NURS 221 - Quiz #6 Pain Management

Which adjuvant drug relieves pain caused by inflammation and bone metastasis? 1. Corticosteroids 2. Antidepressants 3. Opioid analgesics 4. Nonsteroidal antiinflammatory drugs

1. Corticosteroids Corticosteroids relieve pain caused by inflammation and bone metastasis. Antidepressants relieve neuropathic pain. Opioid analgesics and non steroidal anti inflammatory drugs are used in acute and chronic pain management and are not adjuvant drugs.

what is does adjuvant mean?

A substance that helps and enhances the effect of a drug, treatment, or biologic system.

The nurse is teaching a group of caregivers about the concept of pain in older adults. Which information would the nurse include? (SATA) A. Older patients underreport pain B. Sleeping indicates pain relief C. Opioids are safe to use in older patients D. Older adults tend to perceive more pain E. Older adults with cognitive impairment do not experience less pain.

A, C, E

A registered nurse is teaching a nursing student about using non steroidal anti inflammatory drugs (NSAIDs) for pain management. Which statement by the students indicates a need for further teaching? A. "NSAIDS work by depressing the central nervous system." B. "NSAIDS act by inhibiting the synthesis of prostaglandins." C. "Patients allergic to aspirin are more likely to be allergic to other NSAIDs." D. "use of NSAIDS in older adults may result in increased risk of adverse events."

A. "NSAIDs work by depressing the central nervous system." Opioids, not NSAIDS, depress the central nervous system.

The nursing instructor asks the student nurse to differentiate between A-delta and C peripheral nerve fibers. Which statement by the student nurse indicates effective learning? A. "The A-delta fibers are myelinated, and the C fibers are unmyelinated." B. "The A-delta fibers are smaller in diameter, and the C fibers are larger in diameter." C. "The A-delta fibers transmit signals slowly, and the C fibers transmit signals rapidly." D. "The A-delta fibers cause a diffuse sensation, and the C fibers cause localized sensation."

A. "The A-delta fibers are myelinated, and the C fibers are unmyelinated." The A-delta fibers are myelinated, whereas the C fibers are myelinated. The A-delta fibers are larger in diameter, whereas the C fibers are smaller in diameter. Because A-delta fibers are larger in diameter, they transmit signals to the central nervous system more rapidly than the smaller C fibers do. The sensations caused by the stimulation of the A-delta fibers are localized, whereas the sensations caused by the stimulation of the C fibers are diffuse.

A patient has had surgery to remove a buildup of septic fluid from an arthritic knee. Postoperatively, the patient received morphine through a patient - controlled analgesia (PCA) device for the management of pain. Which statement describes an advantage of PCA that the nurse would teach the patient? A. PCA allows self-administration of analgesics B. PCA is associated with a risk of overdose C. PCA does not allow administration of opioids D. PCA allows intramuscular administration of medications

A. PCA allows self-administration of analgesics PCA allows the patient to self-administer analgesic medication whenever needed. There is no risk of overdosage as a result of the programming.

A group of nursing students is learning about nociceptive and neuropathic pain. What is an example of neuropathic pain? (SATA) A. Aching muscles B. Diabetic neuropathy C. Trigeminal neuralgia D. Nerve root compression E. Throbbing pain at knee joint

B, C, D Neuropathic pain arises when there is abnormal processing of sensory input by the peripheral or central nervous system. Pain felt along the distribution of many peripheral nerves as in diabetic neuropathy is neuropathic pain.

The nurse is teaching a group of nursing students about concepts of pain in infants. Which information would the nurse including in the teaching? (SATA) A. Infants cannot express pain B. Absorption of drugs is faster than expected C. Infants are less sensitive to pain than adults are D. Preterm neonates have greater sensitivity to pain than older children do E. Assessment of pain involves behavioral cues and physiological indicators

B, D, E Absorption of drugs in infants is faster than expected. The drugs that are excreted by the kidneys should be administered in a lower dosage. Preterm neonates have greater sensitivity than term neonates or older children. Using behavioral cues such as facial expressions and physiological indicators such as changes in VS provide proper assessment of pain.

The registered nurse is teaching a nursing student about applying transcutaneous electrical nerve stimulation (TENS) to a patient. Which statement by the student indicates a need for further teaching? (SATA) A. "I should set the frequency to no more than 50 Hz." B. "I should use TENS on patients who have chronic cancer pain." C. "I should place TENS electrodes directly over or near the site of pain." D. "I should apply hair or skin preparations before placing TENS electrodes." E. "I should remove TENS electrodes if the patient feels a buzzing or tingling sensation."

