Class 8 Test bank 345

Each of the following is a pharmacologic intervention for pain except which one? a. Acupuncture treatments b. Adjuvant therapy c. Lidocaine patch d. Capsaicin

ANS: A Acupuncture is a nonpharmacologic treatment that helps reduce the perception of pain. An adjuvant is a medication that has been developed for a different purpose but serves to alter the perception of pain, possibly in combination with a pain medication. Lidocaine patches are a pharmacologic treatment for pain relief. Capsaicin is a pharmacologic means of providing comfort and alleviating pain and distress.

Which of the following pain sensations are associated with neuropathic pain? (Select all that apply.) a. Infection b. Obstruction c. Inflammation d. Postamputation

ANS: D Neuropathic involves a pathophysiological process of peripheral or central nervous system. Infection, obstruction, and inflammation are considered nociceptive pain sensations that are associated with injury to skin, mucosa, muscle, or bone.

Which pharmacokinetic parameter is affected most by decreased intestinal motility related to the aging process? a. Absorption b. Distribution c. Metabolism d. Excretion

ANS: A Decreased intestinal motility increases the amount of time a substance remains in contact with the intestinal mucosa of the small intestine, where most absorption takes place. With increased exposure, absorption can be increased and the drug effect enhanced. Many medications taken by older adults can also decrease intestinal motility, thereby complicating the titration of medications or introducing new adverse effects through drug-to-drug interactions. Decreased body water leads to higher serum concentrations of water-soluble drugs, increased body fat increases the longevity of fat-soluble drugs, and decreased serum albumin increases the serum concentration of serum protein-bound drugs. Reduced liver mass and hepatic dysfunction can impair oxidative metabolism, which can lead to an accumulation of toxic levels of a drug. Impaired renal function can impair the excretion of drugs through the kidneys.

Which process is increased in the early morning? a. Fibrinolytic activity b. Blood plasma c. Asthma symptoms d. Rheumatoid arthritis pain

ANS: A Fibrinolytic activity is increased in the early morning. Blood plasma volume falls at night, thus hematocrit increases. Asthma symptoms peak at approximately 4 to 5 AM. Pain from rheumatoid arthritis is most severe in the late afternoon.

Through which pathways are drugs and their metabolites eliminated? (Select all that apply.) a. Sweat b. Saliva c. Kidneys d. Spleen

ANS: A, B, C Drugs and their metabolites are excreted in sweat, saliva, and other secretions but primarily through the kidneys. Metabolites are not eliminated through the spleen.

An older aphasic client has severe osteoarthritis, bilateral contractures of the lower extremities, and a stage IV pressure ulcer. The nurse practitioner prescribes analgesic medications to be administered around the clock, with as-needed doses to be administered as appropriate. What observation by the nurse would indicate that the pain regimen is effective? (Select all that apply.) a. The client slept throughout the night. b. The client winces only when turned and repositioned. c. The client slept during dressing change. d. The client cooperative during morning care. e. The client ate 80% of breakfast, 70% of lunch, and 100% of dinner.

ANS: A, C, D, E Pain cues presented by this client is the wincing when being turned, indicating that this intervention is pain producing. The remaining observations are concurrent with effective pain management.

Which of the following statements are true about pain in older adults? (Select all that apply.) a. Pain is not a normal aging process. b. Pain sensitivity decreases with age. c. If patients do not complain, they do not have pain. d. Opioid analgesics are often the best treatment for persistent pain.

ANS: A, D Pain is not a normal aging process. Something pathological is usually causing the pain. Pain sensitivity does not decrease with age. Some patients have a variety of reactions to pain; many are stoic and refuse to give in to their pain. Opioid analgesics are beneficial for moderate to severe persistent pain.

An older patient who has a history of atrial fibrillation, myocardial infarction, and hypertension is taking warfarin, aspirin, and a beta blocker is purchasing lunch in the cafeteria after his outpatient appointment. Which of the following meals is most appropriate for this patient? a. Tuna salad on a bed of spinach and a glass of a cup of decaffeinated coffee b. Tuna salad sandwich on whole wheat bread and a cup of decaffeinated coffee c. Tuna and kale salad with a whole wheat roll and a cup of decaffeinated coffee d. Large romaine lettuce salad with broccoli, carrots, tomatoes, and grilled chicken and a cup of decaffeinated coffee

ANS: B Leafy green vegetables decrease the anticoagulant effects of warfarin. A tuna salad sandwich on whole wheat bread and a cup of decaffeinated coffee does not include leafy green vegetables.

