FUNDS EXAM 3

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 opportunity to be treated fairly."

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" "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 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 has the right to receive effective pain management."

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.)

- 3 year old toddler who has a fractures femur - 14 year old with cognitive delay and developmental delays - 5 year old preschooler who is experiencing pain during a sickle cell crisis

numeric rating scale can be used by

- 32 year old client who is postoperative following an appendectomy - 50 year old client who has a herniated disc.

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 - inadequate pain assessment

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?

- negligence

Wong-Baker FACES scale can be used by:

-8 year old child who has a broken arm - 4 year old child who has a sore throat

What does PQRST stand for?

P(precipitating cause) Q(quality), R(region), S(severity), T(timing)

biopsychosocial model

suggest that three categories of factors form the experience of pain. - biological - physiological - social

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. - sweating

pain threshold

the point at which a stimulus causes the client perceive pain

cognitive behavioral therapy

therapy to help clients learn to manage and target negative thoughts to help reduce pain, especially chronic pain.

The nurse's role with informed consent for surgery is to verify and witness that the informed consent has been signed by the client or client's legal representative who is competent and has adequate information to make the decision.

true

The preoperative phase begins when the client decides to have surgery and ends when the client is transferred to the surgical suite for the surgical procedure.

true

pain is whatever the client says that it is?

true! - nurses should not impose their own opinions or perceptions of a client pain. but recognize that the client is the only person who can truly rate and describe their own pain.

cancer pain

tumor pain, bone pain and treatment associated pain such as chronic post surgical pain, radiation induced pain and neuropathies related to chemo.

non verbal pain scales may be used by:

- 66 year old client who is on a mechanical ventilator - 40 year old client who is sedated - 22 year old client who is unable to speak following a stroke

the four ethical principles related to pain management

- beneficence - nonmaleficence -autonomy - justice

A nurse is caring for a client who is experiencing pain. Which of the following are influencing factors of pain?

- client risk factors - client trends - anxiety - types of pain medication used

five pain scales

Numeric Rating Scale, Visual Analog Scale, Wong-Baker FACES Pain Rating Scale, Nonverbal Pain Scale (NVPS), CRIES

cutaneous stimulation

Therapy applied to the skin such as heat and cold, touch, massage, acupuncture, acupressure, or TENS.

chronic pain

slow, diffuse, constant pain. usually lasts longer than 6 months.

A nurse is assessing her client who has returned from post-op after having her gallbladder removed. The client reports her pain is 6/10 on a numeric pain scale. The client's report of pain is what type of pain indicator?

subjective

acute pain

sudden and slow onset of any intensity an an anticipated or predictable end. less than 6 months

The nurse is reviewing the client's chart during the preoperative assessment to identify what surgical risk factors? (Select all that apply.)

- clients weight - clients age - nutritional status - HX of tobacco or substance abuse

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 -activity -consolability - cry

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.)

- respiratory rate - capnography (measures co2) - oxygen saturation

non opioid analgesics

affect cox- 1 and cox-2 - nsaids and acetaminophen and aspirin -

biopsychosocial model: physiological

comprise mood/affect, catastrophizing (worst assumption), stress and coping.

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 point to where you are having your pain?"

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?

20 min

Neglegence

Failure to exercise a reasonable amount of care in either doing or not doing something, resulting in harm or injury to a person

malpractive

Negligence by a professional person

nonpharmacological pain interventions include all of the following except?

OPIOIDS - no meds!!!

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

Offer to assist the client with nonpharmacological relief strategies.

pain tolerance

how much of a stimulus the client is willing to accept.

principle for heat and cold therapy (mins off and on)

20 min on and 20 min off

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?

Children may deny pain to avoid IM injection or bad tasting oral medicine.

adjuvant analgesics

aid in pain relief by working on underlying pain generators such as antidepressants, corticosteroids and botulinum toxin. - gabapentin - carbamazepine

neuropathic pain

referred as nerve pain. - diabetic neuropathy - phantom pain - pins and needles - nerve pain; no tissue damage

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."

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.)

-TENS -massage -Acupuncture -Cold therapy

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 -backache -menstral discomfort -swollen extremity

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 provides a client with the opportunity to take an intramuscular injection or oral medication for pain relief. - allows the patient to make an informed decision

The nonverbal pain scale (NVPS) uses smiling/frowning faces for clients who are able to verbalize so that they can point to the face of how their pain makes them feel.

false

biopsychosocial model: : social

include cultural and economic factors, the social environment and social support.

biopsychosocial model: biological

includes disease severity, nociception, inflammation and brain function.

A client has been admitted to the hospital with a complaint of severe bone pain. The nurse knows that the client is experiencing what type of pain?

nociceptive pain

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?

withdrawn

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 will keep the morphine bottle in a locked cabinet in my kitchen." -Morphine is a medication that carries significant risks to others, including children, and should only be accessible and used by the client for whom it is prescribed. Storing the medication in a high cabinet prevents accidental access to the morphine by others.

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 - culture -social support -disease severity

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" - "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 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. -use a pain scale specific to each clients cognitive abilities - determine the effectiveness of nonpharmacological status.

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 -increased diaphoresis

A nurse is explaining to a student the importance of providing client teaching throughout all phases of the perioperative process. The student nurse indicates an understanding of the perioperative process when identifying which of the perioperative phases below? SATA

-preoperative phase -intraoperative phase -postoperative phase

A nurse is performing a preoperative assessment on a client. The preoperative assessment has been completed when the nurse: (select all that apply)

-reviews the client's medical history -ensures that the client's ordered preop laboratory and diagnostic tests have been completed -completes a head to toe assessment on the client

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 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 diabetes mellitus and reports bilateral burning foot pain without signs of injury

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?

Evaluate the client for pain by observing their behavior.

mnemonic used to screen clients for opioid addiction.

SBIRT - Screening -Brief -Intervention -Referral - Treatment

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 - When a client has a prescription that includes a range, and the client has never taken the medication previously, the nurse should administer the lowest dose to the client. If the dose is ineffective, the nurse can increase the dosage up to the maximum amount in the range prescribed by the provider.

opioids

can cause depression in the respiratory system. and sedation. - orthostatic depression can happen. - constipation. ex: morphine, codeine, heroine, hydrocodone, oxycodone and hydromorphone, fentanyl

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?

chronic pain

nociceptive pain

found in multiple parts of the body: can be caused by chem. substances, tissue damage, extreme temps. usually localized pain and described as throbbing or aching. - Pain that is felt in the tissue, an organ, a damaged part of the body, or a referred pain.

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

PCA pump

patient controlled analgesia!!!!! no one else!!!!!