CHAPTER 9: Assessing Pain

SOMATIC PAIN

Originates from skin, muscles, bones, and joints. Patients usually describe somatic pain as sharp.

VISCERAL PAIN

abdominal organs; "crampy, gnawing"

NEUROPATHIC PAIN

abnormal processing of pain message; burning, shooting in nature

REFERRED PAIN

pain that is felt in a location other than where the pain originates

Which would the nurse recognize as an example of visceral pain? Select all that apply. A. Liver pain B. Gallbladder pain C. Pancreatic pain D. Burn pain E. Muscular pain

A. Liver pain B. Gallbladder pain C. Pancreatic pain Explanation: Examples of visceral pain include pain associated with the liver, gallbladder, and pancreas. Pain associated with a burn is an example of cutaneous pain. Muscular pain is a type of somatic pain. Reference: Weber, J.R., & Kelley, J.H., Health Assessment in Nursing, 7th ed., Philadelphia, Wolters Kluwer, 2022, Chapter 9: Assessing Pain, Aspects and Manifestations of Pain, p. 140.

The nurse understands the importance of performing an accurate pain assessment. In addition to having the client rate the pain on a pain scale, other things to assess are the following: (Check all that apply.) A. Location and duration B. Quality and description C. Diet and allergies D. Alleviating and aggravating factors E. Urine output and pulse oximetry value

A. Location and duration B. Quality and description D. Alleviating and aggravating factors Explanation: In a pain assessment. the nurse asks the client to use a pain scale to rate the intensity of the pain. Other areas to assess are location and duration, quality and description, and any alleviating or aggravating factors. Although the nurse would want to assess the client's allergies before giving pain medications, diet is not included, nor is urinary output or oxygenation. Reference: Weber, J.R., & Kelley, J.H., Health Assessment in Nursing, 7th ed., Philadelphia, Wolters Kluwer, 2022, Chapter 9: Assessing Pain, CONCEPTUAL FOUNDATIONS, p. 139.

When documenting assessment data, the nurse should avoid which phrases because of their lack of description? Select all that apply. A. "Client looks pale and fatigued." B. "Client presented as well developed." C. "Client is alert with appropriate eye contact." D. "Client is of average height and well nourished." E. "Client appears to be in no apparent physical distress."

B. "Client presented as well developed." D. "Client is of average height and well nourished." E. "Client appears to be in no apparent physical distress." Explanation: Choose vivid and graphic words such as "pale" and "appropriate eye contact." Avoid clichés such as "well developed," "well nourished," or "in no acute distress" because they are nondescript and could apply to any client. Reference: Weber, J.R., & Kelley, J.H., Health Assessment in Nursing, 7th ed., Philadelphia, Wolters Kluwer, 2022, Chapter 9: Assessing Pain, Collecting Subjective Data: The Nursing Health History, p. 144.

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. Analgesics B. Surgery C. Relaxation techniques D. Cutaneous stimulation

Correct response: A. Analgesics Explanation: Analgesics are most often the primary treatment measure for pain, although a growing trend involves the integration of complementary, nonpharmacologic measures with conventional medicine. Reference: Weber, J.R., & Kelley, J.H., Health Assessment in Nursing, 7th ed., Philadelphia, Wolters Kluwer, 2022, Chapter 9: Assessing Pain, Validating and Documenting Findings, p. 155.

The nurse is caring for a 4-week-old postoperative client. The most appropriate pain assessment tool would be the: A. Face, Legs, Activity, Cry, Consolability Scale B. FACES Pain Scale C. Numeric Pain Intensity Scale D. Combined Thermometer Scale

