Prep U CH. 9
C. Nodding up and down in response to questions
A 12-year-old boy has reported to the emergency department after having fallen off his bicycle and sustained what appear to be minor injuries. The nurse is assessing him for pain. Which of the following objective findings would most tend to indicate pain? A. Maintaining a consistent position and posture B. Sustained eye contact with the nurse C. Nodding up and down in response to questions D. Upright posture while sitting
D. neuropathic
A client describes pain in the soles of both feet as constantly burning. Which type of pain should the nurse suspect this client is experiencing? A. visceral B. somatic C. referred D. neuropathic
A. Increased heart rate B. Perspiration C. Sleeplessness
A client enters the emergency department moaning and complaining of severe pain in his lower back. Which of the following clinical manifestations should the nurse expect to see in this client as a physiologic response to pain? Select all that apply. A. Increased heart rate B. Perspiration C. Sleeplessness D. Hypoglycemia E. Increased intestinal motility
A. Visceral pain
A client has a severe abdominal injury with damage to the liver and colon from a motorcycle crash. What type of pain will predominate? A. Visceral pain B. Neuropathic pain C. Psychogenic pain D. Cutaneous pain
D. Endorphins
A client has been taught relaxation exercises before beginning a painful procedure. What chemicals are believed to be released in the body during relaxation to relieve pain? A. Sedatives B. A-delta fibers C. Narcotics D. Endorphins
B. Referred pain
A client in the Emergency Department is diagnosed with a myocardial infarction (heart attack). The client describes pain in his left arm and shoulder. What name is given to this type of pain? A. Allodynia B. Referred pain C. Nociceptive D. Cutaneous pain
B. Tissue injury leading to inflammation
A client injures his thumb by accidently slamming the car door shut on it. He arrives at the emergency department in intense pain. Which of the following processes is associated with the transduction process of this pain? A. Changes or inhibitions to the pain message relay in the spinal cord B. Tissue injury leading to inflammation C. Inflammation leading to conduction of an impulse to the spinal cord D. Emotional response and rational interpretation and response
C. Give the prn morphine
A client on a medical-surgical unit reports pain of 10 on a scale of 0 to 10 and wants more pain medication. The nurse does not think the pain is as bad as the client says. The physician left orders for prn morphine for breakthrough pain. What is the priority nursing action? A. Document the client's pain rating on a scale of 0 to 10 B. Call the physician to check the order C. Give the prn morphine D. Hold the medication and wait 30 minutes
C. Acute
A client presents to the ED with pain in the upper right quadrant that worsens after eating. The client describes the pain as sharp, stabbing, and at times very intense. This is a description of which type of pain? A. Chronic B. Phantom C. Acute D. Cutaneous
C. "Rate your pain on a 0-10 scale; 0 being no pain and 10 the worst."
A client recently recovering from shingles states that he suffers from pain and burning along his back and sides where the lesions are dried and crusted and requests pain medication. What is the nurse's best response? A. "Shingles is a viral condition and shouldn't be painful." B. "Visceral pain can not be treated until an abdominal CT scan is performed." C. "Rate your pain on a 0-10 scale; 0 being no pain and 10 the worst." D. "Chronic pain is usually not treated with narcotic analgesia."
D. Neuropathic
A client recovering from a stroke complains of pain. The nurse suspects this client is most likely experiencing which type of pain? A. Nociceptive B. Idiopathic C. Somatic D. Neuropathic
D. Somatic
A client recovering from abdominal surgery is complaining of pain. The nurse realizes that the client is most likely experiencing which type of pain? A. Idiopathic B. Psychogenic C. Neuropathic D. Somatic
D. The release of endorphins
A client reports after a back massage that his lower back pain has decreased from 8 to 3 on the pain scale. What opioid neuromodulator may be responsible for this increased level of comfort? A. The release of insulin B. The release of melatonin C. The release of dopamine D. The release of endorphins
B. Somatic
A client who suffers from arthritis complains of sharp pain in her knees and elbows. The nurse recognizes this is what type of pain? A. Referred B. Somatic C. Visceral D. Cutaneous
C. Modulation
A construction worker in his mid-40s suffered a severe laceration on his leg while on the job site. Soon after he arrives at the emergency room, a nurse assesses his pain. The client states that pain, although severe, has lessened since the accident first occurred. The nurse knows that the pain message likely has been inhibited by release of endorphins and other neurotransmitters. Which physiological process does this represent? A. Transmission B. Perception C. Modulation D. Transduction
B. Somatic pain
A cyclist reports to the nurse that he is experiencing pain in the tendons and ligaments of his left leg, and the pain is worse with ambulation. The nurse will document this type of pain as which of the following? A. Cutaneous pain B. Somatic pain C. Phantom pain D. Visceral pain
C. Consult with the healthcare provider about increasing the dose of medication.
A male client with a history of a back injury 2 months ago has been taking daily doses of narcotic pain medication. He is currently hospitalized with a leg fracture after falling down the stairs. He complains of 10/10 pain in his back and leg after taking pain medication one hour ago. What is the nurse's best action? A. Tell the client to take his own prescription medication. B. Request a psychiatric evaluation for drug seeking behavior. C. Consult with the healthcare provider about increasing the dose of medication. D. Inform the client that the next dose of medication is due in one more hour.
