Exam 1 - Pain

The home health nurse is developing a plan of care for a patient who will be managing his chronic pain at home. Using the nursing process, which concepts should the nurse focus the patient teaching on? a) Self-care and safety b) Autonomy and need c) Health promotion and exercise d) Dependence and health

a) Self-care and safety

Which of the following is a true statement with regards to the nursing process of pain control? a) Formulate treatment plans based on behaviors. b) Nonverbal expressions of pain are reliable indicators of the quality of pain. c) The use of physiologic signs to indicate pain is unreliable. d) Usually all patients exhibit the same pain behaviors.

c) The use of physiologic signs to indicate pain is unreliable.

The client is postoperative for a total hip arthroplasty and denies pain when asked by the nurse. The client remains still in the bed and refuses to move. She finally reports feeling pressure at the site upon continued questioning by the nurse. The best nursing intervention is to a) Wait to medicate the client until the client reports pain. b) Use a 0 to 10 numeric pain intensity scale to measure pain. c) Re-educate the client to use the word pain instead of pressure. d) Use the term "pressure" when asking the client about pain.

d) Use the term "pressure" when asking the client about pain.

Choice Multiple question - Select all answer choices that apply. The client reports chest pain. The nurse uses which of the following questions to assess the pain further. Select all answers that apply. a) "Please point to where you are experiencing pain." b) "Rate the pain on a scale of 0 to 10, with 10 being the worst possible pain." c) "How long have you experienced this pain?" d) "You've never had this pain before, have you?" e) "What aggravates your chest pain?"

a) "Please point to where you are experiencing pain." b) "Rate the pain on a scale of 0 to 10, with 10 being the worst possible pain." c) "How long have you experienced this pain?" e) "What aggravates your chest pain?"

A client with end-stage dementia is admitted to the orthopedic unit after undergoing internal fixation of the right hip. How should the nurse manage the client's postoperative pain? a) Administer analgesics around the clock. b) Administer oral opioids as needed. c) Administer pain medication through a transdermal patch. d) Provide patient-controlled analgesia.

a) Administer analgesics around the clock.

The nurse is caring for a patient with chronic fatigue and poorly controlled back pain. What would the nurse know to assess for other than pain in this patient? a) Depression b) The need for a placebo c) Potential contractures d) Sleep-pattern disturbances

a) Depression

An older adult is being treated with opioids for pain relief. Which of the following should the nurse strongly recommend to this client? a) Follow a bowel regimen. b) Reduce fiber intake. c) Exercise regularly. d) Avoid harsh sunlight.

a) Follow a bowel regimen.

Owen Li, a 59-year-old male, has returned from his hip repair surgery with a PCA to effectively control his post-op pain. What extra steps must you take to ensure he doesn't overdose on narcotic analgesia? a) None b) Assess client every hour c) Assess client every 15 minutes d) Assess client every half hour

a) None

You are caring for a patient with sickle cell disease in her home. Over the years, there has been joint damage, and the patient is in chronic pain. The patient has developed a tolerance to pain medication. When does the tolerance to pain medication become a problem? a) When delivering or administering the medication b) When dealing with the withdrawal symptoms from the tolerance c) When having to report the patient's addiction to her physician d) When the family becomes concerned about increasing dosage

a) When delivering or administering the medication

A teenage client is undergoing a dressing change to burns on the thigh. The client refuses pain medication and states, "I do not hurt, and I don't need it." He is withdrawn, grimaces, and turns away during the dressing change. He was last medicated 8 hours ago. The best statement by the nurse is a) "You are so brave to not take your pain medication when the dressing change will hurt." b) "If you need pain relief, I can give you some medication when I have completed the dressing change." c) "Please explain why you say you do not hurt when I see you grimacing during the dressing change." d) "You are so right to not take your pain medication. You can become dependent on the medication."

c) "Please explain why you say you do not hurt when I see you grimacing during the dressing change."

