Pain - HESI

The clinic nurse is caring for a client who has been prescribed fentanyl, a potent opioid, for chronic pain. In what forms is it available for chronic pain administration in the at-home setting?

-Intranasal spray -Oral transmucosal lozenge -72-hour transdermal patch -Effervescent buccal oralets

A child is seen in the school nurse's office with complaints of pain in his right forearm. In reviewing the child's record the nurse notes that he has a history of being physically abused by the mother. Which should be the initial intervention with this child?

Assess the child's physical status.

The nurse is caring for a postoperative client who is receiving demand-dose hydromorphone via a patient-controlled analgesia (PCA) pump for pain control. The nurse enters the client's room and finds the client drowsy and records the following vital signs: temperature 97.2°F (36.2°C) orally, pulse 52 beats per minute, blood pressure 101/58 mm Hg, respiratory rate 11 breaths per minute, and SpO2 of 93% on 3 liters of oxygen via nasal cannula. Which action should the nurse take next?

Attempt to arouse the client. The nurse should suspect opioid overdose. The nurse should first attempt to arouse the client and then reassess the vital signs.

The nurse is caring for a client with a back injury sustained 1 year ago. To obtain the most complete assessment data about the client's chronic pain pattern, what should the nurse ask the client?

Can you describe your daily activities in relation to your pain

The nursing instructor is discussing the topic of pain with a student nurse who is assessing the status of pain in a cognitively impaired older adult. What comment by the student implies that further education is needed?

Clients in this age group are less sensitive to pain and have a greater pain tolerance. Rationale: They are not less sensitive to pain and do not necessarily have a greater pain tolerance.

A client who had abdominal surgery is receiving epidural analgesia. The nurse monitors the client closely, knowing that which is a potential complication of this therapy?

Dislodgment of the epidural catheter because the catheter is not sutured in place

To prevent postoperative atelectasis in a client recovering from an open cholecystectomy, what should the nurse do first?

Ensure that the client is experiencing adequate pain control.

The health care provider (HCP) writes a prescription for acetylsalicylic acid, or aspirin, for a client who was admitted to the hospital with joint pain from rheumatoid arthritis. The nurse contacts the HCP to verify the prescription if which finding is noted in the assessment data?

Gastric ulceration

A staff nurse is precepting a new graduate nurse and the new graduate is assigned to care for a client with chronic pain. Which statement, if made by the new graduate nurse, indicates the need for further teaching regarding pain management?

I will be sure to cue in to any indicators that the client may be exaggerating their pain. Pain is a highly individual experience. should not assume that the client is exaggerating his pain

The nurse plans care for an older client admitted with a fractured hip. Which analgesic prescribed by the health care provider at standard doses and frequencies would the nurse question?

Meperidine hydrochloride by intramuscular route. it should be used only short term and is not recommended for use in older clients.

The nurse is caring for a client who is receiving morphine sulfate by the intravenous route for acute pain. The nurse ensures that which medication is available in the event that the client's respiratory status and level of consciousness deteriorate?

Naloxone (Protamine sulfate is the antidote for heparin)

The nurse is discussing pain management with a student who is caring for a 1-day postoperative abdominal surgery client who is a known opioid substance abuser. What comment by the student indicates a need for further education?

Opioid substance abusers are less tolerant to opioids and require decreased doses. Rationale: They developed a tolerance to opioids and require higher

The nurse is assessing the status of pain in an alert elderly client who was recently admitted to the hospital with a diagnosis of ruptured lumbar disc. What are some of the beliefs and concerns older adults have about pain?

Pain is something that must be lived with. Nurses are too busy to listen to reports of pain. Pain signifies a serious illness or impending death. Reporting pain will result in being labeled as a "bad" client.

A client with a fractured femur who has had an open reduction-internal fixation is receiving ketorolac. Which assessment measurement will assist the nurse in determining the effectiveness of this medication?

Pain rating. Ketorolac is a nonopioid analgesic and nonsteroidal antiinflammatory agent.

The nurse is caring for a client who had a cholecystectomy 1 day ago. The nurse plans pain-management techniques, knowing that the severity of the client's pain can be related to which factor?

Positioning of the client during surgery The duration of the operation, and the degree of tissue trauma also contribute to the presence and severity of postoperative pain.

The nurse is assessing a client's postoperative pain using the PQRSTU method. Using this method, which questions would the nurse ask the client?

R = Where is the pain located? Q = What does the pain feel like? U = How does the pain affect you? P = What makes your pain better or worse?

The nurse works in a long-term care facility, caring for older clients. The nurse should make which interpretation when an older client complains of pain?

Something is wrong, and an assessment should be made.

The nurse is making initial rounds on the nursing unit to check the condition of assigned clients. The client complains of discomfort at the intravenous (IV) site, and the nurse notes that the site is cool, pale, and swollen and that the solution is infusing slowly. What action should the nurse take first?

Stop the IV infusion. because it has infiltrated

The nurse is instructing a client about receiving patient-controlled analgesia to control postoperative pain. What comment by the client indicates that further instruction is needed?

That's great that overdosing can't happen.

A client is being started on tramadol therapy for pain management after a back injury. When educating this client on tramadol therapy, what is the priority?

The client cannot drink alcohol while taking tramadol.

The home health care nurse is caring for a client with cancer who is complaining of acute pain. The most appropriate determination of the client's pain should include which assessment?

The client's pain rating

The nurse is setting up a transcutaneous electrical nerve stimulation unit on a client with chronic pain. As the nurse turns up the level of stimulation, the client complains of discomfort. Based on this finding, the nurse should make which interpretation?

The maximal stimulation has been reached, and it should be decreased slightly.

The nurse is caring for a client who takes ibuprofen for pain. The nurse is gathering information on the client's medication history, and determines it is necessary to contact the health care provider (HCP) if the client is also taking which medications?

Warfarin Glimepiride Amlodipine