Person Module 3 - Comfort

Lifestyle

A patient reports back discomfort that is exacerbated by standing at work all day. Which specific area of concern in the patient interview does this information address?

Encouraging a positive attitude

A patient reports experiencing back pain "for years." Which intervention should the nurse select to most directly support this patient's psychological well-being?

"I recommend you use an inline or room humidifier."

A patient does not want to use the continuous positive airway pressure (CPAP) machine because of discomfort and waking up with a dry mouth. How should the nurse respond to this patient?

"How many hours a night do you sleep?"

A patient reports experiencing headaches in the morning. Which question should the nurse ask the patient?

Current Problem

A patient reports experiencing pain that started about 2 weeks ago. Which specific area of concern does this patient's comment address?

Obesity

A patient reports lower back pain. Which risk factor should the nurse include when assessing this patient?

"Reiki is a biofield therapy that does not have side effects or interact with other medications or treatments."

A patient experiencing pain from renal cancer asks about the use of Reiki to help with the pain. Which response should the nurse give that best reflects current evidence concerning biofield therapies such as Reiki?

Lack of restful sleep

A patient hospitalized for a health problem reports staying up until late in the evening, then sleeping in the next morning. Which comfort-related issue is this patient most likely to experience due to hospitalization?

"When you fall asleep, are you able to remain asleep?"

A patient is demonstrating symptoms of insomnia. Which question should the nurse ask this patient when completing the health history?

Sleep hygiene

A patient requests information to improve sleep. Which should the nurse include when teaching this patient?

Medication side effects

A patient taking medication for insomnia reports drinking several cups of coffee each day, exercising only once per week or less, and leaving the television on throughout the night. When providing the discharge teaching, which information should the nurse emphasize to this patient?

"A living will is put into place when you are not able to make your own decisions and dictate what type of care you will receive."

A patient is diagnosed with terminal cancer. The nurse suggests that the patient consider a living will, but the patient does not want anyone else making healthcare decisions right now. Which statement should the nurse provide to the patient?

Palpation

A patient is experiencing right-upper-quadrant abdominal pain. Which technique should the nurse use to pinpoint the location of the pain?

Fibromyalgia

A patient is waiting for the results of genetic testing that was done to help identify health problems. Which pain disorder should the nurse recall that has been associated with a mutation of the SCN9A gene?

Encouraging to try to eat a favorite meal

A patient nearing end of life is experiencing anorexia. Which action should the nurse take to support this patient's needs?

Provide sleeping medication as prescribed.

A patient nearing the end of life slept throughout the day but is wide awake at midnight. Which action should the nurse take to support this patient's needs?

"This medication is for short-term use only."

A patient prescribed zolpidem (Ambien) for insomnia asks how long the medication needs to be taken. How should the nurse respond to this patient?

Nerve block

A patient presents with a history of chronic unrelieved pain related to leukemia. Which intervention of last resort should the nurse expect to be prescribed for this patient?

Guarding of the abdomen

A patient rates abdominal pain as being an 8/10 and states that it frequently occurs after eating a heavy meal. Which observation should the nurse identify as best validating the patient's complaint?

Music therapy

A patient receiving pain medication for end-stage prostate cancer continues to experience pain. Which complementary approach should the nurse implement for this patient?

Contact the family to be with the patient.

A patient receiving palliative care for terminal cancer is experiencing apneic periods and increasing confusion. Which action should the nurse take to ensure the patient's social needs are met?

"Let's talk to your parents and healthcare provider. It's important for you to discuss this with them."

A 16-year-old male patient who recently learned of having terminal leukemia wishes to withhold future care. Which response by the nurse is appropriate?

Hold and comfort the child.

A 2-year-old child is recovering from surgery and experiencing pain. Which action should the nurse instruct the parents to perform to help with this patient's discomfort?

"The fibromyalgia will most likely persist into adulthood."

A patient recently diagnosed with fibromyalgia asks why the body hurts so much. Which response should the nurse make?