Which of the following statements is true about analgesic medications for older adults? a. Opioids are less effective in older patients than in younger patients. b. Stool softeners and laxatives should be used with opioids. c. Over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs) are generally harmless. d. The dose limit for acetaminophen is difficult to reach for older adults.

ANS: B Opioids often cause constipation and necessitate bowel stimulation to prevent constipation. A bowel regimen should be instituted at the same time as opioid treatment. Because of changes in metabolism with aging, opioids have a greater and longer lasting analgesic effect in older patients. NSAIDs can cause gastrointestinal bleeding, kidney and liver damage, and drug interactions with potentially fatal results. The maximum daily dose of acetaminophen is 4000 mg, and the limit is lower for patients with kidney or liver failure and patients who use alcohol. A typical dose is two 500-mg ("extra-strength") tablets.

The nurse uses comfort measures to enhance an older adult's pharmacologic pain management. Which of the following would be most helpful for the nurse to use to identify the relationships between the comfort measures, activity, and pharmacotherapy, and the older adult's pain level? a. Older adult's self-report b. Older adult's pain diary c. Faces Pain Scale-revised (FPS-R) d. Pain medication frequency

ANS: B The nurse instructs the older adult to maintain a pain diary to help the individual achieve some control over the pain experience. The diary is then used to identify trends or the timing of pain and the relationships between the patient's pain level and the comfort measures, activity, and pain medications. Many older adults report feeling useful and having some control over the pain, or at least the pain management program, through maintaining a pain diary. Self-reporting is one parameter used to evaluate pain, but drawing a relationship between the pain level and other factors is still necessary. The FPS-R is a reliable pain assessment tool, but the task remains to link the pain rating to other factors. The frequency of medication administration provides a clue about the patient's pain level.

An older adult admitted for back surgery asks for opioid pain medication. The nurse knows the patient asks for pain medication 15 minutes before it is due. Which recommendation should the nurse implement? a. Validate the pain with other assessment data. b. Administer the pain medication as requested by the patient. c. Tell the patient that it is too soon for pain medication. d. Teach the patient alternative comfort measures.

ANS: B The nurse should administer the opioid pain medication as requested because the patient is asking for the pain medication within the prescription's time limit. Most institutions allow the nurse to administer opioid medications 15 to 30 minutes before the designated time on the prescription; therefore, the patient is not asking for the medication too early. In addition, the nurse has an obligation to the patient to administer the pain medication; not doing so violates the patient's rights. The nurse can rely on the patient's report to determine the need for pain medication. As long as the timing is suitable and the patient is stable, the nurse should administer the medication. The nurse should use assessment data to support withholding pain medication in the presence of oversedation or another assessment that would be potentially aggravated by administering the pain medication. The nurse violates the patient's rights by stating that it is too soon for the medication and ignores the possibility that the patient's pain is real. Although the nurse may believe the patient is not having pain and is exhibiting drug-seeking behavior, the nurse must administer the medication. The nurse must administer the pain medication as requested. When patients are experiencing pain, most often, it is not the optimal time to teach patients. However, when the patient's pain is under control, the nurse should teach alternative comfort measures. Comfort measures can be used to enhance the therapeutic effect of the medication and breakthrough pain.

A nurse is caring for an older adult with cognitive impairment who recently had hip surgery. The nurse assesses the client for pain. The nurse would suspect that the client is in pain when the client demonstrates which of the following? (Select all that apply.) a. The client ate all of her meals. b. The client pushes caregivers away when they attempt to change the dressing on her hip. c. The client rocks back and forth repetitively when sitting in a chair. d. The client sleeps soundly throughout the night. e. The client cries out repeatedly when anyone approaches her.

ANS: B, C, E Pain cues in people with communication difficulties involve changes in behavior including restlessness, resistance to care, repetitive movements, and vocalizations. Other cues including sleeplessness and a decreased appetite.

An older patient who is receiving haloperidol (Haldol) is noted to have a change in mental status (increasing confusion). Upon assessment, the nurse notes that the patient has a fever, with temperature,102°F; blood pressure, 92/60 mm Hg; heart rate, 118 beats/min; and respirations, 24 breaths/min. The patient is noted to have rigidity of the upper and lower extremities. The first action of the nurse is to a. administer acetaminophen (Tylenol) for the elevated temperature. b. place the patient on fall precautions because of the rigidity of the lower extremities. c. contact the medical provider immediately. d. force fluids to treat the low blood pressure.