Correct response: A. Face, Legs, Activity, Cry, Consolability Scale Explanation: The Face, Legs, Activity, Cry, Consolability Scale is the appropriate pain assessment tool for a 4-week-old postoperative client. This tool measures pain using observable behaviors as pain indicators. The FACES Pain Scale is appropriate for children age 3 and older, using six faces ranging from happy with a wide smile to sad with tears on the face. The other two scales are appropriate for use with older children and adults. The Numeric Pain Intensity Scale is a one-dimensional pain scale using an 11-poing Likert-type scale ranging from 0 to 10, where 0 means "no pain" and 10 means "worst possible pain." The Combined Thermometer Scale looks like a thermometer and has both numbers that increase from the bottom up and descriptor words to measure pain intensity. Reference: Weber, J.R., & Kelley, J.H., Health Assessment in Nursing, 7th ed., Philadelphia, Wolters Kluwer, 2022, Chapter 9: Assessing Pain, Collecting Objective Data: Physical Examination, p. 154.

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. Cardiac pain D. Arthritic pain

Correct response: A. Gallbladder pain Explanation: Visceral pain originates from abdominal organs, such as the gallbladder. Burns cause cutaneous pain, which is derived from the dermis, epidermis, and subcutaneous tissues. Referred pain originates from a specific site, but is experienced in another site along the innervating spinal nerve, such as occurs with cardiac pain. Somatic pain originates from skin, muscles, bones, and joints, such as arthritic pain. Reference: Weber, J.R., & Kelley, J.H., Health Assessment in Nursing, 7th ed., Philadelphia, Wolters Kluwer, 2022, Chapter 9: Assessing Pain, Aspects and Manifestations of Pain, p. 140.

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. Give the prn morphine B. Hold the medication and wait 30 minutes C. Call the physician to check the order D. Document the client's pain rating on a scale of 0 to 10

Correct response: A. Give the prn morphine Explanation: Pain is what the client says it is, and it exists whenever the client says it does. It would not be appropriate to hold the medication for 30 minutes, call the physician to check the order, or just document the client's pain. Reference: Weber, J.R., & Kelley, J.H., Health Assessment in Nursing, 7th ed., Philadelphia, Wolters Kluwer, 2022, Chapter 9: Assessing Pain, CONCEPTUAL FOUNDATIONS, p. 137.

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. National Institutes of Health Standards for Pain Treatment. C. American Cancer Society Guidelines for Pain Management. D. American Pain Society Guidelines for Pain Management.

Correct response: A. Joint Commission Standards for Pain Management. Explanation: Joint Commission Standards for Pain Management were revised and published in 2000-2001. The standards require health care providers and organizations to improve pain assessment and management for all clients. Reference: Weber, J.R., & Kelley, J.H., Health Assessment in Nursing, 7th ed., Philadelphia, Wolters Kluwer, 2022, Chapter 9: Assessing Pain, CONCEPTUAL FOUNDATIONS, p. 137.

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. Pharmacologic pain relief should be used only as an intervention of last resort. D. A numeric scale should be used to assess pain if the child is older than 5 years of age.

Correct response: A. Pain assessment may require multiple methods in order to ensure accurate pain data. Explanation: It is often necessary to use more than one technique for pain assessment in children. Though their neurological system is indeed developing, children feel pain acutely, and it is inappropriate to withhold analgesics until they are a "last resort." It is simplistic to specify a numeric pain scale for all clients above a certain age; the assessment tool should reflect the client's specific circumstances, abilities, and development. Reference: Weber, J.R., & Kelley, J.H., Health Assessment in Nursing, 7th ed., Philadelphia, Wolters Kluwer, 2022, Chapter 9: Assessing Pain, Collecting Subjective Data: The Nursing Health History, p. 146.

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. Visceral pain B. Referred pain C. Cutaneous pain D. Somatic pain

Correct response: A. Visceral pain Explanation: Visceral pain occurs when organs stretch abnormally and become distended, ischemic, or inflamed. Appendicitis is characterized by inflammation of the vermiform appendix. Cutaneous pain is superficial and somatic pain is more commonly associated with tendons, ligaments, and bones. Referred pain is perceived distant from its point of origin, but this client's pain is sensed near the location of his appendix. Reference: Weber, J.R., & Kelley, J.H., Health Assessment in Nursing, 7th ed., Philadelphia, Wolters Kluwer, 2022, Chapter 9: Assessing Pain, Aspects and Manifestations of Pain, p. 140.

