Funds final
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 precepting a newly licensed nurse and suggests using the IDEAL method to structure the client's discharge planning. The client's caregiver is also in the room. Which of the following statements made by the newly licensed nurse demonstrates the correct the use of the IDEAL method?
"I will include the client and caregivers in the discharge discussion."
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."
A charge nurse is reinforcing teaching with a newly licensed nurse about the concept of team nursing. Which of the following statements by the newly licensed nurse indicates an understanding of the teaching?
"Nurses will pair together to care for an assigned group of dients
A nurse is speaking with a client who is noncompliant in performing a daily blood glucose testing regimen. Which of the following responses should the nurse make?
"What is preventing your consistency with your daily blood glucose checks?"
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 assisting with 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 contributing to a plan to teach 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 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 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 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 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 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. -Use a pain scale specific to each client's cognitive abilities.
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 -Consolability
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) —Massage -Acupuncture -Cold therapy
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 minutes
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 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.
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.
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
s://student.atitA nurse is caring for a client who is being transferred to another unit, but the receiving nurse is unavailable to take report. Which of the following concepts is being violated that could place the client at risk?
Continuity of care
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.
A nurse is collecting data from a client who is nonverbal to determine the presence of pain. Which of the following assessment findings indicates an increased level of discomfort? (Select all that apply.)
Grimacing, Restlessness, Increased diaphoresis
A newly licensed nurse is reviewing the client assignments for a shift and determining tasks to complete. Which of the following is a time management strategy the nurse should use?
Make a list and prioritize a plan.
A nurse is caring for a client who has severe pain and repeatedly asks for pain medication. The nurse is busy and forgets to collect data about the client's pain and administer prescribed pain medication. Which of the following can the nurse be charged with?
Negligence
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.
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 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 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.
A charge nurse is reinforcing teaching with a group of nurses about protecting themselves from an abusive client. Which of the following statements by a nurse within the group demonstrates an understanding of the teaching?
should try to escape or put a barrier between myself and the client.
A nurse is reinforcing teaching about the use of the SMART goal method with a client who has diabetes mellitus and is setting nutrition and weight loss goals. Which of the following client statements should indicate to the nurse an understanding the teaching?
will reduce my sugar intake by 10 grams each Week for 1 month until I reach the desired level.
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 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 Menstrual discomfort
A nurse is assisting with the care of 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
A nurse is giving change-of-shift report to an oncoming nurse using BAR reporting. Which of the following entries by the nurse demonstrates the correct use of SBAR?
The client in room 1 has been experiencing breakthrough pain following an exploratory surgery yesterday. Vital signs are stable. Recommend calling the provider for a breakthrough dose if pain continues
A charge nurse is reviewing client acuities and tasks to make the nursing staff's daily assignments. When using the Five Rights of Delegation, which of the following should the charge nurse use to ensure client safety?
The right task