ANS: C A rare but potentially life-threatening adverse drug reaction to antipsychotics is neuroleptic malignant syndrome (NMS). The most typical symptoms are fever greater than 100.4°F, muscle rigidity, autonomic instability (e.g., labile BP, tachycardia), and altered mental status. The onset is rapid, and unless the patient is treated appropriately, death can occur quickly. The drug most associated with NMS is haloperidol (Haldol), but NMS has also been seen when a person is taking chlorpromazine (Compazine) and promethazine (Phenergan). It occurs most often in the first 2 weeks of the start of treatment but must also be considered whenever a dose is increased. The medical provider must be contacted immediately because this is a medical emergency.

A nurse is caring for an older adult in a nursing home. During medication reconciliation, the nurse notes that the patient is prescribed two medications that are listed on the Beers criteria. What is the best action by the nurse? a. Refuse to administer the medications. b. Substitute an alternate medication of the same drug classification. c. Contact the prescriber and to inform the prescriber that the medications are on the list. d. Inform the resident.

ANS: C The Beers criteria includes lists of medications that have been demonstrated to cause harm; those specific drug-drug interactions known to cause harm, medications that should only be used with caution, and those that require dosage adjustments in the presence of altered kidney function. The best action by the nurse is to contact the prescriber and notify him or her of the fact that the medications are on the Beers list. The nurse cannot substitute a medication without a prescriber's order, nor should the nurse refuse to administer the medications. Informing the resident is important, but most important is resolving the issue with the prescriber.

When educating a client on the use of an adjuvant medication, which statement best demonstrates the nurse's understanding of this therapy? a. "These medications are used instead of opioids to decrease the likelihood of addiction." b. "Adjuvant medications are prescribed because they seldom cause any significant side effects." c. "These types of medications are used to eliminate the side effects of opioid medications." d. "These drugs are used in combination with analgesics to increase the effect of the analgesics."

ANS: D Adjuvant medications are not analgesics but are thought to alter the perception of pain and are used with analgesics to potentiate the effect of the analgesics. Adjuvant medications are used with opioids and may have long half-lives in older adults. The nurse must monitor the patient for adverse effects. Adjuvant medications do not eliminate the side effects of opioids.

The nurse administers an opioid analgesic to an older male postoperative patient in the surgical unit. Which is the most important intervention for the nurse to implement before leaving the patient's room? a. Place all side rails up. b. Position the patient comfortably. c. Offer toileting and a sip of water. d. Instruct him to ask for help before getting up.

ANS: D The most important intervention for fall and injury prevention is for the nurse to instruct the older adult to ask for help before getting up after receiving an opioid medication. This intervention is important because the medication can cause sedation and dizziness; therefore, the nurse instructs him to ask for help to prevent a fall or injury. Putting all side rails up is considered a restraint and may place the patient at risk for injury. Comfortable positioning is also a good supplemental intervention after administering pain medication. Offering toileting and hydration is a reasonable intervention to implement after administering pain medication, but it does not offer the same degree of safety as instructing the patient to call for help.

When completing medication reconciliation for an older woman, the nurse notes that the patient is being discharged home on anticoagulant therapy. The nurse also notes that at admission, the patient reported that she uses herbal supplements at home. Which instruction should the nurse include during discharge teaching? a. "You may need to supplement with only ginkgo while on anticoagulant therapy." b. "You may need to increase the use of garlic supplements while on anticoagulant therapy." c. "Avoid using Hawthorn supplements while taking an anticoagulant medication." d. "Avoid using chamomile supplements while on anticoagulant therapy."

ANS: D The nurse's priority is to stop this older adult's intake of chamomile supplements at home; they will increase the effectiveness of anticoagulation. The nurse instructs this individual to avoid chamomile while she is taking an anticoagulant because the woman's blood will be much less able to clot, exposing her to a very high risk of a catastrophic injury in the event of a fall or trauma. The patient does not need to supplement with only ginkgo; the patient should cease taking ginkgo while on anticoagulant therapy, as well as the use of garlic supplements. Both increase the effectiveness of anticoagulation. The use of Hawthorn supplements has not been shown to affect the use of anticoagulant medications.