A. Intensity
A nurse asks a client to rate his pain on a scale of 0 to 10, with 0 being no pain and 10 being worst pain. What characteristic of pain is the nurse assessing? A. Intensity B. Location C. Duration D. Chronology
A. When did the pain start? C. Where is the pain located? D. Describe the pain.
A nurse assesses a client with acute small-bowel obstruction who reports intermittent pain. He only noticed symptoms of this condition earlier today. Which questions are appropriate for the nurse to ask when assessing the client's pain? Select all that apply. A. When did the pain start? B. Mention past experiences with pain. C. Where is the pain located? D. Describe the pain. E. What therapies were used?
D. Faces Pain Scale
A nurse assesses a cognitively impaired adult client who grimaces and points to the right knee following a motor vehicle accident. Which pain scale would be most appropriate for the nurse to use to assess the client's pain? A. Numeric Rating Scale B. Verbal Descriptor Scale C. Visual Analog Scale D. Faces Pain Scale
A. Maintain a quiet and calm environment B. Assure the client's privacy D. Document the terms used by the client
A nurse attempts to assess a client's pain but finds the client is having difficulty describing the pain. Which interventions by the nurse may help with the collection of subjective data about the client's pain? Select all that apply. A. Maintain a quiet and calm environment B. Assure the client's privacy C. Ask the client yes/no questions D. Document the terms used by the client E. Give a laundry list of terms to help the client choose
B. "How often do you experience the pain?"
A nurse begins to assess pain in a client admitted to the hospital for new onset of severe nausea and vomiting. What question should the nurse ask the client to assess the pattern of pain? A. "Where is the pain located?" B. "How often do you experience the pain?" C. "What therapies have you tried to control the pain?" D. "When did your pain start?"
A. Modulation
A nurse is administering prescribed medicine to a client who experienced acute pain in the lower back after a motor vehicle accident. The client tells the nurse that compared to the previous week, his pain had reduced considerably. Which phase of pain is the client experiencing? A. Modulation B. Transmission C. Transduction D. Perception
A. How does the pain influence your overall mood?
A nurse is assessing the effect of a client's chronic back pain on his affective dimension. Which question should the nurse ask for this assessment? A. How does the pain influence your overall mood? B. What is the highest level of education you've completed? C. Where is the pain located? D. What medical conditions do you have?
D. Visceral pain
A nurse is caring for a client with dull ache in her abdomen. On the way to the health care facility, the client vomits and shows symptoms of pallor. What kind of pain is the client experiencing? A. Cutaneous pain B. Somatic pain C. Neuropathic pain D. Visceral pain
A. Acute pain in the ED
A pathophysiology instructor is discussing pain and its treatment across cultures. The instructor points out that clients from racial and ethnic minorities often receive less pain medication compared to Caucasians for what specific conditions? A. Acute pain in the ED B. Chronic pain from fibromyalgia C. Head injuries D. Broken limbs
B. Administer prescribed analgesia as ordered.
A post-operative client is observed breathing 24 breaths/minute while complaining of 10/10 abdominal pain. The client's oxygen saturation is 90% on 2 liters nasal cannula. What is the nurse's priority action? A. Explain why deep breathing and coughing is important. B. Administer prescribed analgesia as ordered. C. Teach and encourage incentive spirometry use. D. Manually ventilate client with ambu bag at bedside.
D. It can lead to neurodevelopmental problems
A student nurse learns that especially in the very young and very old pain can be inadequately treated. What else would the student learn about inadequate pain treatment in the very young? A. It can lead to higher client compliance with medication B. It can lead to nutritional deficiencies from lack of appetite C. It can lead to an increase in hormonal disorders D. It can lead to neurodevelopmental problems
D. Spiritual dimension
An elderly farmer has sustained severe injuries after a serious accident involving a combine harvester. At the hospital, he tells the nurse that he thinks the pain he is feeling now is "payback" for living a "mean, selfish life." The nurse recognizes that this response by the man indicates which dimension of pain? A. Sociocultural dimension B. Cognitive dimension C. Affective dimension D. Spiritual dimension
C. A-delta and C fibers
As a nurse is adjusting a client's hospital bed, the nurse accidently pinches a finger between the bed and the wall. Which of the following components is involved in the transduction of the pain the nurse feels? A. K-fibers B. L-beta fibers C. A-delta and C fibers D. neuronal plasticity