A popular pain assessment scale for children is: A. Visual Analog Scale. B. Descriptive Pain Intensity Scale. C. FLACC Pain Assessment Scale. D. Memorial Pain Assessment Card.

Correct response: A. Visual Analog Scale. Explanation: The visual analog scale is appropriate to assess pain in children. Reference: Weber, J.R., & Kelley, J.H., Health Assessment in Nursing, 7th ed., Philadelphia, Wolters Kluwer, 2022, Chapter 9: Assessing Pain, Psychosocial Factors Affecting Pain Perception and Assessment, p. 142.

A client presents to the health care clinic with reports of a 2-day history of sore throat, ear pressure, fever, and stiff neck. The client states she has taken Tylenol and lozenges without relief. Which nursing diagnosis can be confirmed by this data? A. Anxiety related to prolonged pain B. Impaired physical mobility related stiff neck C. Risk for deficient fluid volume related to fever D. Acute pain related to sore throat

Correct response: Acute pain related to sore throat Explanation: The client describes pain of 2 days' duration, which is within the definition for acute pain. The client did not describe or display any major defining characteristics of anxiety such as restlessness, concern about lifestyle changes, or sleep disturbances. The stiff neck was not confirmed by objective data collected by the nurse. No evidence exists for the client to have risk for deficient fluid volume. Reference: Weber, J.R., & Kelley, J.H., Health Assessment in Nursing, 7th ed., Philadelphia, Wolters Kluwer, 2022, Chapter 9: Assessing Pain, Aspects and Manifestations of Pain, p. 141.

A nurse is interviewing a 65-year-old client with a history of atrial fibrillation, type 2 diabetes, obesity, and congestive heart failure. The nurse determines the client is experiencing chronic neuropathic pain when the client makes which of the following statements? A. "My shoulder has been hurting off and on for the year." B. "The burning sensation in my feet has gotten worse over the past year." C. "I have had this aching pain in the right side of my stomach for a few months now." D. "I have been so depressed since my husband died that I ache all over."

Correct response: B. "The burning sensation in my feet has gotten worse over the past year." Explanation: Neuropathic pain results from damage or dysfunction of any level of the nervous system, including peripheral nerves. This client has a long history of type 2 diabetes, which can cause peripheral neuropathy (burning, tingling sensation). The client has been experiencing the pain for longer than a year. Constant pain lasting more than 6 months is classified as chronic. Shoulder pain that comes and goes would be classified as nociceptic pain. Pain in the abdomen that has been ongoing for a few months would be acute visceral pain. The client statement about being depressed and aching all over indicates psychogenic pain, which occurs when psychological pain becomes physical. Reference: Weber, J.R., & Kelley, J.H., Health Assessment in Nursing, 7th ed., Philadelphia, Wolters Kluwer, 2022, Chapter 9: Assessing Pain, TABLE 9-1 Classifications of Pain, p. 140.

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. Visceral B. Neuropathic C. Somatic D. Referred

Correct response: B. Neuropathic Explanation: Visceral pain originates from abdominal organs and is often described as crampy or gnawing. Somatic pain originates from the skin, muscles, bones, and joints. Referred pain originates from a specific site, but the client experiencing the pain feels it at another site along the innervating spinal nerve. Neuropathic pain is described as burning, painful numbness, or tingling. Reference: Weber, J.R., & Kelley, J.H., Health Assessment in Nursing, 7th ed., Philadelphia, Wolters Kluwer, 2022, Chapter 9: Assessing Pain, Aspects and Manifestations of Pain, p. 140.

