Chapter 9: Assessing Pain
A client is reporting pain and rates it as 7 on a scale of 1 to 10. When the nurse asks him to describe the pain, he states, "It feels like a knife is stabbing or cutting me." The nurse knows that this type of pain is conducted by which fibers?
A-delta fibers
A client recovering from a stroke complains of pain. The nurse suspects this client is most likely experiencing which type of pain?
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:
Neuropathic
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?
Somatic
A client who is cringing says that the pain is the worse that it has ever been. If using the numeric pain intensity scale, which number is the client describing?
10
How may a nurse demonstrate cultural competence when responding to clients in pain?
Avoid stereotyping responses to pain by clients.
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?
"Could you tell me more about your pain?"
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?
"The burning sensation in my feet has gotten worse over the past year."
Which would the nurse recognize as an example of visceral pain? Select all that apply.
-Liver pain -Gallbladder pain -Pancreatic pain
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.)
-Location and duration -Quality and description -Alleviating and aggravating factors
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-delta and C fibers
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?
Analgesics
A middle aged female client presents to the emergency department complaining of indigestion and left arm pain. What is the nurse's best action?
Check the client's vital signs and connect her to a cardiac monitor.
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?
Consult with the healthcare provider about increasing the dose of medication.
The nurse is working on a pediatric unit caring for a 4-year-old who is recovering from the surgical repair of the pelvis. When assessing the client's pain, what is the most appropriate pain assessment tool for the nurse to use?
FACES Pain Scale
The nurse is working in the post anesthesia care unit and assessing pain in a 6 month old infant. Which method should the nurse use to assess the infant's pain?
FLACC scale.
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?
Give the prn morphine
A client complains of pain in several areas of the body. How should the nurse assess this client's pain?
Have the client rate each location separately.
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?
How does the pain influence your overall mood?
Which of the following principles should the nurse integrate into the pain assessment and pain management of pediatric clients?
Pain assessment may require multiple methods in order to ensure accurate pain data.
A nurse is caring for an elderly client who is unable to walk without a support due to knee pain. During his initial assessment, however, the client does not mention pain. Which of the following beliefs common in elderly clients may cause them to underreport their pain?
Pain is a normal part of aging
What is the main issue that a nurse should consider when choosing a pain assessment tool to collect objective data?
Produce accurate results each time it is used
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?
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?
Referred pain
A client recovering from abdominal surgery is complaining of pain. The nurse realizes that the client is most likely experiencing which type of pain?
Somatic
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?
Somatic 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?
Visceral pain
Which of the following statements most accurately conveys an aspect of the gate-control theory?
Specialized cells can decrease pain transmission by exciting inhibitory neurons.
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?
The release of endorphins
A nurse is collecting subjective data from a client who is reporting pain. Which of the following actions should the nurse take to determine the severity of the pain?
Use a pain scale to measure the pain.
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?
neuropathic
A nurse is interviewing a client with a long history of a tumor who is receiving chemotherapy and radiation treatment. The nurse expects which of the following findings?
reduction in pain
