medical resident writes an order for OxyContin SR 10 mg PO q12 hours prn. Which part of the order does the nurse question?
A new medical resident writes an order for OxyContin SR 10 mg PO q12 hours prn. Which part of the order does the nurse question? The time interval
The nurse recognizes that which of the following is a modifiable contributor to a patient's perception of pain?
Anxiety and fear
A nurse receives an order from a health care provider to administer Vicodin ES, which contains 750 mg acetaminophen and 7.5 mg hydrocodone, to a patient who is experiencing 8/10 postsurgical pain. The order is to give 2 tablets every 6 hours by mouth as needed for pain. What is the nurse's best next action?
Ask the health care provider to verify the dosage and frequency of the medication.
The nurse is caring for a patient who suddenly experiences chest pain. What is the nurse's first priority?
Ask the patient to rate and describe the pain.
What is the most appropriate way to assess the pain of a patient who is oriented and has recently had surgery?
Ask the patient to rate the level of pain.
After having received 0.2 mg of naloxone (Narcan) intravenous push (IVP), a patient' s respiratory rate and depth are within normal limits. The nurse now plans to implement the following action:
Assess patient's vital signs every 15 minutes for 2 hours
A health care provider writes the following order for an opioid naive patient who returned from the operating room following a total hip replacement. "Fentanyl patch 100 mcg, change every 3 days." Based on this order, the nurse takes the following action:
Calls the health care provider, and questions the order
Which of the following symptoms or signs in an opioid-naive patient is of greatest concern to the nurse when assessing the patient 1 hour after administering the opioid?
Difficulty arousing the patient
Which of the following is the best way for the nurse to manage pain for a patient with chronic pain from arthritis?
Give medications around-the-clock.
The nurse is assessing a patient for opioid tolerance. Which finding supports the nurse's assessment?
Increasingly higher doses of opioid are needed to control pain.
The nurse is caring for an infant in the intensive care unit. Which of the following is the most accurate description of factors that will influence the perception and management of pain for this patient?
Infants respond behaviorally and physiologically to painful stimuli.
What nursing intervention is most effective in preventing injury to a patient following administration of epidural anesthesia?
Labeling the tubing that leads to the epidural catheter
The nurse is caring for two patients; both are having a hysterectomy. The first patient is having the hysterectomy aftera complicated birth. The second patient has uterine cancer. What will most likely influence the experience of pain for these two patients? a. Neurological factors
Meaning of pain
Which one of the following instructions is crucial for the nurse to give to both family members and the patient who is about to be started on a patient-controlled analgesia (PCA) of morphine?
Only the patient should push the button.
The nurse is administering ibuprofen (Advil) to an older patient. Which of the following assessment data causes the nurse to hold the medication? (Select all that apply.)
Past medical history of gastric ulcer. Stated allergy to aspirin
A nurse is caring for a patient with rheumatoid arthritis who is now going to be taking 2 acetaminophen (Tylenol) tablets every 6 hours to control pain. Which part of the patient's social history is the nurse most concerned about?
Patient drinks 1 to 2 glasses of wine every night.
A patient with chronic low back pain who took an opioid around-the-clock (ATC) for the past year decided to abruptly stop the medication for fear of addiction. He is now experiencing shaking chills, abdominal cramps, and joint pain. The nurse recognizes that this patient is experiencing symptoms of:
Physical Dependence
A patient with a history of a stroke that left her confused and unable to communicate returns from interventional radiology following placement of a gastrostomy tube. The health care provider's order reads as follows: "Vicodin 1 tab, per tube, q4 hours, prn." Which action by the nurse is most appropriate?
Request to have the ordered changed to ATC for the first 48 hours.
A patient arrives at the emergency department experiencing a headache and rates the pain as 7 on a 0 to 10 pain scale. What nonpharmacological intervention does the nurse implement for this patient while awaiting orders for pain medication from the health care provider?
Softly plays music that the patient finds relaxing
A nurse is caring for a patient who fell on the ice and has connective tissue damage in the wrist and hand. What does type of pain does the nurse document that the patient has?
Somatic Pain
A patient is being discharged home on an around-the-clock (ATC) opioid for chronic back pain. Because of this order, the nurse anticipates an order for which class of medication?
Stimulant laxative
When teaching a patient about transcutaneous electrical nerve stimulation (TENS), which information do you include?
TENS electrodes are applied near or directly on the site of pain.
The nurse notices that a patient has received oxycodone/acetaminophen (Percocet) (5/325) two tablets PO every 3 hours for the past 3 days. What concerns the nurse the most?
The amount of daily acetaminophen
A patient who had a motor vehicle accident 2 days ago is experiencing pain and is receiving patient-controlled analgesia (PCA). How does the nurse know that the patient is experiencing effective pain management with the PCA?
The patient rates pain at an acceptable level of 3 on a 0 to 10 scale.
The nurse is administering pain medication for several patients. Which patient does the nurse administer medication to first?
The patient who is experiencing 8/10 pain and has a STAT order for pain medication
A nurse is caring for a patient who recently had spinal surgery. The nurse knows that patients usually experience acutepain following this type of surgery. The patient refuses to get up and walk and is not moving around in the bed. However, thepatient is stoic and denies experiencing pain at this time. What most likely explains this patient's behavior and response to surgery?
The patient's culture is possibly influencing the patient's experience of pain.
The nurse is evaluating the effectiveness of guided imagery for pain management as used for a patient who has second- and third-degree burns and needs extensive dressing changes. Which statement best describes that guided imagery is effectively controlling the patient's pain during dressing changes?
The patient's need for analgesic medication decreases during the dressing changes.
The patient rates his pain as a 6 on a scale of 0 to 10, with 0 being no pain and 10 being the worst pain. The patient's wife says that he can't be in that much pain since he has been sleeping for 30 minutes. Which is the most accurate resource for assessing the pain?
The patient's report of pain is the best method for assessing the pain.
While caring for a patient with cancer pain, the nurse knows that the World Health Organization (WHO) analgesic ladder recommends
Transitioning use of adjuvants with nonsteroidal antiinflammatory drugs (NSAIDs) to opioids
The nurse knows that which technique is best for assessing pain in a child who is 4 years of age?
Use the FACES scale.
A nurse is assessing a patient who started to have severe pain 3 days ago. When the nurse asks the patient to describe the pain, the patient states, "The pain feels like it is in my stomach. It is a burning pain, and it spreads out in a circle around the spot where it hurts the most." What type of pain does the nurse document that the patient is having at this time?
Visceral pain