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. Referred pain C. Cutaneous pain D. Somatic pain

Correct response: B. Referred pain Explanation: Referred pain originates from a specific site, but the person feels the pain at another site along the innervated spinal nerve. An example is cardiac pain that the person experiences as arm pain and indigestion. Visceral pain originates from abdominal organs. Cutaneous pain derives from the dermis, epidermis, and subcutaneous tissues. Somatic pain originates from skin, muscles, bones, and joints. Reference: Weber, J.R., & Kelley, J.H., Health Assessment in Nursing, 7th ed., Philadelphia, Wolters Kluwer, 2022, Chapter 9: Assessing Pain, Aspects and Manifestations of Pain, pp. 139-140.

A client who suffers from arthritis complains of sharp pain in her knees and elbows. The nurse recognizes this is what ty.pe of pain? A. Visceral B. Somatic C. Cutaneous D. Referred

Correct response: B. Somatic Explanation: Pain nociception has various locations. Visceral pain originates from abdominal organs; clients often describe this pain as crampy or gnawing. Somatic pain originates from skin, muscles, bones, and joints; clients usually describe somatic pain as sharp (D'Arcy, 2014). Cutaneous pain derives from the dermis, epidermis, and subcutaneous tissues. It is often burning or sharp, such as with a partial-thickness burn. Referred pain originates from a specific site, but the person experiencing it feels the pain at another site along the innervating spinal nerve. Reference: Weber, J.R., & Kelley, J.H., Health Assessment in Nursing, 7th ed., Philadelphia, Wolters Kluwer, 2022, Chapter 9: Assessing Pain, Aspects and Manifestations of Pain, p. 140.

A nurse enters a client's room to conduct an assessment. The client is crying and states they have so much pain. What is the best response of the nurse? A. "When did it start?" B. "I am sorry to hear that." C. "Could you tell me more about your pain?" D. "Do you want some pain medication?"

Correct response: C. "Could you tell me more about your pain?" Explanation: The nurse will elicit more information about the pain with an open-ended question. Asking when the pain started will not provide enough information. The nurse telling the client that they are sorry to hear about the pain will not elicit information about the pain. The nurse needs to perform a full pain assessment prior to administering pain medications. Reference: Weber, J.R., & Kelley, J.H., Health Assessment in Nursing, 7th ed., Philadelphia, Wolters Kluwer, 2022, Chapter 9: Assessing Pain, ASSESSMENT TOOL 9-10 Clinically Aligned Pain Assessment (CAPA©), p. 150.

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. neuronal plasticity B. L-beta fibers C. A-delta and C fibers D. K-fibers

Correct response: C. A-delta and C fibers Explanation: The nurse is experiencing nociceptive or somatic pain. A-delta fibers are large nerve fibers covered with myelin that conduct pain impulses rapidly. The sharp or stabbing pain the nurse feels as the finger is pinched involves these fibers. C fibers are smaller, unmyelinated nerve fibers that conduct pain impulses more diffusely and slowly. The achy pain that lingers after the nurse has withdrawn the finger—that the nurse might "shake off"—involves these fibers. Neuronal plasticity refers to changes in pain signal processing due to a prolonged stimulus; the result is chronic sensation of pain after the original stimulus is removed. There are no "K-fibers" or "L-beta fibers." Reference: Weber, J.R., & Kelley, J.H., Health Assessment in Nursing, 7th ed., Philadelphia, Wolters Kluwer, 2022, Chapter 9: Assessing Pain, CONCEPTUAL FOUNDATIONS, p. 138.

A middle aged female client presents to the emergency department complaining of indigestion and left arm pain. What is the nurse's best action? A. Alert the healthcare provider to the client's somatic pain complaints. B. Administer an antacid and apply a topical anesthetic for the arm pain. C. Check the client's vital signs and connect her to a cardiac monitor. D. Request a strong narcotic analgesic for the client's visceral pain complaints.