"Sometimes the symptoms of fibromyalgia present similar to the symptoms of hypothyroidism. Knowing how your thyroid is functioning will allow for an accurate diagnosis."

A 35-year-old patient with symptoms of fibromyalgia asks why testing for thyroid function is being done. Which response should the nurse make to this patient?

Hospice

A patient recently learns of having terminal breast cancer and will most likely pass away in a few months. Which referral should the nurse request to ensure this patient's quality of life?

Encouraging relaxation techniques

A hospitalized patient reports difficulty sleeping. Which action should the nurse implement?

Assessing the patient's normal circadian rhythm

A hospitalized patient reports not getting enough rest because of being woken up for procedures and activities. Which action should the nurse take to best address this situation?

"Snoring may be a symptom of airway obstruction, which could cause some problems with the quality of your sleep."

A middle-aged patient reports frequent nighttime waking despite being informed by the spouse of snoring throughout the night while asleep. Which response should the nurse make to this patient?

Love and belonging

A mother is upset because her adolescent child has changed appearance to fit in with friends and has been reading books about fairies and magic. Which level of Maslow's hierarchy of needs best describes the adolescent's behavior?

A participant in a community health program asks why it is important for fibromyalgia to be promptly diagnosed and treated. Which response should the nurse make to this participant?

A participant in a community health program asks why it is important for fibromyalgia to be promptly diagnosed and treated. Which response should the nurse make to this participant?

Physical or emotional trauma

A patient asks how the new diagnosis of fibromyalgia occurred. Which condition should the nurse identify as a contributor to the development of fibromyalgia?

"How long have you been taking the medication?"

A patient who has been taking the hypnotic drug zolpidem (Ambien) to aid in sleep is concerned about being addicted to the medication. Which response should the nurse make first to this patient?

Administering morphine via standing order

A patient who is actively dying is experiencing severe muscle cramps in the back. Which action should the nurse implement to help this patient?

Anticipatory grief

A patient who is dying from congestive heart failure expresses sadness at the thought of not seeing his grandchildren grow up. The nurse should realize that the patient is experiencing which condition?

Notifying the patient's family

A patient who is in the last hours of life is experiencing the "death rattle" with increasing periods of apnea. The patient has a signed do-not-resuscitate (DNR)/do-not-intubate (DNI) in the chart. Which action should the nurse take?

Reposition the patient in the bed to aid in comfort.

A patient who is nearing the end of life is restless. Which action should the nurse take at this time?

"It may be useful for detecting various sleep disorders."

A patient who is scheduled for a polysomnography (PSG) asks the nurse to explain the purpose of using video and audio equipment during the sleep study. How should the nurse respond to this patient?

"Narcolepsy is sometimes linked to a deficiency of a brain neurotransmitter."

A patient who recently learned of the diagnosis of narcolepsy asks what causes the disorder. Which response should the nurse make?

"Do you drink caffeinated beverages or alcohol?"

A patient who reports difficulty falling asleep is slumped over, has dark circles under the eyes, and is slow to respond to questions. Which question should the nurse ask this patient?

"Melatonin is the best option because it is a hormone your body already produces."

A patient who works the night shift is unable to sleep during the day and asks for a natural substance to promote sleep. How should the nurse respond to this patient?

Mobility: Physical, Impaired

A patient with a fractured arm is experiencing acute pain. Which nursing diagnosis should the nurse use to guide this patient's care?

Performing adequate pain assessment

A patient with a history of abusing hydrocodone is admitted following a motor vehicle crash resulting in multiple injuries. Which action should the nurse include in this patient's care?

Sluggish healing of a foot wound

A patient with a history of chronic pain has not been sleeping well. Which finding should the nurse expect when assessing this patient?

The patient states that the goal of care is to resume strength and return home.

A patient with a terminal illness is admitted for worsening symptoms and loss of appetite. After assessment, the nurse determines that the patient is in the closed state of awareness. Which observation did the nurse use to make this determination?

Enhanced psychosocial well-being

A patient with chronic pain spends time with family and friends several times a week. Which outcome should the nurse expect when assessing this patient?

