Question 1

The nurse is caring for a group of patients. Which patient is experiencing acute pain?

Accepted Answer

A)  A patient who has experienced back pain for 2 years
B)  A patient with a diagnosis of pancreatitis
C)  A patient who experienced a knee injury in high school 12 years ago
D)  A patient diagnosed with osteoarthritis last year B

Question 2

A patient receiving large doses of opioids is lethargic and difficult to arouse, with a respiratory rate of 6 per minute and constricted pupils. Which medication should the nurse anticipate being prescribed?

Accepted Answer

A)  Naloxone (Narcan) 
B)  Furosemide (Lasix) 
C)  Diazepam (Valium) 
D)  Flumazenil (Romazicon)  A

Question 3

A patient with peripheral neuropathy states, "I don't know why the doctor put me on an antidepressant. I am not depressed!" Which response by the nurse is best?

Accepted Answer

A)  "Depression is often a factor in pain. Treating the depression helps treat the pain."
B)  "Maybe you are more depressed than you realize. Would you like to talk about it?"
C)  "Antidepressants are sometimes used to treat nerve pain such as you are experiencing."
D)  "Why don't you try it for a while, and if you don't feel better, you can ask your doctor if you can stop it?" C

Question 4

The nurse is performing a pain assessment on a newly admitted patient. Which question best assesses the severity of pain?

Accepted Answer

A)  "Can you tell me when the pain began?"
B)  "Is there anything that makes the pain better or worse?"
C)  "Can you point to where the pain is located?"
D)  "Can you please rate your pain on a scale of 0 to 10?"

Question 5

The nurse enters a room just as a patient's daughter pushes the button of his IV patient-controlled analgesia (PCA) pump. Which response by the nurse is appropriate?

Accepted Answer

A)  "Thanks for helping out your dad. Is he too weak to push the button?"
B)  "If you need to push the button for your dad, first be sure his respiratory rate is higher than 10."
C)  "It is dangerous for anyone but your dad to push the button. Remind him to push it himself if he needs it."
D)  "It is against hospital policy for anyone but the patient to push the button. If I see you pushing it again, I will have to call the supervisor."

Question 6

A patient who has just returned from abdominal surgery states, "I learned relaxation exercises, so I won't need any drugs." Which statement about relaxation therapy should the nurse use to guide care for this patient?

Accepted Answer

A)  Relaxation therapy works much the same as a placebo.
B)  Relaxation therapy is not useful for postoperative patients or for severe pain.
C)  Relaxation therapy is an excellent adjunct treatment for pain when used with analgesics.
D)  Effective use of relaxation therapy can eliminate the need for analgesics postoperatively.

Question 7

A patient reports that she has been having bloody stools for the past month. Which medication can the nurse expect to note on the medication history?

Accepted Answer

A)  Gabapentin (Neurontin) 
B)  Duloxetine (Cymbalta) 
C)  Naproxen (Aleve) 
D)  Fentanyl (Duragesic)

Question 8

A patient has been on opioids for 3 months to control pain caused by injuries from a motor vehicle crash. The patient asks about the risk of withdrawal symptoms when the drugs are no longer needed. How should the nurse respond to the patient?

Accepted Answer

A)  "Ask your doctor for a sedative to get you through the worst of the withdrawal symptoms."
B)  "As long as you taper the drug dose down slowly, you should not experience withdrawal symptoms."
C)  "You would have to be on these drugs much longer than 3 months to have problems with withdrawal."
D)  "You were using the drugs for legitimate pain, so you will not have to go through withdrawal when you stop them."

Question 9

The nurse is preparing to provide an opioid medication for a patient's postoperative pain. Which action should the nurse take first?

Accepted Answer

A)  Determine the respiratory rate.
B)  Observe the patient's skin color.
C)  Take the patient's oral temperature.
D)  Ask the patient when he last ate something.