Correct response: C. Check the client's vital signs and connect her to a cardiac monitor. Explanation: Pain nociception has various locations. Visceral pain originates from abdominal organs; clients often describe this pain as crampy or gnawing. Somatic pain originates from skin, muscles, bones, and joints; clients usually describe somatic pain as sharp (D'Arcy, 2014). Cutaneous pain derives from the dermis, epidermis, and subcutaneous tissues. It is often burning or sharp, such as with a partial-thickness burn. Referred pain originates from a specific site, but the person experiencing it feels the pain at another site along the innervating spinal nerve. An example is cardiac pain that a person experiences as indigestion, neck pain, or arm pain. Phantom pain is pain in an extremity or body part that is no longer there (e.g., a client who experiences pain in a leg with an amputation). The client is presenting with atypical chest pain and should be assessed for pain of a cardiac origin. Reference: Weber, J.R., & Kelley, J.H., Health Assessment in Nursing, 7th ed., Philadelphia, Wolters Kluwer, 2022, Chapter 9: Assessing Pain, Pathophysiology, p. 138.

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. Psychogenic B. Idiopathic C. Neuropathic D. Somatic

Correct response: D. Somatic Explanation: Somatic pain is caused by tissue damage, which would occur after abdominal surgery. Psychogenic pain relates to factors that influence the client's report of pain such as anxiety and depression. Idiopathic pain does not have an identified cause. Neuropathic pain results from direct injury to the peripheral or central nervous system. Reference: Weber, J.R., & Kelley, J.H., Health Assessment in Nursing, 7th ed., Philadelphia, Wolters Kluwer, 2022, Chapter 9: Assessing Pain, Aspects and Manifestations of Pain, p. 140.

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. Verbal Descriptor Scale B. Numeric Rating Scale C. Faces Pain Scale D. Visual Analog Scale

Correct response: C. Faces Pain Scale Explanation: The nurse should use the Faces Pain Scale (FPS) to rate the pain felt by the client. The FPS shows different facial expressions; the client is asked to choose the face that best describes the intensity or level of pain being experienced. This tool is best suited for cognitively impaired adults. A Verbal Descriptor Scale (VDS) ranges pain on a scale between mild, moderate, and severe. The Numeric Rating Scale (NRS) rates pain on a scale from 0 to 10: 0 reflects no pain and 10 reflects pain at its worst. It has been shown to be best for older adults with no cognitive impairment. The Visual Analog Scale (VAS) rates pain on a 10-cm continuum numbered from 0 to 10: 0 reflects no pain and 10 reflects pain at its worst. These scales would require verbal communication between the client and the nurse. Reference: Weber, J.R., & Kelley, J.H., Health Assessment in Nursing, 7th ed., Philadelphia, Wolters Kluwer, 2022, Chapter 9: Assessing Pain, HEALTH ASSESSMENT, pp. 144-145.

When assessing the client for pain, the nurse should: A. doubt the client when he or she describes the pain. B. assess for underlying causes of pain, then believe the client. 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.

Correct response: C. believe the client when he or she claims to be in pain. Explanation: "Pain is whatever the person says it is." It is important to remember this definition when assessing and treating pain. Reference: Weber, J.R., & Kelley, J.H., Health Assessment in Nursing, 7th ed., Philadelphia, Wolters Kluwer, 2022, Chapter 9: Assessing Pain, Collecting Subjective Data: The Nursing Health History, p. 144.

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."

Correct response: D. "There's a very minimal risk of addiction, and controlling his pain is our first concern." Explanation: Concerns about addiction are normally unfounded. Nonetheless, it is inaccurate to characterize the possibility of addiction as a myth, on one hand, or a very real risk, on the other. Tolerance would not necessitate discontinuation. Reference: Weber, J.R., & Kelley, J.H., Health Assessment in Nursing, 7th ed., Philadelphia, Wolters Kluwer, 2022, Chapter 9: Assessing Pain, CONCEPTUAL FOUNDATIONS, p. 137.

A nurse reviews the vital signs of a new client: temperature 99.3° F (37.38° C), pulse 105 beats/min, blood pressure 143/83 mm Hg, and respiratory rate 22 breaths/min. What action should the nurse take first? A. Ask the client if they have a history of high blood pressure. B. Notify the health care provider of the abnormal vital signs. C. Ask the client to rest quietly and then retake the vital signs. D. Ask the client if they are experiencing any discomfort.