Chronic ingestion of alcohol

A patient with chronic pain will be using acetaminophen (Tylenol) for pain relief when discharged. Which information found in the patient's history should the nurse identify as increasing the risk for hepatotoxicity from the use of this medication?

Begin cardiopulmonary resuscitation (CPR).

A patient with chronic renal failure reverses a do-not-resuscitate (DNR)order so that a diagnostic test can be performed the next day. Overnight, the patient goes into cardiac arrest. Which action should the nurse take at this time?

Dietary supplements, including vitamins

A patient with fibromyalgia expresses a desire to use complementary and alternative treatment methods as much as possible. Which complementary treatment option should the nurse list as being the least effective?

"The sleep disturbance is due to elevated cortisol levels in the evening."

A patient with fibromyalgia is fatigued and does not sleep well. Which reason for the sleep disturbances should the nurse provide to the patient?

Transdermal patch

A patient with pain caused by cancer is prescribed a topical pain medication with a preset dose. For which medication route should the nurse provide teaching for this patient?

You can try adjusting the air pressure of the machine."

A patient with sleep apnea reports difficulty "breathing out" when using the continuous positive airway pressure (CPAP) machine. Which teaching should the nurse provide to this patient?

"Our priority is to control your pain but ensure you are still able to function normally."

A patient with terminal liver cancer expresses concern that receiving pain medication will cause addiction and alter the ability to enjoy what little time is left. Which response by the nurse is appropriate?

Providing timely, sensitive, and open communication

A pediatric patient with a terminal illness is nearing death. Which intervention should the nurse implement to meet the needs of the patient and family at this time?

Sleep-hygiene practices

A pregnant client is having difficulty sleeping because of the weight of the baby and the need to void frequently throughout the night. Which instruction should the nurse include to help this patient with sleep?

Faces rating scale

A preschool-age child is brought for emergency care after falling down on the playground. Which pain assessment tool should the nurse use for this patient?

Respiratory status

A young adult sustains a fractured ankle and is prescribed an intravenous opioid for pain control. Which assessment should the nurse include when evaluating the effectiveness of the pain medication?

Assisting the patient in writing letters for her children to look at one day

A young mother who has three children at home is dying from cervical cancer. The nurse finds the patient crying and stating that she will never see her daughters get married or have children. Which intervention is the best for the nurse to provide?

"You will report improved quality and quantity of sleep."

After receiving information on sleep hygiene, the patient asks, "How will I know if this works?" Which response should the nurse make to this patient?

"Certain herbal supplements may interact with prescribed medications, so it's always best to check with your healthcare provider first."

An older adult patient taking prescribed medication for restless leg syndrome expresses the desire to use an herbal tea to improve sleep. How should the nurse respond to this patient?

"Pain medication may mask symptoms that reveal the underlying cause of your condition."

An older adult patient with abdominal pain is upset because pain medication is being withheld until an ultrasound is completed. Which response by the nurse is correct?

Providing around-the-clock oral care

An older adult patient with end-stage renal disease has no desire to eat and has stopped taking oral fluids. Which intervention should the nurse implement to support the patient at this time?

The patient will state that she is comfortable.

An older adult patient with metastatic breast cancer is experiencing severe pain and skin irritation caused by radiation therapy. She has requested that no further treatments occur and wants to be permitted to die in peace. Which patient outcome should the nurse identify when planning care for this patient?

"Age-related changes to the digestive tract can affect absorption of medication."

An older patient received medication for pain an hour ago and asks the nurse, "How come that medication is no longer working?" Which response by the nurse is accurate?

Age-related changes to the gastrointestinal tract

An older patient with shingles reports continued pain after receiving oral medication an hour ago. Which factor should the nurse consider as a reason for this patient's ongoing pain?

"I can give you an extra dose of pain medication if you would like.

Before assessing a new patient with terminal cancer, the nurse reads in the chart that the patient and family are using mutual pretense awareness. The patient reports back pain. Which statement by the nurse best respects the patient and family's awareness preferences?