The nurse admits an older man who had abdominal surgery. Admission vital signs are heart rate (pulse) (P), 73 beats/min; respiration rate (R), 20 breaths/min; and blood pressure (BP), 136/84 mm Hg. He is receiving intravenous (IV) fluids but has not requested pain medication since surgery. Seven hours later, his vital signs are P, 98 beats/min; R, 26 breaths/min; and BP, 164/90 mm Hg, and he denies pain. Which intervention should the nurse implement? a. Administer an opioid medication by IV route. b. Check the surgical dressing for bleeding. c. Report the vital signs to the health care provider. d. Ask if he has about discomfort at the surgical site or any other location.

ANS: D The patient's P, R, and BP increased significantly since his admitting vital signs and indicate the potential for pain or discomfort from the surgical incision. This patient may also be experiencing pain unrelated to the surgery because of arthritic changes, neuropathies, and so on. The patient can be misunderstanding the nurse's question or be barred from saying "yes" by cultural patterns. Such miscommunication is common; therefore, the nurse rewords the question using another term for pain such as discomfort, burning, or pressure. Administering an opioid medication by IV route is unethical without the patient's request. When checking the surgical dressing for bleeding, the patient may show signs of pain rather than blood loss. Reporting the vital signs to the health care provider would be premature; the patient's pain assessment is not complete.

An older woman had hip replacement surgery 1 day ago, and the nurse thinks that the woman also has dementia. Which patient assessment does the nurse use to determine whether this woman is experiencing pain? a. Holds her abdomen tightly b. Has stable vital signs c. Is not verbalizing d. Moves during sleep

ANS: A Because this older adult has a potential cognitive impairment and is likely to self-report pain unreliably, the nurse uses additional clinical indicators to detect pain. Muscle rigidity and guarding are clinical indicators of pain for a postoperative older adult, regardless of a cognitive impairment. An individual experiencing pain is unlikely to have stable vital signs. Not verbalizing can indicate a sensory impairment and warrants further investigation by the nurse. Nonetheless, this older adult's verbalizations are potentially unreliable indicators of pain. Older adults move normally during sleep to adjust their position in bed; moving during sleep is not an indicator of pain unless the movements are agitated or restless in nature.

A nurse is administering medications to an older patient who has renal insufficiency. The nurse understands which of the following? (Select all that apply.) a. Certain drugs may need to be avoided in this patient. b. Certain drug dosages may need to be adjusted based on this patient's creatinine clearance. c. Larger doses of most drugs frequently need to be administered in this patient. d. This patient should never be administered acetaminophen (Tylenol). e. Drug effects would in general be diminished in this patient.

ANS: A, B Drugs that are metabolized in the kidneys may need to be avoided or dosages adjusted based on the patient's creatinine clearance. Dosages of drugs usually are decreased in patients with renal insufficiency. Because of renal insufficiency, drug effects would be increased, not decreased. In general, Tylenol is not avoided in older patients; it is just limited to a maximum of 4 g/day. Tylenol is of greatest concern in patients with hepatic issues.

Common causes of polypharmacy in older patients include which of the following? (Select all that apply.) a. Use of multiple different health care providers b. Presence of multiple chronic conditions c. Use of multiple pharmacies to obtain medications d. High cost of medications e. Lack of adequate education on medications

ANS: A, B, C, E Polypharmacy is a common problem in older adults. Contributing factors include multiple chronic conditions, multiple health care providers, use of multiple pharmacies, and inadequate education on medications provided to the patient.

Which herbal supplements when taken with an anticoagulant increase the effectiveness of the medication and should be avoided during anticoagulant therapy? (Select all that apply.) a. Chamomile b. Garlic c. Ginkgo d. Hawthorn e. Ginseng f. Green tea

ANS: A, B, C, E, F The intake of chamomile, garlic, ginkgo, ginseng, and green tea supplements at home should be avoided because each increases the effectiveness of anticoagulation. Individuals should avoid these herbal supplements while taking an anticoagulant because the patient's blood will be significantly less able to clot, exposing them to the risk of a catastrophic injury in the event of a fall or trauma. The use of Hawthorn supplements has not been shown to affect the use of anticoagulants.

Common symptoms of digoxin toxicity include which of the following? (Select all that apply.) a. Ataxia b. Blurred vision c. Confusion d. Halo vision e. Orthostatic hypotension

ANS: B, C, D Common symptoms of digoxin toxicity include confusion, headache, anorexia, vomiting, arrhythmias, blurred vision or visual changes (halos, frost on objects, color blindness), and paresthesias.

