Week 12 - Pain
A nurse is assisting with a staff in-service regarding pain control. Which of the following statements by a staff member indicates an understanding of the information? (Select all that apply.) "A client's religious beliefs might affect the way they respond to pain." "Herbal therapies are not permitted for a client receiving prescription pain medication." "The client's past pain experiences are not related to their current pain and pain management." "If a client can rate their pain using a numeric pain scale, there is no need to note nonverbal findings." "Pain control might be harder to achieve if the nurse and client speak different primary languages."
"A client's religious beliefs might affect the way they respond to pain." "The client's past pain experiences are not related to their current pain and pain management." "Pain control might be harder to achieve if the nurse and client speak different primary languages."
A nurse is speaking with a client who reports experiencing frequent, severe migraines and asks, "Can you tell me about biofeedback?" Which of the following responses should the nurse make? "Biofeedback measures skin tension and uses learned techniques to relieve pain." "Biofeedback provides soothing visual images identified by the client to promote relaxation." "Biofeedback includes listening to an increasing volume of music until the pain subsides." "Biofeedback stimulates the skin with a mild electric current when pain occurs."
"Biofeedback measures skin tension and uses learned techniques to relieve pain."
A nurse is evaluating a client's pain level using the PQRST mnemonic. Which of the following questions should the nurse ask to evaluate the letter "R"? "Can you rate your pain on a scale of 0 to10, with 0 being no pain and 10 being the worst pain you can imagine?" "Can you point to where you are having your pain?" "What does your pain feel like?" "What were you doing when your pain started?"
"Can you point to where you are having your pain?"
A nurse is teaching staff about the ethical principle of justice and how it relates to pain management for clients. Which of the following statements should the nurse make? "Justice allows the client the freedom of choice." "Justice allows the client the opportunity to be treated fairly." "Justice is causing no harm to the client." "Justice is doing good for the client."
"Justice allows the client the opportunity to be treated fairly."
During a pain assessment, a nurse asks questions about the quality of an adult client's pain. Which of the following statements by the client refers to pain quality? "The pain in my abdomen began last night and has gotten worse." "My pain is at a 9 on a scale of 0 to 10." "My pain feels like I'm being stabbed by a knife." "The pain is worse when I bend over at my waist."
"My pain feels like I'm being stabbed by a knife."
what is nociceptive pain
-arises from damage to or inflammation of tissue, which is a noxious stimulus that triggers the pain receptors called nociceptors and causes pain. -It is usually throbbing, aching, and localized. -This pain typically responds to opioids and non-opioid medications.
A nurse is caring for a client who has a prescription for heat therapy for knee pain. The nurse should apply heat therapy to the client's knee for how long? 60 min 20 min 30 min 45 min
20 min
A nurse is caring for a group of clients on the pediatric unit. For which of the following clients should the nurse use the FLACC Pain Scale to determine their pain level? (Select all that apply.) A 12-year-old client who has had an appendectomy A 3-year-old toddler who has a fractured femur A 6-day-old infant who had a surgical repair of a heart defect A 14-year-old client who has severe cognitive and developmental delays A 5-year-old preschooler who is experiencing pain during a sickle cell crisis
A 3-year-old toddler who has a fractured femur A 14-year-old client who has severe cognitive and developmental delays A 5-year-old preschooler who is experiencing pain during a sickle cell crisis
A nurse is assessing a client who reports severe abdominal pain. The nurse asks the client if there has been any accompanying nausea and vomiting. Which of the following pain characteristics is the nurse attempting to determine? A Presence of associated manifestations B Location of the pain C Pain quality D Aggravating and relieving factors
A Presence of associated manifestations
In addition to using an age-appropriate pain scale, the nurse should also note and document additional subjective data. Which of the following subjective data should the nurse have assessed and documented for the client in the video? A Withdrawn B Palmar sweating C Crying D Increased heart rate
A Withdrawn
A nurse is planning to teach coworkers about the legal and ethical principles used with pain management. Which of the following examples should the nurse include as an example of autonomy? A nurse allows a client to wait longer for their pain medication than other clients. A nurse does not properly clean a vial of pain medication prior to withdrawing medication from the vial, which results in the client contracting an infection. A nurse administers scheduled pain medication and provides therapeutic distraction techniques for a client in pain. A nurse provides a client with the opportunity to take an intramuscular injection or oral medication for pain relief.
A nurse provides a client with the opportunity to take an intramuscular injection or oral medication for pain relief. (This is an example of autonomy. The nurse is providing the client their right of self-determination by permitting the client an ability to make an informed decision.) A nurse allows a client to wait longer (This is an example of a violation of justice) A nurse does not properly clean a vial of pain medication prior (This is an example of negligence) A nurse administers scheduled pain medication (This is an example of beneficence)
What are adjuvent analgesics?