"Maintaining a healthy lifestyle is the best way to reduce the risk of developing fibromyalgia."

During a community health fair, a participant asks how fibromyalgia can be prevented. Which response by the nurse is accurate?

"Why don't we give you some time to weigh the risks and benefits of this medication."

During a consultation with the parents of a young child with a terminal diagnosis, the physician mentions an experimental medication but, due to the severe side effects associated with the treatment, believes that the child should be placed in hospice care. The mother of the child says, "That's great news! There's another treatment that will save our child!" Which response by the nurse is appropriate?

"Surgery is usually only considered if continuous positive airway pressure (CPAP) therapy is not tolerated."

The clinical nurse specialist is teaching a group of staff nurses about surgical treatments that may be included in the care of patients who are diagnosed with obstructive sleep apnea. Which statement should the nurse include?

Paradoxical reaction

The nurse administers a prescribed sleeping aid to an older adult patient. For which potential reaction should the nurse assess this patient?

Respiratory depression

The nurse administers an opioid analgesic to a patient experiencing acute pain. Which assessment finding should the nurse address immediately?

Discuss palliative and hospice care options with the parents.

The nurse caring for a child who has recently been diagnosed with terminal leukemia attends a care consultation. The healthcare provider does not mention options for advance care planning during the meeting with the parents. Which action should the nurse implement next?

Female, age 45, with a history of rheumatoid arthritis

The nurse discusses risk factors for the development of fibromyalgia with colleagues. Which patient should the nurse indicate is most at risk for developing the disease?

I am more active than I was because my pain is better controlled."

The nurse evaluates the care of a patient diagnosed with fibromyalgia. Which patient statement indicates to the nurse that treatment was effective?

"I tried some pain medicine my friend had, and it worked even though it made me sleepy."

The nurse interviews a female patient with three children about ongoing symptoms of fibromyalgia. Which patient statement should indicate to the nurse the need for further teaching regarding self-care?

Pain between dosages of medication

The nurse is caring for a patient with a fractured ankle. Which manifestation differentiates breakthrough pain from acute pain?

Agreeing to a pain contract

The nurse is caring for a patient with a history of drug and alcohol abuse who is experiencing pain. Which intervention should the nurse suggest to this patient?

Muscle tension

The nurse is caring for a patient with a history of peripheral neuropathy and spinal stenosis. Which clinical manifestation should indicate to the nurse that the patient is experiencing chronic pain?

Increased perspiration

The nurse is assessing a patient during a routine clinic appointment. Which physiologic change should indicate to the nurse that the patient might be experiencing pain?

"Even if I eat healthy, something causes me pain anyway."

The nurse is assessing a patient during a wellness visit. Which patient statement should the nurse identify as a barrier to effective pain control?

"The fibromyalgia will most likely persist into adulthood."

The nurse is caring for a 13-year-old who was recently diagnosed with juvenile primary fibromyalgia syndrome (JPFS). The patient's parents do not understand their daughter's disease, and they have many questions for the nurse. Which information should the nurse include when talking with the parents?

A widespread pain index

The nurse is caring for a patient with suspected fibromyalgia. Which diagnostic tool should the nurse anticipate will be used to properly diagnose this patient?

Allowing the child to sit in the parent's lap

The nurse prepares to assess a toddler who is crying and tugging on the right ear. Which is the most appropriate method for the nurse to follow when assessing this child's level of comfort?

WBC Count

The nurse is caring for a patient experiencing discomfort. Which diagnostic lab test should the nurse analyze to assesses for infection as an underlying biological cause for the patient's discomfort?

The patient will verbalize a 50% reduction in pain.

The nurse is caring for a patient experiencing pain from knee-replacement surgery. Which outcome should the nurse identify for this patient?

Repositioning for comfort

The nurse is caring for a patient in the postsurgical unit following a knee replacement. Which independent nursing intervention should the nurse implement to address this patient's acute pain?

Prednisone

The nurse is caring for a patient receiving analgesics for pain. Which medication should the nurse identify as a coanalgesic?