A nurse is reviewing an older resident's medication list in a long-term care facility. The nurse notices that two of the medications are on the Beers criteria. The nurse understands that the Beers criteria (Select all that apply.) a. include medications that are not permitted to be administered in long-term care facilities. b. include medications that should be used in caution in older adults. c. include specific drug-drug interactions that are known to cause harm in older adults. d. include medications that need to be dose adjusted in older adults with impaired kidney function. e. include medications that are not reimbursed by Medicare and Medicaid.

ANS: B, C, D The Beers criteria include lists of medications that have been demonstrated to cause harm, specific drug-drug interactions known to cause harm, medications that should only be used with caution, and those that require dosage adjustments in the presence of altered kidney function.

Common side effects of the selective serotonin reuptake inhibitors (SSRIs) include (Select all that apply.) a. decreased appetite. b. dry mouth. c. nausea. d. sexual dysfunction. e. dizziness.

ANS: B, C, D, E The SSRIs (e.g., Zoloft, Prozac, Lexapro, Celexa) and serotonin-norepinephrine reuptake inhibitors (e.g.,Effexor) have been found to be highly effective, with minimal or manageable side effects, and are the drugs of choice for use in older adults. Most of these cause initial problems with nausea or a dry mouth. Although effective, these drugs must be used with caution especially related to serum sodium levels. The SSRIs should also be used with caution in persons with a history of falls because of the potential to produce ataxia or dizziness. One side effect of the SSRIs that does not resolve with time, if experienced, is sexual dysfunction.

Which conditions are likely to cause an older adult chronic pain? (Select all that apply.) a. Hip replacement b. Bone metastasis c. Hypoproteinemia d. Migraine headache e. Compression fracture f. Postherpetic neuralgia

ANS: B, E, F Bone metastasis is likely to cause an older adult chronic pain because it is extremely difficult to eradicate cancer metastasis from bone. In addition, the invasion of cancer into bone can be very painful as a result of tumor growth pressing on nerves. Compression fractures are likely to cause chronic pain because the compressed vertebra is likely to press on spinal nerves, causing muscle spasms. Postherpetic neuralgia is a result of nerve damage from shingles and is likely to cause chronic pain; it is very difficult to treat effectively. A hip replacement is performed to relieve chronic pain or to repair a fracture and is more likely to cause acute pain. Hypoproteinemia is unlikely to cause chronic pain but is more likely to cause fatigue. A migraine headache is likely to cause acute, intense pain. Although headaches can be recurrent, they are usually time limited.

In questioning an older adult, which question is likely to elicit the most accurate information about the individual's adherence to the medication plan? a. "You take digoxin (Lanoxin) at the correct time, don't you?" b. "Why didn't you take all of your digoxin (Lanoxin) last month?" c. "How many doses of digoxin (Lanoxin) do you think you missed?" d. "You have never missed a dose of digoxin (Lanoxin), have you?"

ANS: C "How many doses of digoxin (Lanoxin) do you think you missed?" is a question that is worded to put the client at ease and to elicit information in a matter-of-fact way. "You take digoxin (Lanoxin) at the correct time, don't you?" sounds like a challenge to the patient's personal qualities. In addition, the nurse is leading the patient to the answer. The patient is likely to respond simply, "Oh, yes." Although the question, "Why didn't you take all of your digoxin (Lanoxin) last month?" is meant to elicit the reason for nonadherence, it has an accusatory tone that is likely to make the patient defensive. "You have never missed a dose of digoxin (Lanoxin), have you?" is a question that can be interpreted as judgmental.

A nurse is preparing to administer medications to an older patient. The nurse consults the drug reference book, which provides the half-life of the drug. The nurse understands that half- life is defined as a. the amount of time that the drug is stable after prepared. b. the amount of time that it takes for the drug to be excreted by the body. c. the amount of time that the drug remains active in the body. d. the amount of time between drug ingestion and absorption.

ANS: C Half-life is defined as the amount of time that the drug remains active in the body.

The older adult is at a higher risk for acute psychological pain than a younger adult because older adults a. have many illnesses. b. possess fewer assets. c. experience more loss. d. live with impairments. .

