NUR 212: Pain Review Questions

Following the initiation of a pain management plan, Pain should be reassessed and documented on a regular basis as a way to evaluate the effectiveness of treatments. Pain should be reassessed at which minimum interval? (SATA) A. With each new report of pain B. Before and after administration of narcotic analgesics C. Every 10 minutes D. Every shift

A, B

A nurse is caring for a 3-year-old child whose parents report that she has an intense fear of painful procedures, such as injections. Which of the following strategies should the nurse add to the child's plan of care? SATA A. Have a parent stay with the child during procedures B. Cluster invasive procedures whenever possible C. Perform the procedure as quickly as possible D. Allow the child to keep a toy from home with her E. Use mummy restraints during painful procedures

A, C, D

A nurse is providing information about pain control for a client who has acute pain following a subtotal gastric resection. Which of the following client statements indicates an understanding of pain control? A. "I will call for pain medication before the previous dose wears off." B. "I will call for pain medication as my pain starts to increase again" C. "I will wait for you to evaluate my pain before asking for more medication" D. "I will ask for less medication to avoid addiction"

A. "I will call for pain medication before the previous dose wears off."

A client who is using patient-controlled analgesia (PCA) is asleep. The nurse observes a family member pushing the PCA button for the sleeping client. What does the nurse say to the visitor? A. "Please allow the client to push the button when needed." B. "Please don't touch any equipment in the clients room" C. "Thank you. I am sure the client appreciated that." D. "The client is asleep and not in pain"

A. "Please allow the client to push the button when needed."

A postoperative client reports, "I have pain from a mild headache." Which PRN medication does the nurse administer? A. Acetaminophen (Tylenol) B. Hydromorphone (Dilaudid) C. Modazolam (Versed) D. Oxycodone hydrochloride/acetaminophen (Tylox)

A. Acetaminophen (Tylenol)

A nurse is caring for a client who requires cold applications with an ice bag to reduce the swelling and pain of an ankle injury. Which of the following actions should the nurse take? A. Apply the bag for 30 minutes at a time B. Reapply the bag 30 minutes after removing it C. Allow room for some air inside the bag D. Place the bag directly on the skin

A. Apply the bag for 30 minutes at a time

A nurse is caring for a 2-month old infant who is postoperative following surgical repair of a cleft lip. Which of the following actions should the nurse take? A. Encourage the parents to rock the infant B. Offer the infant a pacifier C. Administer ibuprofen as needed for pain D. Position the infant on her abdomen

A. Encourage the parents to rock the infant

A nurse is teaching a client who has fibromyalgia syndrome about measures to reduce the occurrence of symptoms. Which of the following interventions should the nurse include in the teaching? A. Establish a regular sleep pattern B. Avoid exercise during flare-ups C. Try jogging or running between flare-ups D. Increase calcium intake

A. Establish a regular sleep pattern

A postoperative client is vomiting and states, "I am having a lot of pain- about a 7 on a scale of 0-10." Which route of administration does the nurse choose to administer an analgesic to the client? A. Intravenous B. Oral C. Rectal D. Transdermal

A. Intravenous

A postoperative client is receiving epidural analgesia and reports itching. What does the nurse do next? A. Reduces the analgesic dose B. Gives diphenhydramine (Benadryl) C. Gives an antiemetic D. Calls the surgeon

A. Reduces the analgesic dose

A nurse is planning care for a client who is postoperative. Which of the following statements about pain management should the nurse consider when implementing client care? SATA A. Use of analgesics will eventually lead to addiction B. Each clients expression of pain may be different and individualized C. Patient controlled analgesia offers a constant level of opioids within therapeutic range D. Pain level and pain tolerance can be assessed using a scale from 0-10 E. The client will express the feeling of pain both verbally and nonverbally