B, D, E TENS is effective in treating acute, emergent, and postsurgical and procedural pain control, but not chronic conditions like cancer pain. The TENS electrodes should be placed directly over or near the site of pain

A health care provider recommends ibuprofen to a patient in pain. Which statement about this medication is correct? (SATA) A. It depresses the central nervous system to relieve pain B. It acts by inhibiting the synthesis of prostaglandins C. It is highly recommended for older adults experiencing pain D. It is the most effective prescription drug available for pain relief E. One of its serious side effects is gastrointestinal bleeding

B, E NSAIDS, such as ibuprofen, act by inhibiting prostaglandin synthesis, thereby inhibiting cellular response to inflammation and thus reducing pain. Gastrointenstinal bleeding is a major adverse effects of NSAIDs. Opiates, not NSAIDs, depress the central nervous system to relieve pain.

which type of pain-management therapy is preferred for relieving chronic cancer pain? A. Local anesthesia B. Topical analgesic C. Epidural analgesia D. Perineural local anesthetic infusion

C. Epidural analgesia

What is referred pain? A. It is a pain that occurs sporadically over time B. It is a moderate pain that occurs constantly for ore than 6 months C. It is a pain that is sensed at a site away from its actual origin or pathology D. It is a neuropathic pain that is generally caused after cancer or a tumor

C. It is a pain that is sensed at a site away from its actual origin or pathology

A student nurse is reading about the mode of action of non-steroidal anti-inflammatory drugs (NSAIDs). NSAIDs decrease the level of a chemical that is known to increase pain sensitivity. Which chemical do NSAIDs react with? A. Renin B. Serotonin C. Prostaglandin D. Diclofenac sodium

C. Prostaglandin

The physician tells the nurse to administer a second drug to a patient already on oxycodone. Which drug would be safe for this patient? A. Fentanyl B. Morphine C. Codeine D. Acetaminophen

D. Acetaminophen acetaminophen is safe to use in combination with opioids like oxycodone for pain relief.

The nurse is assessing a patient who has sustained severe injuries in a motor vehicle accident. The patient is in severe pain and is diaphoretic. On assessment, the patient's heart rate is increased, pupils are dilated, and blood pressure is decreased. Which finding is caused by the stimulation of the parasympathetic nervous system? A. Diaphoresis B. Dilation of pupils C. Increased heart rate D. Decrease in blood pressure

D. Decrease in blood pressure Superficial pain or mild-to-moderate pain stimulates the sympathetic nervous system. The parasympathetic nervous system is stimulated by continuous, deep, or severe pain involving visceral (internal) organs

Which statement is true regarding opiates for pain management? A. Morphine is available only for oral administration B. Hydrocodone is only available intravenously C. Oxycodone is available for both oral and intravenous administration D. Hydromorphone is available for both oral and intravenous administration

D. Hydromorphone is available for both oral and IV administration All remaining are wrong. Morphine is also available both orally and intravenously. Hydrocodone and oxycodone are available only for oral administration

The nurse administers 250 mg of acetaminophen along with 5 mg of hydrocodone to a patient in pain. Why is acetaminophen part of this protocol? A. To reduce the risk of hepatotoxicity B. To prevent the risk of oversedation C. To prevent the occurrence of respiratory depression D. To decrease the dose of opioid required for pain control

D. To decrease the dose of opioid required for pain control Administration of acetaminophen will reduce the dose of opioid drug required to achieve maximum pain relief.

what is acute pain?

Pain that results from an active injury, has a rapid onset and short durationm and subsides when the injury is healed (e.g. Trauma, surgery, labor, acute disease)

The nurse is reviewing the clinical data of four patients who are on pain management therapy. Which patient is at the HIGHEST risk of renal insufficiency? Patient A - Fentanyl Patient B - Ibuprofen Patient C - Acetaminophen Patient D - Hydromorphone

Patient B - ibuprofen Renal insufficiency is a common side effect of nonsteroidal ant inflammatory drugs (NSAIDS). Ibuprofen is an NSAID, so patient B is at the highest risk of renal insufficiency.

What is a pain that occurs sporadically over time?

chronic episodic pain

What is a moderate pain that occurs constantly for more than 6 months?

chronic/persistent noncancerous pain

A cancer pain is known as _______ and is generally caused after cancer or a tumor

neuropathic pain