Pain

A nurse is teaching a client about how to use her new hearing aids. Which of the following statements should the nurse identify as an indication that the client needs further instruction? A. "I will clean the hearing aids with alcohol wipes." B. "I will not use hairspray if I am wearing the hearing aids." C. "I will change the batteries once a week." D. "I will expect the hearing aids to whistle when I cup my hand over them."

A. "I will clean the hearing aids with alcohol wipes."

A nurse is speaking with the mother of a 6-year-old child. Which of the following statements by the mother should concern the nurse? A. "The teacher says my child has to squint to see the board." B. "My child has recently lost both front top teeth." C. "My child often cheats when we play board games." D. "Sometimes my child acts bossy with his friends."

A. "The teacher says my child has to squint to see the board."

A nurse at a clinic is collecting data about pain from a client who reports severe abdominal pain. The nurse asks the client if there has been any accompanying nausea and vomiting. Which of the following pain characteristics is the nurse attempting to determine ? A. Presence of associated manifestations B. Location of the pain C. Pain quality D. Aggravating and relieving factors

A. Presence of associated manifestations

.A nurse is planning care for a client who is postoperative. Which of the following statements about pain management should the nurse consider when implementing client care? (Select all that apply.) A. Use of analgesics will eventually lead to addiction. B. Each client's expression of pain may be different and individualized. C. Patient-controlled analgesia (PCA) offers a constant level of opioids within therapeutic range. D. Pain level and pain tolerance can be assessed using a scale from 0 to 10. E. The client will express the feeling of pain both verbally and nonverbally.

B. Each client's expression of pain may be different and individualized. C. Patient-controlled analgesia (PCA) offers a constant level of opioids within therapeutic range. D. Pain level and pain tolerance can be assessed using a scale from 0 to 10.

A nurse is teaching a client who has a new prescription for ibuprofen to treat hip pain. Which of the following instructions should the nurse include in the teaching? A. Expect ringing in your ears. B. Take the medication with food. C. Store the medication in the refrigerator. D. Monitor for weight loss

B. Take the medication with food.

A nurse is caring for a client who is receiving morphine via a patient-controlled analgesia (PCA) infusion device after abdominal surgery. Which of the following statements indicates that the client knows how to use the device? A. "I'll wait to use the device until it's absolutely necessary." B. I'll be careful about pushing the button to much so I don't get an overdose." C. "I should tell the nurse if the pain doesn't stop while i am using this device." D. "I will ask my adult child to push the dose button when I am sleeping."

C. "I should tell the nurse if the pain doesn't stop while i am using this device."

A nurse is monitoring a client for adverse effects following the administration of an opioid. Which of the following effects should the nurse identify as an adverse effect of opioids? (SATA) A. Urinary incontinence B. Diarrhea C. Bradypnea D. Orthostatic hypotension E. Nausea

C. Bradypnea D. Orthostatic hypotension E. Nausea

A nurse is caring for a client who requests prescription pain medication. Which of the following actions should the nurse perform first? A. Reposition the client. B. Administer the medication. C. Determine the location of the pain D. Review the effects of the pain medication.

C. Determine the location of the pain

A nurse is collecting data from a client who is reporting pain despite taking analgesia. Which of the following actions should the nurse take to determine the intensity of the clients pain? A. Ask the client what precipitates the pain B. Question the client about the location of the pain C. Offer the client a pain scale to measure their pain D. Use open-ended questions to identify the clients pain sensations

C. Offer the client a pain scale to measure their pain

A nurse is caring for a client who is 1-day postoperative following a total laryngectomy and has begun a soft diet. The client is not eating well and tells the nurse that the hospital food has no taste. Which of the following responses is appropriate for the nurse to make? A. "You should ask your family to bring you some food from home." B. "Clients frequently complain about the taste of hospital food." C. "I would be happy to get you food that you prefer to eat." D. "Because of your surgery, you have an altered ability to smell and taste."

D. "Because of your surgery, you have an altered ability to smell and taste."

A nurse is discussing the care of a group of clients with a newly licensed nurse. Which of the following clients should the newly licensed nurse identify as experiencing chronic pain? A. A client who had a broken femur and reports hip pain B. A client who has incisional pain 72 hr following a pacemaker insertion C. A client who has food poisoning and reports abdominal cramping D. A client who has episodic back pain following a fall 2 years ago

D. A client who has episodic back pain following a fall 2 years ago

A nurse is caring for a client who had total hip arthroplasty 1 day ago and is receiving morphine sulfate by PCA pump for pain control. The client reports nausea and vomiting. Which of the following actions should the nurse take? A. Insert a nasogastric tube B. Administer an antiemetic C. Encourage use of the incentive spirometer. D. Auscultate bowel sounds.

