Question 1

The nurse caring for a patient who has a patient-controlled analgesia (PCA)knows that it

Accepted Answer

A)  allows the family to participate in pain management for the patient. 
B)  prevents mistakes in medication administration. 
C)  can be used by all hospitalized patients. 
D)  provides a more constant level of medication. 
A)  allows the family to participate in pain management for the patient. 
B)  prevents mistakes in medication administration. 
C)  can be used by all hospitalized patients. 
D)  provides a more constant level of medication. D

Question 2

While reviewing a patient's medication history,the nurse determines that intraspinal analgesia is contraindicated as a result of

Accepted Answer

A)  previous spinal anaesthesia. 
B)  recent administration of anticoagulants. 
C)  a history of cardiac problems. 
D)  a diagnosis of advanced cancer. 
A)  previous spinal anaesthesia. 
B)  recent administration of anticoagulants. 
C)  a history of cardiac problems. 
D)  a diagnosis of advanced cancer. B

Question 3

A nurse checks the continuous intravenous (IV)infusion for the intraspinal analgesia.The IV setup should be changed if

Accepted Answer

A)  tubing with a Y-port is attached. 
B)  an infusion pump is attached. 
C)  the tubing connections are all taped. 
D)  a diluted,preservative-free medication is used. 
A)  tubing with a Y-port is attached. 
B)  an infusion pump is attached. 
C)  the tubing connections are all taped. 
D)  a diluted,preservative-free medication is used. A

Question 4

Catheter migration into the______________ can produce dangerously high medication levels.Only physicians and nurse anaesthetists administer medications in this space.

Accepted Answer

A)  subdural space 
B)  dural space 
C)  subarachnoid space 
D)  epidural space 
A)  subdural space 
B)  dural space 
C)  subarachnoid space 
D)  epidural space

Question 5

__________________ is an interactive method of pain management that permits patient control over pain through self-administration of analgesics.

Accepted Answer

A)  Around-the-clock analgesia 
B)  Transcutaneous analgesia 
C)  Epidural analgesia 
D)  Patient-controlled analgesia (PC
A)  
A)  Around-the-clock analgesia 
B)  Transcutaneous analgesia 
C)  Epidural analgesia 
D)  Patient-controlled analgesia (PC
A)

Question 6

When evaluating the effects of patient-controlled analgesia (PCA),the nurse notes that the patient is sedated and is difficult to arouse.What step should the nurse take next?

Accepted Answer

A)  Insert an airway. 
B)  Turn patient to the side. 
C)  Stop the PCA. 
D)  Expect this as a patient outcome of the therapy. 
A)  Insert an airway. 
B)  Turn patient to the side. 
C)  Stop the PCA. 
D)  Expect this as a patient outcome of the therapy.

Question 7

Which of the following statements about evaluating patients in pain is true?

Accepted Answer

A)  The best judge of the existence of pain is the nurse. 
B)  Visible signs always accompany pain. 
C)  Patients often are hesitant to report pain. 
D)  Nonpharmacological interventions are better than pain medications. 
A)  The best judge of the existence of pain is the nurse. 
B)  Visible signs always accompany pain. 
C)  Patients often are hesitant to report pain. 
D)  Nonpharmacological interventions are better than pain medications.

Question 8

The patient had knee-replacement surgery and has a local infusion pump to provide a local anaesthetic to the surgical site.The patient puts on the call light and complains that pain at the site is more intense than it has ever been and is getting worse.The nurse checks the site and finds that the dressing is damp but intact.The infusion pump is pumping,and there is medication in the bag.The most probable cause of the problem might be the

Accepted Answer

A)  catheter may be clogged. 
B)  pump may be releasing too much medication into the site. 
C)  catheter may be displaced. 
D)  patient may be exaggerating the pain. 
A)  catheter may be clogged. 
B)  pump may be releasing too much medication into the site. 
C)  catheter may be displaced. 
D)  patient may be exaggerating the pain.

