ADN 210 Exam 3

A client sustained second-and third-degree burns to the chest and neck 4 days ago and is now refusing analgesics stating, "I don't want to become addicted to pain medication. "What is the best response by the nurse? a) "I don't blame you for feeling that way; we have people who do become addicted." b) "Don't worry about this now; take the pain medications, and we will worry about addiction later." c) "Although misusing the medication may cause addiction, there is little evidence that those who require narcotics for legitimate pain become addicted." d) "The physician has ordered the medication every 4 hours, and you must take it so that you will heal quicker."

"Although misusing the medication may cause addiction, there is little evidence that those who require narcotics for legitimate pain become addicted."

Which statement by the client indicates further teaching about epidural anesthesia is necessary? a) "I will become unconscious." b) "I will lose the ability to move my legs." c) "I will be able to hear the surgeon during the surgery." d) "A needle will delivery the anesthetic into the area around my spinal cord."

"I will become unconscious."

You have completed a preoperative teaching session with a patient who will receive morphine via a patient-controlled analgesia pump (PCA) after surgery/ Which of the following statements by the patient indicates the need for further teaching? a) "I will remind my family member to push the PCA pump button for me if i doze off during the day." b) "I will let my nurse know if the pain medication is not effective enough to help me move after surgery." c) "I can push the button whenever I feel pain." d) "I will use the PCA pump until oral pain medication controls my pain."

"I will remind my family member to push the PCA pump button for me if i doze off during the day."

After completing client teaching on use of patient-controlled analgesia (PCA) the nurse determiens that the client understands when the client says: a) "it is okay for my family to press the button for me if I am too tired to do it myself." b) "I should wait until the pain is really bad before I push the button to get more pain medicine." c) "The machine will give me only the prescribed amount of pain medication even if I push the button too soon." d) "I have to be careful about pushing the button too many time or I will overdose."

"The machine will give me only the prescribed amount of pain medication even if I push the button too soon."

The nurse is preparing to care for an 86-year-old client who just returned to the unit after surgery to repair a fractured hip. The client has severe dementia. Which pain management strategy would be most appropriate for this client? a) IV patient-controlled analgesia b) Oral patient-controlled analgesia (PCA) c) Around-the-clock oral pain medication d) As needed (PRN) IV pain medication

Around-the-clock oral pain medication

A client is receiving morphine sulfate by a patient-controlled analgesia (PCA) system after a left lower lobectomy about 4 hours ago. The client reports moderately severe pain in the left thorax that worsens when coughing. The nurse's first course of action is to: a.) reassure the client that the PCA system is working and will relieve pain. b.) encourage the client to rest; no further assessment is needed. c.) Asses the pain systemically with the hospital approved pain scale. d.) Encourage the client to take deep breaths and expectorate the mucous that is stimulating the cough.

Asses the pain systemically with the hospital approved pain scale.

A client who is 1 day postoperative is using a morphine PCA pump. The client is confused and disoriented. What is the priority intervention by the nurse? a) Check the respiratory rate and depth as well as oxygen saturation levels b) Check the pulse rate and blood pressure c) Check whether the client is self-administering a bolus too frequently d) Check for shortness of breath, signifying a pulmonary embolism.

Check the respiratory rate and depth as well as oxygen saturation levels

The nurse is preparing a patient for a colonoscopy. The nurse is familiar with the colonoscopy procedures at the hopsital and is aware that which type of anesthesia is commonly used for this procedure? a) Conscious sedation b) Nerve block c) Spinal anesthesia d) Epidural anesthesia

Conscious sedation

A nurse is caring for a client who just had an appendectomy. The client is receiving opioid analgesics routinely for pain. The nurse should focus her follow-up assessment on which complication? a) Constipation b) Anorexia c) Anxiety d) Diarrhea

Constipation

A client who is recovering from a bilateral adrenalectomy has a patient-controlled analgesia (PCA) system with morphine sulfate. The nurse should: a) observe the client at regular intervals for opioid addiction b) encourage the client to reduce analgesic use and tolerate the pain. c) evaluate pain control at least every 2 hours. d) increase the amount of morphine if the client does not administer the medication

Evaluate pain control at least every 2 hours

The nurse is teaching a client how to manage their post-operative pain through a PCA pump. The nurse determines that additional teaching is needed when the client states which of the following? a) This will allow me to control my own pain medication b) I should only take medication when my pain is intense c) I give myself the pain medication by pushing the button d) The pump is programmed to limit the chance of over-medicating

I should only take medication when my pain is intense

A patient is being seen in the ER following a motor vehicle accident (MVA). He is having severe back pain. The preferred route of administration of medication in the most acute care situations is which of the following routes? a) Intravenous b) Epidural c) Subcutaneous d) Intramuscular

Intravenous

You are caring for a patient who is receiving morphine via a PCA pump. You note that the patient's respiratory rate is 10 breaths per minute. The patient is somnolent, with minimal response to physical stimulation. You should prepare to administer which of the following medications? a) Intravenous naloxone (Narcan) b) Intravenous flumazenil (Romazicon) c) Oral modafinil (Provigil) d)Nebulized albuterol (Proventil)

Intravenous naloxone (Narcan)

The nurse is assisting with conscious sedation for a 6 year old undergoing a bone marrow biopsy. The nurse's most important responsibility during the procedure is to: a) Administer the topical anesthetic b) Keep the parents informed c) Monitor the patient d) Record the procedure

Monitor the patient

The nurse preparing to admit a client receiving epidural opioids should make sure that which of the following medications is readily available on the unit? a) Narcan b) Lasix c) Lopressor d) Digoxin

Narcan

A client who underwent a left lower lobectomy has been out of surgery for 48 hours. The client is receiving morphine sulfate via PCA system and reports having pain in the left thorax that worsens when coughing. After checking the PCA system, the nurse should next: a) Let the client rest, so the client is not stimulated to cough. b) Encourage the client to take deep breaths to help control the pain. c) Reassure the client that the machine is working and will administer medication to relieve the pain. d) Obtain a more detailed assessment of the client's pain using a pain scale.