B, C, D

A client reports increasing pain during dressing changes. Which interventions are recommended for the client? SATA A. Assistance by the client with the dressing change B. Distraction C. Epidural analgesia D. Music therapy E. Premedication F. Transcutaneous electrical nerve stimulation

B, D, E

The family of a client with chronic cancer pain says to the nurse, "Can you please reduce Dad's pain medication so that we can spend more quality time with him?" How does the nurse respond? A. "I will ask his oncologist about your question." B. "Let's ask your father about your request." C. "No, his pain relief is more important than your concerns." D. "Yes, this is a valuable way for all of you to make needed adjustments"

B. "Let's ask your father about your request."

The nurse has discussed non-pharmacological pain management measures with a patient who takes opioid medication for chronic pain. Which patient statement required further nursing teaching? A. "I can practice meditation while taking opioid medication" B. "Reading should be used in place of drug therapy" C. "Nonpharmacologic interventions can help to control pain" D. "I plan to practice relaxation breathing tonight"

B. "Reading should be used in place of drug therapy"

Which patient does the nurse recognize that would benefit most from the use of a patient controlled analgesia pump? A. 19-year-old with head injury following MVA today B. 34-year-old with ankle fracture after skiing accident yesterday C. 56-year-old with slurred speech after falling and breaking hip one week ago D. 78-year-old with delirium and fever following surgery 2 days prior

B. 34-year-old with ankle fracture after skiing accident yesterday

Stephanie is a 70-year-old retired schoolteacher who is interested in nondrug, mind-body therapies, self-management, and alternative strategies to deal with joint discomfort from rheumatoid arthritis. Which of the following options should you suggest for her plan of care, considering her expressed wishes? A. Using a stationary exercise bicycle and free weights and attending a spinning class B. Using mind-body therapies such as music therapy, distraction techniques, meditation, prayer, hypnosis, guided imagery, relaxation techniques, and pet therapy C. Drinking chamomile tea and applying icy/hot gel D. Receiving acupuncture and attending church services

B. Using mind-body therapies such as music therapy, distraction techniques, meditation, prayer, hypnosis, guided imagery, relaxation techniques, and pet therapy

A hospitalized client expresses satisfaction after using a recommended complementary and alternative medicine therapy, saying that pain was diminished and anxiety reduced. Which CAM did the client most likely use? A. Herbs B. Homeopathy C. Imagery D. Tai chi

C. Imagery

A nurse is caring for a client who is in labor. Which of the following nursing actions reflects application of the gate control theory of pain? A. Administer prescribed analgesic medication B. Encourage the client to rest between contractions C. Massage the clients back D. Turn the client onto her left side

C. Massage the clients back

When assessing a client for acute or chronic pain, what question does the nurse ask the client to obtain the most data? A. "Did someone do this to you?" B. "Does it hurt badly?" C. "Is the pain really bad?" D. "When does it hurt?"

D. "When does it hurt?"

A client with osteoarthritis pain tells the nurse, "I take two arthritis strength Tylenol (650 mg) every 8 hours." How does the nurse respond? A. "Aspirin would be a better, more effective choice for your pain relief." B. "More Tylenol is needed to provide effective pain relief for you." C. That is the appropriate does of Tylenol for your pain." D. "You will need to have routine liver and kidney function laboratory tests."

D. "You will need to have routine liver and kidney function laboratory tests"

The nurse is establishing a plan of care for a hospitalized client with chronic pain caused by fibromyalgia. Which nursing action does the nurse delegate to a nursing assistant? A. Application of a transcutaneous electrical nerve stimulation (TENS) device B. Education about nonpharmacologic interventions for pain control C. Referral to available community resources for pain management D. Engagement in conversation about the clients family to distract the client

D. Engagement in conversation about the clients family to distract the client

A nurse is assessing a client prior to the administration of morphine. The nurse should recognize that which of the following assessments is the priority? A. Pupil reaction B. Urine output C. Bowel sounds D. Respiratory rate