Correct response: D. Ask the client if they are experiencing any discomfort. Explanation: The nurse should first ask the client if they are experiencing pain. If a client is in acute pain, their respiratory rate, heart rate, and blood pressure may increase as seen in these findings. The client also has a low-grade fever. Asking the client if they have a history of high blood pressure is not the best answer because there are other abnormal values; such questioning will not assist in understanding the underlying problem causing the abnormal vital signs. Asking the client to rest quietly and then retaking the vital signs is not the best first action. However, if the client denies pain, the nurse may want to ask about activity prior to having the vital signs taken. The nurse does not have enough information to notify the health care provider yet. Reference: Weber, J.R., & Kelley, J.H., Health Assessment in Nursing, 7th ed., Philadelphia, Wolters Kluwer, 2022, Chapter 9: Assessing Pain, Collecting Subjective Data: The Nursing Health History, p. 151.

A client complains of pain in several areas of the body. How should the nurse assess this client's pain? A. Ask the client to rate the area with the highest pain level. B. Mark each site on the client's body with a marker. C. If pain does not radiate, there is no need to rate that area. D. Have the client rate each location separately.

Correct response: D. Have the client rate each location separately. Explanation: When assessing pain location, ask the client to point to the painful area. If more than one area is painful, have the client rate each one separately, and note which area is the most painful. Marking each site is not necessary practice for assessing pain. Pain is a subjective sensation for the client. Radiating pain is notable, because such radiation may affect treatment choices. Reference: Weber, J.R., & Kelley, J.H., Health Assessment in Nursing, 7th ed., Philadelphia, Wolters Kluwer, 2022, Chapter 9: Assessing Pain, Aspects and Manifestations of Pain, pp. 139-141.

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. Somatic C. Idiopathic D. Neuropathic

Correct response: D. Neuropathic Explanation: Neuropathic pain can occur from central nervous system brain injury caused by a stroke. Nociceptive pain is caused by tissue damage. Somatic pain is another term used for nociceptive pain. Idiopathic pain does not have an identified cause. Reference: Weber, J.R., & Kelley, J.H., Health Assessment in Nursing, 7th ed., Philadelphia, Wolters Kluwer, 2022, Chapter 9: Assessing Pain, Aspects and Manifestations of Pain, pp. 140--141.

A client with an amputated arm tells a nurse that sometimes he experiences throbbing pain or a burning sensation in the amputated arm. What kind of pain is the client experiencing? A. Cutaneous pain B. Visceral pain C. Chronic pain D. Neuropathic pain

Correct response: D. Neuropathic pain Explanation: The client is experiencing neuropathic pain or functional pain. Neuropathic pain is often experienced days, weeks, or even months after the source of the pain has been treated and resolved. The client is not experiencing cutaneous, visceral, or chronic pain. In cutaneous pain, the discomfort originates at the skin level. In visceral pain, the discomfort arises from internal organs caused from a disease or injury. In chronic pain the discomfort lasts longer than 6 months. Reference: Weber, J.R., & Kelley, J.H., Health Assessment in Nursing, 7th ed., Philadelphia, Wolters Kluwer, 2022, Chapter 9: Assessing Pain, Aspects and Manifestations of Pain, p. 140.

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. somatic B. referred C. visceral D. neuropathic

Correct response: D. neuropathic Explanation: Pain resulting from direct injury to the peripheral or central nervous system is termed neuropathic. Over time, neuropathic pain may become independent of the inciting injury and be described as burning. Somatic pain originates from skin, muscles, bones, and joints and is usually described as sharp. Referred pain is pain felt in a body area, away from the pain source. Visceral pain originates from abdominal organs and is usually described as cramping or gnawing. Reference: Weber, J.R., & Kelley, J.H., Health Assessment in Nursing, 7th ed., Philadelphia, Wolters Kluwer, 2022, Chapter 9: Assessing Pain, Aspects and Manifestations of Pain, p. 140.