Aid in pain relief by working on underlying pain generators, such as antidepressants, corticosteroids, and botulinum toxin.
what is acute pain
Anticipated or predictable end; lasts less than 6 months.
A nurse is discussing the challenges of assessing pain in children with a group of parents. Which of the following statements should the nurse include? A The presence of the child's parent can make it more difficult to assess a child's pain. B Children may deny pain to avoid IM injection or bad tasting oral medicine. C Children often cannot identify where the pain is located. D Young children do not exhibit pain.
B Children may deny pain to avoid IM injection or bad tasting oral medicine.
A nurse is caring for a client who is receiving morphine via a patient-controlled analgesia (PCA) infusion device after abdominal surgery. Which of the following statements indicates that the client knows how to use the device? A "I'll wait to use the device until it's absolutely necessary." B "I'll be careful about pushing the button too much, so I don't get an overdose." C "I should tell the nurse if the pain doesn't stop while I am using this device." D "I will ask my adult child to push the dose button when I am sleeping."
C "I should tell the nurse if the pain doesn't stop while I am using this device."
A nurse is monitoring a client for adverse effects following the administration of an opioid. Which of the following effects should the nurse identify as an adverse effect of opioids? Select all that apply. A Urinary Incontinence B Diarrhea C Bradypnea D Orthostatic hypotension E Nausea
C Bradypnea D Orthostatic hypotension E Nausea
A nurse is caring for a client who reports muscle pain to the lower back that has persisted for over a year after a motor-vehicle crash. In which way should the nurse categorize this client's pain? Cancer pain Acute pain Chronic pain Neuropathic pain
Chronic pain
what is chronic pain
Constant or recurring; lasts longer than 6 months.
A nurse is discussing the care of a group of clients with a newly licensed nurse. Which of the following clients should the newly licensed nurse identify as experiencing chronic pain? A A client who has a broken femur and reports hip pain. B A client who has incisional pain 72 hr following pacemaker insertion. C A client who has food poisoning and reports abdominal cramping. D A client who has episodic back pain following a fall 2 years ago.
D A client who has episodic back pain following a fall 2 years ago.
what is age related pain
Due to Chronic diseases such as arthritis, diabetes, heat disease, liver disease, kidney and lungs disease.
A nurse is discussing the FLACC scale with a newly licensed nurse. Which of the following categories should the nurse include? (Select all that apply.) Face Legs Alert Circulation Consolability
Face Legs Consolability
A nurse is discussing end-of-life pain management with a group of coworkers. Which of the following should the nurse include as barriers to end-of life pain management? (Select all that apply.) Fear of addiction Belief that pain is an expected part of their illness Inability to sleep Lack of support Inadequate pain assessment
Fear of addiction Belief that pain is an expected part of their illness Inadequate pain assessment
A nurse is assessing a client who is nonverbal for the presence of pain. Which of the following findings indicate an increased level of discomfort? (Select all that apply.) Grimacing Restlessness Elevated temperature Increased diaphoresis Bradycardia
Grimacing Restlessness Increased diaphoresis
A nurse is planning to administer a dose of morphine sulfate IV for a client who is postoperative. Which of the following pain management protocols should the nurse use when caring for this client? Withhold the medication for a respiratory rate of 14/min. Perform the IV injection over 1 min. Avoid administering opioid agonists on a fixed schedule. Have an opioid antagonist available during the administration.
Have an opioid antagonist available during the administration.
subjective Qs for pain
Onset Location Duration Characteristics Alleviating factors Relieving factors Treatment
what is the PQRST
Precipitating cause Quality Region Severity Timing
A nurse is monitoring a client who is 2 hr postoperative and is receiving morphine via PCA pump. Which of the following findings should the nurse plan to monitor to detect opioid-induced ventilatory impairment (OIVI)? (Select all that apply.) Bowel sounds Deep tendon reflexes Respiratory rate Capnography Oxygen saturation
Respiratory rate Capnography (measuring carbon dioxide) Oxygen saturation
A charge nurse is reviewing factors that can affect a client's perception of pain with a newly licensed nurse. Which of the following should the charge nurse include? (Select all that apply.) Stress Dietary practices Culture Social support Disease severity
Stress Culture Social support Disease severity
A nurse is caring for a client who has kidney stones. Which of the following manifestations is an objective indicator of pain? The client is diaphoretic. The client is experiencing stabbing pain. The client is nauseated. The client states feeling dizzy.
The client is diaphoretic.
what is somatic nociceptive pain
bones, joints, muscles, skin, or connective tissues.
what is visceral nociceptive pain
internal organs (the stomach or intestines). It can cause referred pain in other body locations separate from the stimulus.