ANS: C Older adults are at higher risk for acute psychological pain than younger adults because they experience more loss such as the pain occurring in early bereavement or in a major depressive episode. Older adults tend to have more illnesses than younger adults, and illness can trigger depression. The lack of assets of younger and older adults is unlikely to be related to acute psychological distress unless a sudden loss of a large asset is experienced. Older adults do not necessarily live with impairments. Furthermore, if impairment causes psychological distress, then the acute phase is likely to occur at the onset rather than in day-to-day activities

The nurse provides instruction about medication safety to older adults. Which instruction should the nurse provide? a. Nausea and vomiting are common, harmless drug side effects. b. Keep a supply of medications at the bedside for convenience. c. Ask the health care provider to describe the purpose of therapy. d. Take your daily medications on an empty stomach with water.

ANS: C Older adults should ask the health care provider for the purpose of each drug and record the information. Although nausea and vomiting are among the most common adverse effects of pharmacotherapy, they ca indicate medication toxicity and should be reported to the health care provider. Keeping a medication at the bedside is dangerous for anyone and can be especially dangerous for older adults who are taking antianxiety agents, hypnotic agents, and opioid analgesics; these and other medications can cause respiratory depression with and without excessive dosing. If sleepy or lethargic, then the older adult can inadvertently take more than the correct dose and have serious consequences as a result. Taking a medication on an empty stomach with water is a suitable instruction for many medications; however, many medications that are likely to cause nausea are taken with food. The nurse should instruct older adults to keep a record of the recommended method of administration.

An older Hispanic man states that he is not having pain, but he had knee replacement surgery 2 days ago. Which is the best pain assessment tool as recommended by the Hartford Institute for Geriatric Nursing (HIGN) from "Try This" for the nurse to apply for this man? a. Numeric Rating Scale b. Verbal Descriptor Scale c. Iowa Pain Thermometer d. Faces Pain Scale-revised (FPS-R)

ANS: D Hispanic men are less likely to report pain because their culture tells them to deny and withstand pain without complaining. The nurse uses the FPS-R to validate the patient's report because the postoperative period in knee replacement surgery is very painful; this fact makes the nurse think that the patient is likely to have pain. The HIGN has data that support the claim that Hispanic and African American older adults prefer using the FPS-R for evaluating pain. The Numeric Rating Scale, the Verbal Descriptor Scale, and the Iowa Pain Thermometer are valid and reliable assessment tools, but older Hispanic adults prefer using the FPS-R.

An older client who was recently admitted to the subacute setting after having a knee replacement, is very anxious and refuses to get out of bed, stating that it is too painful. Which intervention will the nurse implement? a. Share with the patient that it's important to get out of bed and that there is pain medication available if it does hurt. b. Use the Hoyer lift to get her out of bed so that the knee will not experience much movement and so there will be little pain. c. Offer pain medication, administer the medication, and wait 20 minutes before getting her out of bed. d. Allow the patient to remain in bed but share that getting up will be required at least twice a day starting the next morning.

ANS: C The administration of an as-needed analgesic 20 to 30 minutes before an activity may eliminate discomfort and fear of discomfort. It may also enhance the individual's capacity for the activity. It is not true that performing an activity quickly will lessen the pain or that the patient will get used to the pain. A Hoyer lift is only indicated when an individual is completely immobile. Activity is an important part of rehabilitation.

A nurse is caring for an older resident in a long-term care facility who has a history of dementia and is becoming agitated. The best response by the nurse to the patient's agitation is to a. call the prescriber and request an order for a psychotropic medication. b. ignore the behavior because psychoactive medications have potentially dangerous side effects in older patients. c. use only nonpharamacologic interventions to manage the patient's behavior. d. conduct a thorough nursing assessment of the patient related to the patient's behavior.

ANS: D A patient should be prescribed a psychotropic medication only after thorough medical, psychological, and social assessments. Nursing assessment before medication intervention contributes knowledge and baseline information that can optimize the patient's medical and psychological improvement. At the same time, assessments should be done quickly to enable the patient to receive the appropriate treatment as soon as possible. Pharmacologic interventions should always be supplemented by nonpharmacologic measures such as counseling, changes in the environment, and other actions that promote healthy aging.

Compared with acute pain, which of the following statements is true of persistent pain? a. Leads to significantly altered vital signs b. Is usually described as a burning pain c. Is generally gone within 4 months d. Can bring about long-term changes in lifestyle

ANS: D Persistent pain affects the patient's experience on a continuing basis. Both acute pain and persistent pain can affect the vital signs. Persistent pain may be described in many possible ways. Persistent pain is unrelenting.