D. Respiratory rate

A client with cancer who is taking pain medication states, "I am still having pain." During the assessment, the client does not exhibit any physical manifestations of pain. What does the nurse do next? A. Decreases the client's standard pain medication dose B. Gives the client a placebo and monitors the outcome C. Gives the pain medication as requested D. Withholds the pain medication

C. Gives the pain medication as requested

A nurse is providing teaching to a client who is postoperative following coronary artery bypass graft (CABG) surgery and is receiving opioid medications to manage discomfort. Aside from managing pain, which of the following desired effects of medications should the nurse identify as most important for the clients recovery? A. It decreases the clients level of anxiety B. It facilitates the clients deep breathing C. It enhances the clients ability to sleep D. It reduces the clients blood pressure

B. It facilitates the clients deep breathing

A nurse is teaching a client who has a new prescription for colchicine to treat gout. Which of the following instructions should the nurse include? A. "Take this medication with food if nausea develops" B. "Monitor for muscle pain" C. "Expect to have increased bruising" D. "Increase your intake of grapefruit juice"

B. Monitor for muscle pain

A 65-year-old woman has fallen while sweeping her driveway, sustaining a tissue injury. She describes her condition as an aching, throbbing back. Which type of pain are these complaints most indicative of? A. Neuropathic Pain B. Nociceptive Pain C. Chronic Pain D. Mixed Pain Syndrome

B. Nociceptive Pain

A postoperative client is requesting medication for pain every 4 hours. In planning effective pain management, what assessment question does the nurse ask the client before administering the medication? A. "Are you bleeding?" B. "Are you able to last more than 4 hours?" C. "Is your pain controlled between doses?" D. "What do you do for pain when you're at home?"

C. "Is your pain controlled between doses?"

A nurse is providing teaching to a client who has a new diagnosis of fibromyalgia. Which of the following client statements indicates an understanding of the teaching? A. "I should increase my caffeine intake" B. "I will take my duloxetine in the morning, so I have more energy to accomplish tasks" C. "Low-impact aerobics can help reduce episodes of pain" D. "A course of chemotherapy treatment should provide a cure"

C. "Low-impact aerobics can help reduce episodes of pain"

A newly admitted client who was in an automobile accident has a concussion and is reporting pain from a fractured femur and broken fingers. Which staff member does the charge nurse on the orthopedic unit assign to care for this client? A. An experienced RN travel nurse who arrived on the unit this morning B. An LPN/LVN who has worked on the orthopedic unit for 6 years C. The neurology unit RN who has floated to the orthopedic unit D. The RN orthopedic case manager who is responsible for discharge planning

C. The neurology RN who has floated to the orthopedic unit

A client with cancer is receiving low dose oral morphine but is reporting both "sharp, tingly" pain and constipation. What intervention does the nurse implement first? A. Administers ordered docusate sodium (Colace) and gabapentin (Neurontin) B. Decreases the morphine (morphine sulfate) dosage for the client C. Gives the client a fleets (sodium bicarbonate) enema D. Records the clients bowel movement

A. Administers ordered docusate sodium (Colace) and gabapentin (Neurontin)

A client being discharged after hip replacement says, "I am going to use hypnosis instead of medication to manage my pain. I believe in mind over body." How does the nurse respond? A. "I will discuss cancelling your medication order with your provider." B. "That sounds like a great plan; can you tell me more about it?" C. "That sounds like a wonderful idea; and I think it will definitely work!" D. "Your plan will not work; people with your type of pain need narcotics."