Adequate pain management

The nurse is caring for a patient who is actively dying from colon cancer. Which intervention should be a priority for this patient?

Applying heat or cold as appropriate

The nurse is caring for a patient who is in pain because of a back spasm. Which independent intervention should the nurse implement for this patient?

Administer morphine.

The nurse is caring for a patient who is in the last few hours of life. The patient's level of consciousness is altered, and the patient is pulling at the indwelling urinary catheter and intravenous line. Which prescription should the nurse anticipate from the healthcare provider?

Explaining the purpose of medications

The nurse is caring for an 85-year-old patient with a chronic illness. Which intervention should the nurse use to enhance this patient's comfort?

"I have continual tenderness in my neck, spine, shoulders, and hips."

The nurse is caring for several patients who have the diagnosis Comfort, Impaired. Which patient statement should the nurse identify as describing discomfort related to fibromyalgia?

Central nervous system (CNS) stimulant

The nurse is caring for the patient with narcolepsy. Which category of medication should the nurse expect to be prescribed for this patient?

"I have had generalized pain throughout my body for at least 3 to 4 months."

The nurse is completing a health history with a patient new to the community clinic. Which statement should cause the nurse to suspect that the patient has fibromyalgia?

Pain is inevitable.

The nurse is concerned that an older adult patient is having pain but continues to refuse pain medication. Which belief should the nurse suspect this patient is demonstrating?

Patient contracts muscle groups progressively from toe to head.

The nurse teaches a patient muscle-relaxation techniques. Which patient observation indicates effective use of these techniques?

The patient received care by the family after death.

The nurse is evaluating outcomes of care for a patient from a non-American culture who dies in the hospital. Which outcome should the nurse identify that indicates that the patient received culturally competent care?

"My pain is a 2 on a scale of 0-10."

The nurse is evaluating whether a patient has achieved adequate pain control following hip replacement surgery. Which patient statement indicates that the goal has been met?

Patient description of symptoms

The nurse is performing an assessment of a patient reporting abdominal pain and discomfort. Which aspect of the comfort assessment should the nurse obtain during the health history?

Pain, Acute

The nurse is planning care for a patient with terminal bone cancer who is experiencing altered consciousness and skin weeping of the lower extremities. Which nursing diagnosis should the nurse use as the priority to guide this patient's care?

Serve as specialized pain receptors

The nurse is preparing a presentation about pain for colleagues. Which information should the nurse explain about nociceptors and pain?

Provide with a full glass of water.

The nurse is preparing to administer a nonsteroidal anti-inflammatory drug (NSAID) to a patient experiencing acute pain. Which action should the nurse implement when providing this medication?

The value of palliative care

The nurse is present when the healthcare provider tells the parents that their 9-year-old has leukemia. Which subject should the nurse discuss with the parents at this time?

Breathing Pattern, Ineffective

The nurse is prioritizing care for a patient with a sleep-rest disorder. Which nursing diagnosis should the nurse identify as being the highest priority?

Obesity

The nurse is teaching a group of community members about risk factors for developing sleep-rest disorders. Which risk factor for obstructive sleep apnea should the nurse emphasize?

Nacrolepsy

The nurse is teaching a group of staff members about sleep-rest disorders. Which example should the nurse use when explaining hypersomnia?

Gastric distress

The nurse is teaching a patient about risks related to the use of nonsteroidal anti-inflammatory drugs (NSAIDs) for pain relief. Which risk related to NSAID use should the nurse include in the teaching?

"These techniques will help me learn to consciously relax my muscles when they become tense due to stress."

The nurse is teaching a patient muscle-relaxation techniques. Which patient statement best describes the impact these techniques have on comfort?

To increase restorative sleep and reduce fatigue

The nurse is teaching a patient with fibromyalgia about self-care. For which main reason should the nurse recommend that the patient engage in good sleep-hygiene practices?

Sleep Loss

The nurse notes that a patient sleeps approximately 5 hours a night. The nurse should assess the patient for which sleep disturbance?