A nurse is caring for a client who has severe pain and repeatedly asks for pain medication. The nurse is busy and forgets to assess the client's pain and administer prescribed pain medication. Which of the following can the nurse be charged with? Malpractice Negligence Nonmaleficence Beneficence
negligence
what is neuropathic pain
nerve pain; no tissue damage
what is cancer pain
newly recognized category of pain that can involve tumor pain, bone pain, and treatment-associated pains such as chronic post-surgical pain.
what is cutaneous nociceptive pain
skin or subcutaneous tissue.
examples of neuropathic pain
•Diabetic Neuropathy •Phantom limb Pain •Spinal Cord Injury
what is PQRST
•Precipitating cause •Quality •Region •Severity •Timing
what are somethings that affect the patients pain scale
•cultural, ethnic, and religious beliefs; family; support systems; gender; age; environment; past experiences with pain; anxiety; and other stressors.
what is idiopathic pain
Due to Chronic diseases such as arthritis, diabetes, heat disease, liver disease, kidney and lungs disease.
A nurse is preparing to assess the pain level of a 4-year-old child. Which of the following pain assessment tools should the nurse use? CRIES instrument COMFORT Behavior scale FACES PAINAD scale
FACES
A nurse is discussing the use of heat therapy with a newly licensed nurse. The nurse should include that heat therapy is effective for which of the following conditions? (Select all that apply.) Muscular pain Active bleeding Backache Menstrual discomfort Swollen extremity
Muscular pain Backache Menstrual discomfort
what is cognitive behavioral therapy (CBT)
Therapy to help clients learn to manage and target negative thoughts to help reduce pain, especially chronic pain.
S&S of pain
Vital signs initially showing an elevation in blood pressure, heart rate, and respiration Muscle tension or rigidity Pallor When pain becomes more severe, there is a decrease in blood pressure and heart rate Nausea and vomiting Fainting Withdrawal to pain Grimacing Restlessness Guarding the area of pain
A nurse is reviewing discharge instructions for a client who has a prescription for morphine oral solution 10 to 20 mg every 4 hr PRN. Which of the following statements by the client indicates an understanding of the instructions? "I can use the morphine as needed as long as I don't take it more than six times a day." "I will use my household teaspoon to measure the correct amount of morphine." "I will monitor for high blood pressure while taking the morphine." "I will keep the morphine bottle in a locked cabinet in my kitchen."
"I will keep the morphine bottle in a locked cabinet in my kitchen."
A nurse is discussing transcutaneous electrical nerve stimulation (TENS) treatment with a client who has chronic lower back pain. Which of the following statements should the nurse include? (Select all that apply.) "You can be taught how to use TENS therapy at home." "We will insert very small sterile needles into your skin to block your pain." "This therapy may result in you having some temporary bruising at the site of application." "The TENS therapy delivers low-voltage electrical impulses to the skin over the painful areas." "We will adjust the intensity, pulse rate, and duration of the electrical pulses during your therapy."
"You can be taught how to use TENS therapy at home." "The TENS therapy delivers low-voltage electrical impulses to the skin over the painful areas." "We will adjust the intensity, pulse rate, and duration of the electrical pulses during your therapy."
A nurse is reviewing a new prescription with a client who reports difficulty managing their chronic pain. Which of the following statements should the nurse include? "You should write down the pain interventions you use and your pain rating before and after." "You should understand that it is impossible to fix everyone's pain." "Your provider is best at determining whether your pain treatments are effective." "Your care partner should manage your pain control because you are unable."
"You should write down the pain interventions you use and your pain rating before and after."
A nurse is providing end-of-life care for a client who is unresponsive and near death. The client's family asks the nurse about managing the client's pain. Which of the following statements should the nurse make to the client's family? "Your family member will not require pain medication." "Your family member can inform the provider about their decision for pain management." "Your family member has the right to receive effective pain management." "Your family member will not be able to tolerate the effects of pain medications."
"Your family member has the right to receive effective pain management."