B. "That sounds like a great plan; can you tell me more about it?"

A client with chronic pain feels no relief with high-dose opioids and says, "I just can't manage living right now." What intervention does the nurse anticipate the health care provider will order for this client? A. Adding acetaminophen (Tylenol) B. Adding duloxetine (Cymbalta) as adjuvant therapy C. Increasing the opioid dose to control the pain D. Replacing the opioid with desipramine (Norpramin) for depression

B. Adding duloxetine (Cymbalta) as adjuvant therapy

A nurse is caring for a client who has a herniated lumbar disc and reports pain. The nurse should assist the client into which of the following positions to help reduce the pain? A. Prone with her arms raised above her head B. Semi-Fowler's with a pillow under her knees C. Supine with her arms elevated on pillows D. Supine with the head of the bed elevated to 15 degrees

B. Semi-Fowler's with a pillow under her knees

A nurse is planning care for a 2-month-old infant following a surgical procedure. Which of the following pain rating scales should the nurse plan to use to determine the infants level of pain? A. FACES Scale B. OUCHER Scale C. FLACC Scale D. PANAD Scale

C. FLACC Scale

A hospitalized client anticipates a daily painful dressing change. Which complementary and alternative medicine therapy might the nurse offer before the procedure? A. Animal-assisted therapy B. Hydrotherapy C. Imagery D. Acupuncture

C. Imagery

A client with extensive burn injuries is to be weaned from long-term opioid use. What type of opioid dependence does the nurse expect this client to have? A. Addiction B. Tolerance C. Physical dependence D. Pseudoaddiction

C. Physical dependence

The nurse manager for an oncology unit is evaluating a newly hired staff nurse. Which action by the nurse is of greatest concern to the nurse manager? A. Asking a client with chest pain if the pain is sharp and stabbing B. Instructing a confused postoperative client about how to use patient controlled analgesia C. Preparing to administer a placebo to a client with chronic low back pain D. Requesting that a client with chronic pain describe the specific location of the pain

C. Preparing to administer a placebo to a client with chronic low back pain

The patient is receiving the first oral dose of an opioid analgesic for chronic pain. Which additional drug does the nurse anticipate will be prescribed? A. NSAID B. Epidural C. Stool softener D. Anti-anxiety agent

C. Stool softener

Which of the following is a priority for a nurse to include in a teaching plan for a patient who desires self-management and alternative strategies? A. Body alignment and superficial heat and cooling B. Patient-controlled analgesia (PCA) pump C. Neurostimulation D. Peripheral nerve blocks

A. Body alignment and superficial heat and cooling

A nurse is assessing a client 15 minutes after administering morphine sulfate 2 mg via IV push. The nurse should identify which of the following findings as an adverse effect of this medication? A. Sleepy, but arousing when her name is called B. Respiratory rate 8/min C. Pain level of 6 on a scale from 0-10 D. SaO2 94%

B. Respiratory rate 8/min

The nurse is planning a dressing change on a postoperative mastectomy client. The client is receiving acetaminophen and oxycodone (Percocet) orally for pain every 4 hours and is due to receive them at 4:00 p.m. When will the nurse change the dressing? A. 3:30 p.m. B. 4:00 p.m. C. 4:30 p.m. D. 7:00 p.m.

C. 4:30 p.m.

Which client does the RN arriving for duty assess first? A. A 27 year old who has chronic severe back pain with movement B. A 51 year old with lung cancer who reports pain "whenever I cough" C. A 56 year old with acute pancreatitis who reports increasing abdominal pain D. A 63 year old who reports ongoing pain associated with rheumatoid arthritis

C. A 56 year old with acute pancreatitis who reports increasing abdominal pain

In the role of the client advocate, what does the nurse do first for a client who reports pain? A. Administers pain medication B. Assesses the level of pain C. Believes the clients report of pain D. Calls the provider for a medication order

C. Believes the clients report of pain

Which activity does the RN team leader on a large medical-surgical unit assign to the LPN/LVN? A. Assessment of a client scheduled for surgery who is crying and expressing fear that the pain will be intolerable B. Assessment of a client using a transcutaneous electrical nerve stimulation unit to relieve chronic pain C. Complex dressing changes for a sacral wound for a client with type 2 diabetes who was given prescriptions for pain medication before wound care D. Instructions to a postoperative hip replacement client who has just been placed on patient controlled analgesia for pain relief