Question 9

A nonpharmacological approach that the nurse may implement for patients who are experiencing pain that focuses on diverting the patient's attention away from the pain sensation by promoting pleasurable and meaningful stimuli is

Accepted Answer

A)  massage. 
B)  heat/cold. 
C)  guided imagery. 
D)  distraction. 
A)  massage. 
B)  heat/cold. 
C)  guided imagery. 
D)  distraction.

Question 10

When assessing a local infusion pump site,the nurse notes that which of the following requires an intervention?

Accepted Answer

A)  The device is labeled,indicating that an anaesthetic is being used. 
B)  The catheter connections are loose. 
C)  Surgical dressings are dry and intact. 
D)  No blood backup is present in the tubing. 
A)  The device is labeled,indicating that an anaesthetic is being used. 
B)  The catheter connections are loose. 
C)  Surgical dressings are dry and intact. 
D)  No blood backup is present in the tubing.

Question 11

The patient has morphine sulphate prescribed for pain every 4 hours as needed (prn).The patient complains of severe pain and usually requests more morphine an hour before it is due.The nurse should (Select all that apply.)

Accepted Answer

A)  request a "placebo prescription" from the physician. 
B)  offer the patient medication around the clock instead of prn. 
C)  offer the patient massage between medication doses. 
D)  offer the patient a nonopioid medication between morphine doses if prescribed. 
A)  request a "placebo prescription" from the physician. 
B)  offer the patient medication around the clock instead of prn. 
C)  offer the patient massage between medication doses. 
D)  offer the patient a nonopioid medication between morphine doses if prescribed.

Question 12

Before administering an epidural medication,the nurse aspirates and suspects that the catheter has migrated into the subarachnoid space when

Accepted Answer

A)  clear drainage is noted. 
B)  no drainage is noted. 
C)  purulent drainage is noted. 
D)  redness,warmth,and edema are noted. 
A)  clear drainage is noted. 
B)  no drainage is noted. 
C)  purulent drainage is noted. 
D)  redness,warmth,and edema are noted.

Question 13

The patient's family is concerned that the patient may get too much pain medication after surgery and become addicted to the medication if he is placed on a patient-controlled analgesia (PCA)pump.They also voice concern about the effectiveness of the PCA.The nurse should instruct the family and the patient that

Accepted Answer

A)  pain relief with the PCA pump is not as good as when the nurse provides it,but it does save on nursing time. 
B)  pain relief is good when the medication peaks,but less so when the levels drop,and that is when the patient will know that he needs more. 
C)  because the device provides medication as soon as the patient needs it,he will probably use less of the medication. 
D)  the patient will be kept in bed for several days after surgery to make sure it is safe to ambulate. 
A)  pain relief with the PCA pump is not as good as when the nurse provides it,but it does save on nursing time. 
B)  pain relief is good when the medication peaks,but less so when the levels drop,and that is when the patient will know that he needs more. 
C)  because the device provides medication as soon as the patient needs it,he will probably use less of the medication. 
D)  the patient will be kept in bed for several days after surgery to make sure it is safe to ambulate.

Question 14

Which of the following are characteristics of cancer pain? (Select all that apply.)

Accepted Answer

A)  It may be acute. 
B)  It may be persistent. 
C)  It usually is related to tumour recurrence or treatment. 
D)  It often is of less intensity than the patient reports. 
A)  It may be acute. 
B)  It may be persistent. 
C)  It usually is related to tumour recurrence or treatment. 
D)  It often is of less intensity than the patient reports.

Question 15

The patient is in the hospital undergoing major abdominal surgery.When the patient returns from the recovery room,the nurse expects that he most likely will be receiving pain medication

Accepted Answer

A)  by mouth. 
B)  intramuscularly. 
C)  via the epidural route. 
D)  intravenously. 
A)  by mouth. 
B)  intramuscularly. 
C)  via the epidural route. 
D)  intravenously.

Question 16

Which of the following patient conditions is categorized as a neurobiological disease?

Accepted Answer

A)  Physical dependence 
B)  Addiction 
C)  Pseudoaddiction 
D)  Tolerance 
A)  Physical dependence 
B)  Addiction 
C)  Pseudoaddiction 
D)  Tolerance

Question 17

The _______________ is a potential space between the vertebral bones and the dura mater,the outermost meninges covering the brain and spinal cord.