Offer a back massage.

The nurse notes that a patient with chronic pain continues to be uncomfortable while waiting for medication to take effect. Which action should the nurse take to help this patient?

Treat neuropathic pain

The nurse notes that a patient with fibromyalgia is prescribed an anticonvulsant. What should the nurse explain to the patient as being the purpose for this medication?

Encourage a routine exercise program

The nurse plans care for a patient with restless leg syndrome. Which intervention should the nurse identify as being the most effective for this health problem?

Aerobic exercise

The nurse prepares a seminar about fibromyalgia for a group of community members. Which type of exercise should the nurse emphasize as being the most beneficial for people with this disorder?

Exercise improves oxygen uptake and decreases pain intensity and fatigue."

The nurse prepares a teaching plan for a patient with fibromyalgia. Which information about exercise should the nurse include?

Take only the prescribed amount every day.

The nurse prepares material for a patient prescribed a nonsteroidal anti-inflammatory drug (NSAID) for management of acute pain. Which information should the nurse emphasize with this patient?

Legal aspects of care

The nurse prepares material on palliative care for a patient with a terminal illness. Which information should the nurse include as being a domain of this type of care?

Alternate periods of activity with periods of rest.

The nurse prepares teaching on nonpharmacologic therapies for a patient with fibromyalgia. Which intervention to treat activity intolerance should the nurse include in the teaching?

"What have you done in the past to help control pain?"

The nurse prepares to assess a patient experiencing an acute onset of pain. Which question should the nurse include when completing the health history?

Stabbing or burning pain in the neck, spine, and shoulders

The nurse prepares to assess a patient experiencing manifestations of fibromyalgia. What manifestation should the nurse expect the patient to exhibit?

May cause depression

The nurse prepares to assess a patient who has been experiencing pain for several months. Which statement correctly describes what the nurse should recall about chronic pain?

Sleeping position

The nurse prepares to assess a patient who is experiencing symptoms of a sleep-rest disorder. Which data should the nurse collect as part of the patient's sleep history?

Supine with the head elevated

The nurse provides a patient who is receiving end-of-life care with morphine to help with shortness of breath. Which position should the nurse suggest to help the patient breathe more comfortably?

Activity Intolerance

The nurse reviews data collected during the assessment of a patient with fibromyalgia. Which nursing diagnosis should the nurse identify for this patient?

The patient who has hypoestrogenemia

The nurse reviews information received during handoff communication from the previous shift. Which patient should the nurse identify as being most at risk for restless leg syndrome?

Providing the highest quality of life for the patient

The nurse reviews medications prescribed for a patient who is approaching end of life. The nurse identifies which goal for pharmacological therapy for this patient?

A 30-year-old woman who was diagnosed with cervical cancer and 3 months to live

The nurse reviews the health status of a group of patients on an oncology care area. Which patient should the nurse identify as being eligible for hospice care?

"Pain and tiredness are worse with increased activity."

The nurse suspects that a patient experiencing neck, back, and hip pain despite having an active lifestyle has fibromyalgia. How should the nurse expect the patient to describe the pain and fatigue?

Complaints of pain in four quadrants of the body and 11 of 18 tender points

The nurse suspects that a patient has undiagnosed fibromyalgia. What finding supports the nurse's suspicion?

Encourage engagement in enjoyable, quiet activities.

The nurse teaches a patient diagnosed with fibromyalgia about management of symptoms. Which intervention to treat fatigue should the nurse include in the teaching?

"Do not administer aspirin. This medication should not be used if your child has influenza."

The parent of a child who is displaying symptoms of influenza asks the nurse about administering aspirin for relief of the child's discomfort. Which response by the nurse is correct?

Structure and processes of care

When planning for a patient's palliative care needs, the nurse identifies the goals and values of the patient and family. The nurse is focusing on which domain of palliative care?

Gently rub the extremities.

Which action should the nurse perform to meet a dying patient's circulatory needs?

Respiratory status

Which patient assessment should the nurse implement following the administration of an opioid pain medication?