C. Complex dressing changes for a sacral wound for a client with type 2 diabetes who was given prescriptions for pain medication before wound care

A nurse is caring for a client who requests pain prescription pain medication. Which of the following actions should the nurse perform first? A. Reposition the client B. Administer the medication C. Determine the location of the pain D. Review the effects of the pain medication

C. Determine the location of the pain

The nurse is caring for a client who had a fractured ankle repaired. Twenty minutes after receiving 1.5 mg of hydromorphone (Dilaudid) IV push, the client is slow to respond and has constricted pupils and a respiratory rate of 6 breaths/min. What action does the nurse take initially? A. Calls the care provider for a change in the medication order B. Changes the order to every 6 hours rather than every 4 hours C. Gives the client a dose of naloxone (Narcan) 0.4 mg IV D. Performs cognitive assessment on the client

C. Gives the client a dose of naloxone (Narcan) 0.4 mg IV

The nurse is preparing a client for home care pain management following discharge. Which intervention does the nurse implement? A. Discuss pain-relieving strategies on the day of discharge B. Discuss home care with only the clients family, not with the client C. Offer flexibility in home management of the clients current regimen D. Offer information about end-of-life pain control management

C. Offer flexibility in home management of the clients current regimen

Which statements true about assessing pain in an older adult client? A. The nurse should assess for present and past pain B. Older adults typically believe that expressing pain is acceptable C. Older adults are at great risk for undertreated Pain D. Older adults usually believe that pain signifies a minor illness

C. Older adults are at great risk for undertreated Pain

During change of shift report, the day shift staff learns that a client who had back surgery has been reporting increasing lower back pain during the night. It is most appropriate for which day staff member to assess the clients pain? A. LPN/LVN who is responsible for administering medications to the client B. RN nurse manager who is in charge of coordinating care for several units C. RN team leader who is responsible for updating the care plan for the client D. RN who has floated to the unit from the emergency department

C. RN team leader who is responsible for updating the care plan for the client

Postoperative surgical patients should be given alternating doses of acetaminophen and which medication throughout the postoperative course, unless contraindicated? A. Antihistamine B. Local anesthetic C. Opioids D. Nonsteroidal anti-inflammatory drug (NSAID)

D. Nonsteroidal antiinflammatory drugs

A hospice nurse is caring for a client who has terminal cancer and takes PO morphine for pain relief. The client reports that he had to increase the dose of morphine this week to obtain pain relief. Which of the following scenarios should the nurse document as the explanation for this situation? A. The client not been taking the medication properly B. The client is experiencing episodes of confusion C. The client has become addicted to the meditation D. The client developed a tolerance to the medication

D. The client developed a tolerance to the medication

A nurse is reviewing the medication administration records of four clients who have a prescription for morphine PRN. Which of the following findings should the nurse identify as a contraindication to this medication? A. The client is experiencing a myocardial infarction B. The client who is 24hr postoperative following hip arthrolasty C. The client who has bronchitis pleurisy D. The client who has paralytic ileus

D. The client who has paralytic ileus

The nurse manager on the surgical unit is making assignments for the day. Who is assigned to check and program the patient controlled analgesia (PCA) pumps on the unit? A. A pharmacy technician B. One registered nurse (RN) and a licensed practical/vocational nurse (OPN/LVN)(LPN/LVN) C. One registered nurse (RN) and a certified nursing assistant (CNA) D. Two registered nurses (RN's)

D. Two registered nurses (RN's)

A client had a hip replacement 2 days ago and reports having a moderate amount of pain, stating that it is "a 7 on a 0-to-10 scale" of intensity. What intervention has the highest priority in the client's nursing care plan? A. Encouraging diversional activities B. Incorporating activities of daily living as soon as possible C. Teaching key points of the relaxation response D. Using preemptive analgesia

D. Using preemptive analgesia