A nurse is caring for a client who is experiencing pain. Which of the following are influencing factors of pain? (Select all that apply.) A Client risk factors B Client trends C Anxiety D Type of pain medication used E Moral considerations F Socioeconomic status
A Client risk factors B Client trends C Anxiety D Type of pain medication used
A nurse is reviewing information for several clients on the unit. The nurse should recognize that which of the following clients is at greatest risk for respiratory depression? A client who has chronic pain and recently started taking paroxetine A client who has cancer and has taken oxycodone PRN for several months A client who has been accidentally taking twice the amount of prednisone as prescribed A client who had surgery 3 hr ago and is receiving IV hydromorphone PRN
A client who had surgery 3 hr ago and is receiving IV hydromorphone PRN
A nurse is evaluating a group of clients who are experiencing pain. Which of the following clients should the nurse identify as experiencing neuropathic pain? A client who has osteoarthritis and reports difficulty ambulating for the past 6 months A client who had surgery to repair a fractured tibia and reports incisional pain A client who has diabetes mellitus and reports bilateral burning foot pain without signs of injury A hospice client who has prostate cancer and reports pelvic pain
A client who has diabetes mellitus and reports bilateral burning foot pain without signs of injury
A nurse is caring for a client who has a prescription for hydromorphone 1 to 2 mg IM every 4 hr as needed for a pain rating of 4 to 6 on a 0 to 10 scale. The client has never taken hydromorphone before. Which of the following actions should the nurse plan to take? Administer 1 mg IM. Request a prescription to give the medication IV instead. Request a prescription for a different medication. Administer 2 mg IM.
Administer 1 mg IM.
A nurse is assessing a client who is reporting pain despite taking analgesia. Which of the following actions should the nurse take to determine the intensity of the client's pain? A Ask the client what precipitates the pain. B Question the client about the location of the pain. C Offer the client a pain scale to measure their pain. D Use open-ended questions to identify the client's pain sensations.
C Offer the client a pain scale to measure their pain.
A nurse is caring for a client prescribed IV morphine via PCA with a demand of 1 mg every 15 min and a 4 mg/hr lockout. The client reports unbearable pain after attempting six demand doses within the last hour. After assessing the client's pain, which of the following actions should the nurse take? Check the IV site and PCA pump for proper functioning. Teach the client proper use of the PCA system. Ask the provider to increase the morphine dose and shorten the interval between doses. Encourage family members to administer a dose of morphine via PCA when the client is in too much pain to do it themselves.
Check the IV site and PCA pump for proper functioning.
A nurse is reviewing the plan of care for several clients who are receiving treatment for pain. Which of the following actions should the nurse plan to take to evaluate the clients' pain control? (Select all that apply.) Consider each client's cultural preferences. Determine the effectiveness of nonpharmacological strategies. Record the clients' subjective reports rather than the nurse's objective observations. Recognize that older adult clients over-report their pain level. Use a pain scale specific to each client's cognitive abilities.
Consider each client's cultural preferences. Determine the effectiveness of nonpharmacological strategies. Use a pain scale specific to each client's cognitive abilities.
A nurse is caring for an older adult client who has a cognitive impairment and is postoperative. Which of the following actions should the nurse take? Use the Crying, Requires Oxygen, Increases Vital Signs, Expression, Sleeplessness (CRIES) pain scale. Reassure family members that older adult clients have a decreased ability to sense pain. Evaluate the client for pain by observing their behavior. Assign a pain scale number based on the FACES pain scale.
Evaluate the client for pain by observing their behavior.
A nurse is caring for a client who is postoperative following abdominal surgery and has a morphine PCA pump. Which of the following medications should the nurse ensure is available in case the client develops respiratory depression? Naloxone Lidocaine Prednisone Amitriptyline
Naloxone
A nurse is caring for a client who was admitted to the emergency department for severe pain following a fall from a ladder. The client reports taking an opioid prescription for chronic pain. Which of the following provider prescriptions for initial pain relief should the nurse question? Morphine sulfate Naloxone Fentanyl Hydromorphone
Naloxone
A nurse is caring for a client who has a prescription for oxycodone 5 to 10 mg PO every 4 to 6 hr as needed for pain rating 7 to 10 on a 0 to 10 scale. Fifteen minutes after receiving the dose, the client reports to the nurse their pain is still a 7 and has not changed. Which of the following actions should the nurse take? Administer another 5-mg dose of the oral opioid now. Administer 10 mg of oxycodone every 2 hr. Inform the provider that the client's pain medication is not effective. Offer to assist the client with nonpharmacological relief strategies.
Offer to assist the client with nonpharmacological relief strategies.
A nurse is caring for two clients who are 2 hr postoperative following the same procedure. Which of the following factors should the nurse expect to be similar for both clients? Perception of the intensity of postoperative pain Prescriptions containing guidelines for pain medication administration Goal of pain management for each client Level of pain indicated by each client on a numeric pain scale
Prescriptions containing guidelines for pain medication administration
A nurse is discussing cutaneous stimulation with a client who has back pain. Which of the following methods should the nurse include? (Select all that apply.) Transcutaneous electronic stimulating unit (TENS unit) Distraction techniques Massage Acupuncture Cold therapy
Transcutaneous electronic stimulating unit (TENS unit) Massage Acupuncture Cold therapy