D. Infants can feel pain and may respond with crying or agitation.
Beliefs of health care providers can serve as barriers to an accurate assessment of a client's pain. Which of the following beliefs will not be likely to impair the assessment of pain? A. Persons asking for pain medication but who are showing no other evidence of pain are just addicted to the medication. B. A sleeping person feels no pain. C. Old people have more pain which is to be expected. D. Infants can feel pain and may respond with crying or agitation.
D. Analgesics
During a lecture on pain management, the nursing instructor informs the group of nursing students that the primary treatment measure for pain is which of the following? A. Cutaneous stimulation B. Surgery C. Relaxation techniques D. Analgesics
A. Avoid stereotyping responses to pain by clients.
How may a nurse demonstrate cultural competence when responding to clients in pain? A. Avoid stereotyping responses to pain by clients. B. Know the action and side effects of all pain medications. C. Treat every client exactly the same, regardless of culture. D. Be knowledgeable and skilled in medication administration.
B. Constipation
In preparing a care plan for a client receiving opioid analgesics, the nurse selects which of the following as an applicable nursing diagnosis associated with side effects of opioid use? A. Diarrhea B. Constipation C. Impaired urinary elimination D. Bowel incontinence
C. Visceral pain
Mark is a 20-year-old college student who has been experiencing increasingly sharp pain in the right, lower quadrant of his abdomen over the last 12 hours. A visit to the emergency department and subsequent diagnostic testing have resulted in a diagnosis of appendicitis. What category of pain is Mark most likely experiencing? A. Referred pain B. Somatic pain C. Visceral pain D. Cutaneous pain
B. Phantom pain.
Pain that is felt in a part of the body that has been removed is called: A. Neuropathic pain. B. Phantom pain. C. Referred pain. D. Radiating pain.
D. "There's a very minimal risk of addiction, and controlling his pain is our first concern."
Recently, lung cancer has metastasized to the bones of a 68-year-old client, precipitating a sudden increase in his pain. The client's wife and daughter are concerned about the consequent increase in the amount of hydromorphone the client requires, citing the risk of addiction. How can the nurse best respond to the family's concern? A. "Even when he becomes addicted, we can take comfort knowing that his pain is controlled." B. "It's actually a myth that clients can become addicted to hospital narcotics." C. "If he ends up needing higher doses to resolve the pain, we will discontinue the drug." D. "There's a very minimal risk of addiction, and controlling his pain is our first concern."
D. The time it takes a pain medication to decrease pain intensity
The Joint Commission mandates that nurses assess and reassess a client's pain level. A nurse's healthcare facility mandates pain reassessment at 30 minutes for any drug given intravenously. This mandate is based on what? A. The research supporting intravenous medications given for pain take half as long to work as oral medications B. The median half-life of an intravenous pain medication C. The time it takes a pain medication to block pain in a client D. The time it takes a pain medication to decrease pain intensity
A. Joint Commission Standards for Pain Management.
The U.S. government has created guidelines for health care providers caring for clients in pain. Which of the following reflect these guidelines? A. Joint Commission Standards for Pain Management. B. American Pain Society Guidelines for Pain Management. C. National Institutes of Health Standards for Pain Treatment. D. American Cancer Society Guidelines for Pain Management.
B. Pain sensation is diminished in older adults.
The charge nurse on a geriatric unit should further educate a new staff nurse who makes which statement? A. Transmission of pain along A-delta and C fibers may be altered in older adults. B. Pain sensation is diminished in older adults. C. Older adults tend to be undertreated for pain. D. There is little information about the effects of increased age on pain.
A. Acute
The client arrives to the emergency room reporting severe abdominal pain that started 3 hours ago. He rates the pain as an 8 on a scale of 1 to 10. After tests are performed, the client is diagnosed with appendicitis. This is an example of which of the following types of pain? A. Acute B. Chronic C. Cutaneous D. Neuropathic
A. Acute
The client arrives to the emergency room reporting severe abdominal pain that started 3 hours ago. He rates the pain as an 8 on a scale of 1 to 10. After tests are performed, the client is diagnosed with appendicitis. This is an example of which of the following types of pain? A. Acute B. Cutaneous C. Chronic D. Neuropathic
D. Referred pain
The client comes to the emergency department reporting indigestion and left arm pain. The physician orders an EKG along with drawing of cardiac enzymes. When the results are back, the client is informed of the diagnosis of heart attack. The indigestion and arm pain are examples of which of the following? A. Visceral pain B. Cutaneous pain C. Somatic pain D. Referred pain
B. Using in-depth questions to collect significant data about the client's pain
The nurse is assessing a client with a history of drug addiction. What will be helpful in determining interventions that will be most beneficial for providing adequate pain relief to this client? A. Collecting subjective data that the nurse notes during assessment B. Using in-depth questions to collect significant data about the client's pain C. Gathering information that the client wants to share about his pain D. Collecting objective data that the client chooses to share