Obtain a more detailed assessment of the client's pain using a pain scale.

A client with multiple myeloma is complaining of severe pain when the nurse comes in to give a bath and change position. What is the priority intervention by the nurse? a) Inform the client that the position must be changed, and then you will give her pain medication and omit the bath b) Inform the client that she will feel better after receiving a bath and clean sheets. c) Obtain the pain medication and delay the bath and position change until the medication reaches its peak d) Inform the client that the bath and positioning is an important part of client care and will be done right after pain medication administration.

Obtain the pain medication and delay the bath and position change until the medication reaches its peak

The nurse is administering oxycodone to a client. To which category of analgesics does this belong? a) Opioid b) Nonsteroidal anti-inflammatory c) Adjuvant d) Multipurpose

Opioid

Which of the following is the priority assessment for a nurse caring for a client with a PCA pump? a) respiratory b) cardiovascular c) peripheral vascular d) neuromuscular

Respiratory

After undergoing a thoracotomy, a client is receiving epidural analgesia. Which assessment finding indicates that the client has developed the most serious complication of epidural analgesia? a) Heightened alertness b) Increased heart rate c) Numbness and tingling of the extremities d) Respiratory depression

Respiratory depression

The nurse teaches the client with chronic cancer pain about optimal pain control. Which recommendation is most effective for pain control? a) Get used to some pain, and use a little less medication than needed to keep from being addicted. b) Take prescribed analgesics on an around-the-clock schedule to prevent recurrent pain. c) Take analgesics only when pain returns d) Take enough analgesics around the clock so that you can sleep 12-16 hours a day to block the pain.

Take prescribed analgesics on an around-the-clock schedule to prevent recurrent pain.

The use of a patient-controlled analgesia (PCA) pump is effective in which situation? a) The client achieves a therapeutic level of analgesia. b) The client does not become dependent on opioids postoperatively c) There is decreased cost by decreasing use of IM injections d) The family can assist the client in managing the pain.

The client achieves a therapeutic level of analgesia.

A client is eligible for patient-controlled analgesia (PCA) when: a) A family member is able to assist with self-dosing b) there are advanced directives in place c) the client has the ability to self-administer d) there is a nurse to assist with self-administration

The client has the ability to self-administer

A patient has been admitted to a post-surgical unit with a patient-controlled analgesia (PCA) system. Which of the following statements is true of this medication delivery system? a) The dose that is delivered when the patient activates the machine is preset. b) Thorough patient teaching is necessary to prevent overdoses. c) Use of opioid analgesics in a PCA is contraindicated due to the risk of respiratory depression d) An antidote is automatically delivered if the patient exceeds the recommended dose

The dose that is delivered when the patient activates the machine is preset.

A nurse observes that a client who underwent knee surgery two weeks ago needs progressively larger doses of analgesics to get relief from pain. The nurse interprets this as which of the following? a) addiction b) tolerance c) dependance d) sedation

Tolerance

While reviewing the chat of a client who was recently admitted, the nurse will use the nursing process to set up a plan of care. Order the activities the nurse will do in the most likely sequence from 1-5. Use all options a) Inquire about the reason for the admission b) Choose the nursing diagnosis of acute pain c) Confer with the client about the desire for pain control d) Administer the prescribed 4 mg of IV push morphine e) Re-assess the pain level.

a) Inquire about the reason for the admission b) Choose the nursing diagnosis of acute pain c) Confer with the client about the desire for pain control d) Administer the prescribed 4 mg of IV push morphine e) Re-assess the pain level.

A physician has ordered a nurse to administer conscious sedation to a client. Which of the following is possible after administering conscious sedation to a client? a) client can respond verbally despite physical immobility b) client can tolerate long therapeutic surgical procedures c) client is relaxed, emotionally comfortable, and conscious d) client's consciousness level can be monitored by equipment

client is relaxed, emotionally comfortable, and conscious

a 31-year-old multigravid client at 39 weeks' gestation admitted to the hospital in active labor is receiving intravenous lactated RInger's solution and a continuous epidural anesthetic. During the first hour after administration of the anesthetic, the nurse should monitor the client for: a) hypotension b) diaphoresis c) headache d) tremors

hypotension

A patient has required frequent scheduled and breakthrough doses of opioid analgesics in the 6 days since admission to the hospital. The patient's medication regimen may necessitate which of the following interventions? a) stool softeners and increased fluid intake b) supplementary oxygen and chest physiotherapy c) calorie restriction and dietary supplements d) frequent turns and application of skin emollients

stool softeners and increased fluid intake

The expected outcome of withholding food and fluids from a client who will receive general anesthesia is to help prevent: a) constipation during the immediate postoperative period b) vomiting and possible aspiration of vomitus during surgery c) Pressure on the diaphragm with poor lung expansion during surgery d) Gas pains and distended during the immediate postoperative period

vomiting and possible aspiration of vomitus during surgery