You are assessing an 86-year-old postoperative patient who is very stoic. When you enter the room, the patient is curled into the fetal position, and he is moaning. His vital signs are elevated and he is perspiring. You ask the patient what his pain level is on a zero-to-ten scale that you did patient education on with this patient prior to surgery. The patient indicates a pain level of two to three. You review your pain-management orders and find that all medications are ordered PRN. How would you treat this patient's pain? a) Treat the clinical symptoms you see b) Call the physician for new orders because it is obvious that the pain medicine is not working c) Believe what the patient says d) Ask the family what they think and treat accordingly

c) Believe what the patient says

Regarding tolerance and addiction, the nurse understands that a) tolerance to opioids is uncommon. b) the nurse must be primarily concerned about development of addiction by the patient in pain. c) addiction to opioids commonly develops. d) although patients may need increasing levels of opioids, they are not addicted.

d) although patients may need increasing levels of opioids, they are not addicted.

The mother of a cancer patient comes to the nurse concerned with her daughter's safety; the morphine dose she needs to control her pain is getting "higher and higher." The mother is afraid that her daughter will overdose. The nurse educates the mother to the fact that a) the dose range is higher with cancer patients, and the medical team will be very careful to prevent addiction. b) frequently, women need higher doses of morphine to be comfortable. c) cancer is a terminal illness that requires higher doses of narcotics. d) there is no maximum opioid dose, and her daughter is just becoming more tolerant to the drug.

d) there is no maximum opioid dose, and her daughter is just becoming more tolerant to the drug.

Which medication should be readily available for patients receiving epidural opioids who are experiencing respiratory depression? a) Ibuprofen b) Diphenhydramine c) Aspirin d) Naloxone

d) Naloxone

An elderly client has a fractured hip and is in Buck's traction. The client is disoriented and cannot express herself. At 0730 the client was calm. Now, at 0930, the client is restless and agitated. The nurse reviews the medication administration record. The last dose of opioid was at 0330. The nurse assesses the client's agitation may be from a) Effects of the opioid medication b) Diminished pain perception c) Increased uptake of opioids d) Recurring pain

d) Recurring pain

Which of the following is the most important potential nursing diagnosis for the client receiving opiate therapy? a) Altered mobility b) Diarrhea c) Risk for injury d) Risk for impaired gas exchange

d) Risk for impaired gas exchange

Choice Multiple question - Select all answer choices that apply. The nurse administered an analgesic to a client who was reporting pain. The medication is ordered as needed every 3 hours. Forty minutes later the client states he has had little relief. The nurse does all of the following: a) evaluates the pain level using the established pain scale b) states, "I can administer the medication to you in about 2 hours" c) assesses respirations, pulse, and blood pressure d) consults with the healthcare provider about the client's report e) plans to place the client in a position of comfort when pain is relieved

a) evaluates the pain level using the established pain scale c) assesses respirations, pulse, and blood pressure d) consults with the healthcare provider about the client's report

Which of the following is important when addressing client pain? a) Schedule analgesics as needed. b) Never doubt the need for pain relief. c) Use alternative therapies sparingly. d) Avoid the use of a patient-controlled analgesia pump.

b) Never doubt the need for pain relief.

The nurse is visiting a client at home with intractable cancer pain. The client has a transdermal fentanyl patch on her right chest area. It is most important for the nurse to a) Assess for the date of the client's last bowel movement. b) Remove the heating pad present on the chest area. c) Instruct the client to note fatigue or extreme sleepiness. d) Inform the client about use of alcohol with fentanyl.

b) Remove the heating pad present on the chest area.

Which of the following is a true statement with regards to the preventative approach to the use of analgesics? a) The use increases peaks and troughs in the serum level. b) Smaller doses of medication are needed. c) It promotes tolerance to analgesic agents d) Larger doses of medication are needed.

b) Smaller doses of medication are needed.