D. Auscultate bowel sounds.

A nurse is caring for a client who has expressive aphasia following a cerebrovascular accident (CVA). Which of the following parameters should the nurse use first in order to assess the client's pain level? A. pulse and blood pressure findings B. behavioral indicators and effect C. scheduled treatments and client illness D. a self-report pain rating scale

D. a self-report pain rating scale

sleep walking

walking during non-REM sleep, nightmares, children usually do

5.A nurse in the emergency department is preparing to administer naloxone 0.4 mg IV bolus to a client who has opioid-induced respiratory depression. Available is naloxone injection 0.2 mg/mL. How many mL should the nurse administer per dose? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)

2 mL

insomnia

inability to sleep

sleep apnea

a disorder in which the person stops breathing for brief periods while asleep, minimum of 10 seconds

8.A nurse is preparing to administer meperidine 35 mg IM to a client every 6 hr PRN for pain. Available is meperidine injection 75 mg/mL. How many mL should the nurse administer per dose? (Round the answer to the nearest tenth. Use a leading zero if it applies. Do not use a trailing zero.)

0.5 mL

Narcolepsy

A sleep disorder characterized by uncontrollable sleep attacks. The sufferer may lapse directly into REM sleep, often at inopportune times.

A nurse is providing information about pain control for a client who has acute pain following a subtotal gastric resection. Which of the following client statements indicates an understanding of pain control? A. "I will call for pain medication before the previous dose wears off." B. "I will call for pain medication as my pain starts to increase again." C. "I will wait for you to evaluate my pain before asking for more medication." D. "I will ask for less medication to avoid addiction."

A. "I will call for pain medication before the previous dose wears off."

A nurse is caring for a client who requires cold applications with an ice bag to reduce the swelling and pain of an ankle injury. Which of the following actions should the nurse take? A. Apply the bag for 30 min at a time. B. Reapply the bag 30 min after removing it C. Allow room for some air inside the bag. D. Place the bag directly on the skin.

A. Apply the bag for 30 min at a time.

A nurse is caring for a client who is postoperative. The nurse should base her pain management interventions primarily on which of the following methods of determining the intensity of the client's pan? A. Vital sign measurement B. The client's self-report of pain severity C. Visual observation for nonverbal signs of pain D. The nature and invasiveness of the surgical procedure

B. The client's self-report of pain severity

A nurse is caring for a client who has chemotherapy- induced peripheral neuropathy. The nurse should expect the client to report having experienced which of the following symptoms? A. Extremities that turned blue when exposed to cold B. Tingling feeling in the extremities C. Jerking movements of the extremities D. Spasms of the extremities

B. Tingling feeling in the extremities

A nurse is caring for a client who is postoperative following abdominal surgery and reports incisional pain. The surgeon has prescribed morphine 4 mg IV bolus every 6 hr as needed. Before administering this medication, the nurse should complete which priority assessment? A. Blood pressure B. Apical heart rate C. Respiratory rate D. Temperature

C. Respiratory rate

.A nurse is admitting a client who has a partial hearing loss. Which of the following is the priority action by the nurse? A. Speak using his usual tone of voice B. Stand directly in front of the client C. Rephrase statements the client does not hear. D. Determine if the client uses hearing aids.

D. Determine if the client uses hearing aids.

sleeping aid meds

GABA agonist/benzo (alprazolam, clonazepam, lorazepam) Nonbenzo hypnotics- (zolpidem) Melatonin

avoid stimulants

caffeine, alcohol, nicotine at least 4-6hrs b4 bed, remove unnecessary light and noise, est a bed time, keep room dark, quite and comfortable, go to bed when tired, exercise at least 3 hrs b4 bed, remove all work items and tv from bedroom, keep naps short and before 3pm, get up after 20 minutes of no sleep

without sleep

challenging to concentrate and respond to the various stimuli present in the environment

Hypersomnia

excessive daytime sleepiness, without sleep improvement

Central Sleep Apnea (CSA)

is a sleep-related disorder in which the effort to breathe is diminished or absent, typically for 10 to 30 seconds either intermittently or in cycles, and is usually associated with a reduction in blood oxygen saturation

Benefits of sleep

necessary for developing and maintaining new pathways for learning and memorication

obstructive sleep apnea (OSA)

related to recurrent episodes of upper airway collapse and obstruction while sleeping Need CPAP causes: smoking, obesity, ETOH