Assessment Related to Pain

A nurse is taking care of a 3-month-old infant who recently had abdominal surgery. The nurse is concerned that the patient may be in pain. Which action made by the nurse indicates proper knowledge of pain assessment?

Using the Neonatal Infant Pain Scale The Neonatal Infant Pain Scale is recommended for children under the age of 1.

A patient with diabetes is being seen in the emergency department for a broken arm. He states that he is in a lot of pain. The nurse understands that pain could have which effect on the patient's blood sugar?

Increased blood sugar Increased blood sugar is likely to be found in a patient with diabetes who is experiencing pain. Blood sugar would increase due to the body's ineffective use of glucose during pain and stress.

The nurse completed a pain assessment on a 16-year-old teen that was hospitalized post-op for open-heart surgery. The patient describes the pain as "constant aching" and is rated 8 on the 0-10 pain scale. Which action made by the nurse indicates proper understanding of pain assessment?

Looking in the patient's chart for pain medication that was ordered, and obtaining an order for pain medication from the provider if none has been prescribed This patient is in severe pain and needs medication. Most likely, the patient would have pain medication ordered in the chart. However, if the medication order is not there, then an order should be obtained from the provider.

A nurse is caring for a patient with kidney stones. The nurse asks the patient to describe the pain on a scale of 0-10.The patient rates the pain a 5. How would the nurse classify this pain?

Moderate pain Moderate pain correlates to a self-reported pain number from 4-7. So, a rating of 5 on the scale is considered moderate pain.

The nurse is working in an urgent care office. A patient comes in with a possible broken ankle, experiencing a lot of pain. The nurse obtains his vital signs and watches him grimace every time his foot is moved. The ankle is edematous. When asked, the patient says his pain is a 9 out of a 10-point scale. The nurse understands that which piece of information is considered subjective data?

Pain scale 9 out of 10 The pain scale of 9 out of 10 is a subjective piece of data. There is not direct way to obtain this information; the patient determines what number he is on the pain scale.

A nurse is caring for a patient with a burn. When conducting the pain assessment, which action should the nurse perform first?

Take the patient's vital signs. The first step in performing a pain assessment is to obtain the patient's vital signs.

A nurse is caring for a patient on the oncology floor. The nurse understands that which observation indicates the patient is in pain?

The patient's urine output has decreased from its normal baseline. Decreased urine output is an indicator of pain. The release of certain hormones in response to pain causes urine output to decrease.

A new nurse is trying to do a pain assessment. The charge nurse reminds the new nurse to use SOCRATES. The new nurse understands that the "T" in SOCRATES stands for what?

Time course The "T" in SOCRATES stands for time course, which has to do with determining whether there is a pattern of the pain, such as if the pain occurs after a specific activity or after meals.

A nurse is assessing pain in a 4-year-old patient who has a femur fracture. Which pain assessment tool would be recommended for this patient?

Universal Pain Assessment Tool The Universal Pain Assessment Tool is a combination of the Verbal Descriptor Scale, Wong-Baker Facial Grimace Scale, and Activity Tolerance Scale, and all three of these tools can be used for children. The Wong-Baker Facial Grimace Scale is most appropriate for a 4-year-old child.

The nurse is talking to a 50-year-old patient about his chronic back pain. Which questions would be appropriate for the nurse to ask?

"Have you had similar pain in the past?" "Have you had similar pain in the past?" is an appropriate question for the nurse to ask. This lets the nurse know more about the recurrence of the pain. "What are your past experiences with pain?" "What are your past experiences with pain?" is an appropriate question for the nurse to ask. This lets the nurse know more about how the patient has experienced similar or different types of pain. "What do you use to deal with your discomfort?" "What do you use to deal with your discomfort?" is an appropriate question for the nurse to ask, in addition to all of the SOCRATES questions. This question provides insight for the nurse as to the patient's coping skills. "What effect does the pain have on your activities of daily living?" "What effect does the pain have on you activities of daily living?" is an appropriate question for the nurse to ask. This lets the nurse learn how the patient is able to deal with routine activities and self care.

A nurse is talking with a patient regarding the patient's pain. The nurse performed the SOCRATES set of questions. The nurse understands that which additional question would be relevant to the pain assessment?

"What are your past pain experiences?" Asking about past pain experiences provides a more thorough understanding of the patient's pain, as this question is not part of the SOCRATES assessment.

The nurse is teaching a patient's family about the effects of pain. Which statement made by the nurse indicates proper teaching?

"When a patient is in chronic pain, the parasympathetic nervous system responds." "When a patient is in chronic pain, the parasympathetic nervous system responds" indicates proper teaching. When a patient is in chronic pain, the parasympathetic nervous system responds, causing responses such as decreased heart rate and blood pressure.

A nurse is performing a pain assessment on a patient who is complaining of chest pain. The nurse understands that which question is appropriate to ask the patient?

"Where is the pain located?" "Where is the pain located?" is the "S" in SOCRATES and is related to the pain assessment, so this would be an appropriate question to ask the patient.

A nurse is performing a pain assessment for a trauma patient. Which questions should the nurse include in the pain assessment?

"Where is the pain located?" Part of the pain assessment is finding out the location of the pain from the patient. "Does the pain radiate anywhere?" Part of the pain assessment is finding out if the pain radiates anywhere. "What makes the pain worse or better?" Part of the pain assessment is finding out what makes the pain better or worse.

The nurse is describing effects of pain to a patient who is getting ready for surgery. Which statement made by the nurse indicates proper understanding of the effects of pain?

"You may experience increased blood pressure." "You may experience increased blood pressure" is an appropriate statement made by the nurse. When a patient experiences pain, blood pressure will rise.