Chapter 18

Which of the following pain sensations are associated with neuropathic pain? (Select all that apply.) a. Infection b. Obstruction c. Inflammation d. Postamputation

D

Each of the following is a pharmacologic intervention for pain except which one? a. Acupuncture treatments b. Adjuvant therapy c. Lidocaine patch d. Capsaicin

A

Which conditions are likely to cause an older adult chronic pain? (Select all that apply.) a. Hip replacement b. Bone metastasis c. Hypoproteinemia d. Migraine headache e. Compression fracture f. Postherpetic neuralgia

B, E, F

An older aphasic client has severe osteoarthritis, bilateral contractures of the lower extremities, and a stage IV pressure ulcer. The nurse practitioner prescribes analgesic medications to be administered around the clock, with as-needed doses to be administered as appropriate. What observation by the nurse would indicate that the pain regimen is effective? (Select all that apply.) a. The client slept throughout the night. b. The client winces only when turned and repositioned. c. The client slept during dressing change. d. The client cooperative during morning care. e. The client ate 80% of breakfast, 70% of lunch, and 100% of dinner.

A, C, D, E

Which of the following statements are true about pain in older adults? (Select all that apply.) a. Pain is not a normal aging process. b. Pain sensitivity decreases with age. c. If patients do not complain, they do not have pain. d. Opioid analgesics are often the best treatment for persistent pain.

A, D

An older adult admitted for back surgery asks for opioid pain medication. The nurse knows the patient asks for pain medication 15 minutes before it is due. Which recommendation should the nurse implement? a. Validate the pain with other assessment data. b. Administer the pain medication as requested by the patient. c. Tell the patient that it is too soon for pain medication. d. Teach the patient alternative comfort measures.

B

The nurse uses comfort measures to enhance an older adult's pharmacologic pain management. Which of the following would be most helpful for the nurse to use to identify the relationships between the comfort measures, activity, and pharmacotherapy, and the older adult's pain level? a. Older adult's self-report b. Older adult's pain diary c. Faces Pain Scale-revised (FPS-R) d. Pain medication frequency

B

When educating a client on the use of an adjuvant medication, which statement best demonstrates the nurse's understanding of this therapy? a. "These medications are used instead of opioids to decrease the likelihood of addiction." b. "Adjuvant medications are prescribed because they seldom cause any significant side effects." c. "These types of medications are used to eliminate the side effects of opioid medications." d. "These drugs are used in combination with analgesics to increase the effect of the analgesics."

D

An older woman had hip replacement surgery 1 day ago, and the nurse thinks that the woman also has dementia. Which patient assessment does the nurse use to determine whether this woman is experiencing pain? a. Holds her abdomen tightly b. Has stable vital signs c. Is not verbalizing d. Moves during sleep

A

The nurse admits an older man who had abdominal surgery. Admission vital signs are heart rate (pulse) (P), 73 beats/min; respiration rate (R), 20 breaths/min; and blood pressure (BP), 136/84 mm Hg. He is receiving intravenous (IV) fluids but has not requested pain medication since surgery. Seven hours later, his vital signs are P, 98 beats/min; R, 26 breaths/min; and BP, 164/90 mm Hg, and he denies pain. Which intervention should the nurse implement? a. Administer an opioid medication by IV route. b. Check the surgical dressing for bleeding. c. Report the vital signs to the health care provider. d. Ask if he has about discomfort at the surgical site or any other location.

D

Which of the following statements is true about analgesic medications for older adults? a. Opioids are less effective in older patients than in younger patients. b. Stool softeners and laxatives should be used with opioids. c. Over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs) are generally harmless. d. The dose limit for acetaminophen is difficult to reach for older adults.

B

A nurse is caring for an older adult with cognitive impairment who recently had hip surgery. The nurse assesses the client for pain. The nurse would suspect that the client is in pain when the client demonstrates which of the following? (Select all that apply.) a. The client ate all of her meals. b. The client pushes caregivers away when they attempt to change the dressing on her hip. c. The client rocks back and forth repetitively when sitting in a chair. d. The client sleeps soundly throughout the night. e. The client cries out repeatedly when anyone approaches her.

B, C, E

An older client who was recently admitted to the subacute setting after having a knee replacement, is very anxious and refuses to get out of bed, stating that it is too painful. Which intervention will the nurse implement? a. Share with the patient that it's important to get out of bed and that there is pain medication available if it does hurt. b. Use the Hoyer lift to get her out of bed so that the knee will not experience much movement and so there will be little pain. c. Offer pain medication, administer the medication, and wait 20 minutes before getting her out of bed. d. Allow the patient to remain in bed but share that getting up will be required at least twice a day starting the next morning.

C

The older adult is at a higher risk for acute psychological pain than a younger adult because older adults a. have many illnesses. b. possess fewer assets. c. experience more loss. d. live with impairments.

C

An older Hispanic man states that he is not having pain, but he had knee replacement surgery 2 days ago. Which is the best pain assessment tool as recommended by the Hartford Institute for Geriatric Nursing (HIGN) from "Try This" for the nurse to apply for this man? a. Numeric Rating Scale b. Verbal Descriptor Scale c. Iowa Pain Thermometer d. Faces Pain Scale-revised (FPS-R)

D

Compared with acute pain, which of the following statements is true of persistent pain? a. Leads to significantly altered vital signs b. Is usually described as a burning pain c. Is generally gone within 4 months d. Can bring about long-term changes in lifestyle

D

The nurse administers an opioid analgesic to an older male postoperative patient in the surgical unit. Which is the most important intervention for the nurse to implement before leaving the patient's room? a. Place all side rails up. b. Position the patient comfortably. c. Offer toileting and a sip of water. d. Instruct him to ask for help before getting up.

D