D. The cause of acute pain can be identified.
The nurse is explaining the difference between acute pain and chronic pain to the client. Which should the nurse include in the explanation? A. Acute pain lasts longer than 3 to 6 months. B. Chronic pain is caused by damage to nerves. C. The duration of chronic pain is short. D. The cause of acute pain can be identified.
C. Burning, tingling
The nurse should assess for which pain complaints from a client diagnosed with Type II Diabetes Mellitus? A. Aching, gnawing B. Sharp, stabbing C. Burning, tingling D. Pain only on movement
B. Referred pain
The nursing instructor is discussing the different types of pain with the nursing class. What type of pain would the instructor explain originates from a specific site, yet the client feels the pain at another site? A. Chronic pain B. Referred pain C. Cutaneous pain D. Somatic pain
C. "Pain is a natural part of aging."
The nursing instructor is teaching a class about how to assess pain in older adults. The teachers tells the students that problems can arise in certain circumstances. The instructor realizes the need for more teaching about pain in the elderly when one of the students replies: A. "Patients are reluctant to report pain because they want to be considered as 'good' clients." B. "Older clients may worry that reporting pain will lead to costly tests." C. "Pain is a natural part of aging." D. "Patients may fear that uncontrolled pain will affect their independence."
A. Gallbladder pain
The nursing student asks the nurse what would be an example of visceral pain. What would be the correct response by the nurse? A. Gallbladder pain B. Burn pain C. Arthritic pain D. Cardiac pain
B. Transduction
What is the element of pain transmission that causes nociceptors to perceive a nerve impulse? A. Modulation B. Transduction C. Transmission D. Perception
D. Gate control theory
What is the most commonly accepted theory of pain? A. Pain stimulus theory B. Pain transmission theory C. Gatekeeper theory D. Gate control theory
C. believe the client when he or she claims to be in pain.
When assessing the client for pain, the nurse should A. assess for underlying causes of pain, then believe the client. B. doubt the client when he or she describes the pain. C. believe the client when he or she claims to be in pain. D. assess for the presence of physiologic indicators (such as diaphoresis, tachycardia, etc.), then believe the client.
D. Neuropathic
When clients report pain, it is important to find the source. When clients describe pain as "burning, painful numbness, or tingling," the source is more than likely: A. Somatic B. Visceral C. Referred D. Neuropathic
C. Pain must be endured to perform gender role duties, but response to it is very expressive.
Which of the following cultural expressions of pain would be likely to be found in a person of Hispanic culture? A. Pain is honorable and should be endured. B. Pain may be caused by past transgressions and helps to atone and achieve higher spirituality. C. Pain must be endured to perform gender role duties, but response to it is very expressive. D. Pain is part of the preparation for the next life in the cycle of reincarnation.
B. Dopamine
Which of the following is not released during the stress response? A. Cortisol B. Dopamine C. Epinephrine D. Norepinephrine
A. Pain assessment may require multiple methods in order to ensure accurate pain data.
Which of the following principles should the nurse integrate into the pain assessment and pain management of pediatric clients? A. Pain assessment may require multiple methods in order to ensure accurate pain data. B. The developing neurological system children transmits less pain than in older clients. C. A numeric scale should be used to assess pain if the child is older than 5 years of age. D. Pharmacologic pain relief should be used only as an intervention of last resort.
A. Specialized cells can decrease pain transmission by exciting inhibitory neurons.
Which of the following statements most accurately conveys an aspect of the gate-control theory? A. Specialized cells can decrease pain transmission by exciting inhibitory neurons. B. Substances such as endorphins are noted to increase pain sensation. C. The transmission and sensation of pain exist completely within the spinal cord. D. Pain transmission and emotional state exist independently of each other.
A. Pancreatic pain B. Liver pain E. Gallbladder pain
Which would the nurse recognize as an example of visceral pain? Select all that apply. A. Pancreatic pain B. Liver pain C. Burn pain D. Muscular pain E. Gallbladder pain
A. The client
Who is the authority on the presence and extent of pain experienced by a client? A. The client B. A surgeon C. An anesthesiologist D. A nurse