Accepted Answer

A)  subdural space 
B)  dural space 
C)  subarachnoid space 
D)  epidural space 
A)  subdural space 
B)  dural space 
C)  subarachnoid space 
D)  epidural space

Question 18

The nurse knows that an advantage of intraspinal analgesia is the

Accepted Answer

A)  smaller doses of epidural than intrathecal medication. 
B)  lack of significant patient complications. 
C)  systemic distribution of morphine faster than fentanyl. 
D)  ability to achieve appropriate analgesia with smaller dosages. 
A)  smaller doses of epidural than intrathecal medication. 
B)  lack of significant patient complications. 
C)  systemic distribution of morphine faster than fentanyl. 
D)  ability to achieve appropriate analgesia with smaller dosages.

Question 19

The nurse frequently must assess a patient who is experiencing pain.When assessing the intensity of the pain,the nurse should

Accepted Answer

A)  ask whether there are any precipitating factors. 
B)  question the patient about the location of the pain. 
C)  offer the patient a pain scale to objectify the information. 
D)  use open-ended questions to find out about the sensation. 
A)  ask whether there are any precipitating factors. 
B)  question the patient about the location of the pain. 
C)  offer the patient a pain scale to objectify the information. 
D)  use open-ended questions to find out about the sensation.

Question 20

The patient is admitted with persistent pain.She states that nothing takes the pain away totally,but that "Dilaudid works best." The fact that the patient calls the medication by name should alert the nurse to

Accepted Answer

A)  suspect that the patient is drug seeking. 
B)  expect that the patient may need smaller doses than normal. 
C)  assess the patient's acceptable level of comfort. 
D)  accept the fact that nothing will help this patient's pain. 
A)  suspect that the patient is drug seeking. 
B)  expect that the patient may need smaller doses than normal. 
C)  assess the patient's acceptable level of comfort. 
D)  accept the fact that nothing will help this patient's pain.

Exam 16: Pain Assessment and Management

The nurse caring for a patient who has a patient-controlled analgesia (PCA)knows that it

While reviewing a patient's medication history,the nurse determines that intraspinal analgesia is contraindicated as a result of

A nurse checks the continuous intravenous (IV)infusion for the intraspinal analgesia.The IV setup should be changed if

Catheter migration into the______________ can produce dangerously high medication levels.Only physicians and nurse anaesthetists administer medications in this space.

__________________ is an interactive method of pain management that permits patient control over pain through self-administration of analgesics.

When evaluating the effects of patient-controlled analgesia (PCA),the nurse notes that the patient is sedated and is difficult to arouse.What step should the nurse take next?

Which of the following statements about evaluating patients in pain is true?

A nonpharmacological approach that the nurse may implement for patients who are experiencing pain that focuses on diverting the patient's attention away from the pain sensation by promoting pleasurable and meaningful stimuli is

When assessing a local infusion pump site,the nurse notes that which of the following requires an intervention?

The patient has morphine sulphate prescribed for pain every 4 hours as needed (prn).The patient complains of severe pain and usually requests more morphine an hour before it is due.The nurse should (Select all that apply.)

Before administering an epidural medication,the nurse aspirates and suspects that the catheter has migrated into the subarachnoid space when

Which of the following are characteristics of cancer pain? (Select all that apply.)

The patient is in the hospital undergoing major abdominal surgery.When the patient returns from the recovery room,the nurse expects that he most likely will be receiving pain medication

Which of the following patient conditions is categorized as a neurobiological disease?

The _______________ is a potential space between the vertebral bones and the dura mater,the outermost meninges covering the brain and spinal cord.

The nurse knows that an advantage of intraspinal analgesia is the

The nurse frequently must assess a patient who is experiencing pain.When assessing the intensity of the pain,the nurse should

The patient is admitted with persistent pain.She states that nothing takes the pain away totally,but that "Dilaudid works best." The fact that the patient calls the medication by name should alert the nurse to

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