Question 10

A patient with chronic back pain has a new order for a fentanyl (Duragesic) patch. As the nurse applies the patch, the patient states, "I'm really glad to get that patch on. I am really hurting bad." Which response by the nurse is correct?

Accepted Answer

A)  "You should feel some relief of your pain within about half an hour."
B)  "The patch may take a while to work. Would you like a pain shot in the meantime?"
C)  "Other analgesics can't be given while the patch is on, so try to bear it until it takes effect."
D)  "Because it is absorbed right through the skin, you will feel relief within minutes after I apply this patch."

Question 11

A patient with chronic pain is on a sustained-release opioid that is ordered every 12 hours. After 6 hours, the patient complains of increasing pain. Which intervention by the nurse is appropriate?

Accepted Answer

A)  Obtain an order for an immediate-release opioid for breakthrough pain.
B)  Teach the patient a relaxation technique to use until the next dose is due.
C)  Assess the patient's vital signs and administer the next dose of opioid early.
D)  Explain to the patient that the medication being administered lasts for 12 hours.

Question 12

The nurse is caring for a group of patients. Which patient should the nurse see first?

Accepted Answer

A)  A patient who underwent an appendectomy 2 hours ago reporting level 8 pain on a 0-to-10 scale
B)  A patient who underwent a knee replacement 3 days ago reporting level 2 pain on a 0-to-10 scale
C)  A patient with chronic back pain reporting level 8 pain on a 0-to-10 scale
D)  A patient with a sprained ankle reporting level 5 pain on a 0-to-10 scale

Question 13

The nurse is caring for a patient who is receiving morphine via PCA. Which finding would be of most concern to the nurse?

Accepted Answer

A)  Blood pressure 114/72 mm Hg
B)  Pulse 76 beats/min
C)  Respirations 10 breaths/min
D)  Report of level 3 pain on 0-to-10 scale

Question 14

The nurse is caring for a patient who underwent an amputation of the left arm. The patient reports level 9 pain on a 0-to-10 scale. Which action should the nurse take?

Accepted Answer

A)  Encourage the patient to use only nonpharmacological therapies.
B)  Administer normal saline and tell the patient it is morphine.
C)  Remind the patient there is nothing there to "hurt."
D)  Administer 4 mg of morphine intravenously as prescribed.

Question 15

The nurse is caring for a group of patients. Which patient is experiencing chronic pain?

Accepted Answer

A)  A patient who underwent heart surgery 2 days ago
B)  A patient who fractured a tibia in a motorcycle accident
C)  A patient who fell off a ladder 6 months ago and injured his back
D)  A patient who sprained her wrist yesterday rollerblading

Question 16

The nurse is preparing to administer midazolam (Versed) 1 mg intravenously. The available dose is midazolam (Versed) 1 mg/1 mL. How many mL will the nurse administer? Enter the numeral only

Accepted Answer

The answer of The nurse is preparing to administer midazolam...

Question 17

The nurse is caring for a patient with lung cancer who has been receiving morphine for 2 weeks and reports the medication is no longer effective. Which is the patient likely experiencing?

Accepted Answer

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

Question 18

The nurse is reviewing medications prescribed for a patient experiencing pain. Which medications should the nurse realize are being used as adjuvant agents for this patient's pain? (Select all that apply.)

Accepted Answer

A)  Steroids
B)  Antibiotics
C)  Cylclooxygenase-2 (COX-2)  inhibitors
D)  Anticonvulsants
E)  Benzodiazepines F) Tricyclic antidepressants

Question 19

The nurse is reviewing orders for a patient and notes an order for extra-strength Tylenol 2 tablets (1,000 mg) every 4 hours around the clock. What action should the nurse take?

Accepted Answer

A)  Seek clarification from the health care provider.
B)  Administer the medication as prescribed.
C)  Give the patient half of the ordered dose.
D)  Administer regular acetaminophen (325 mg)  every 4 hours around the clock.

Question 20

The nurse is teaching a patient about nonpharmacological therapies. Which topics should the nurse include in the teaching? (Select all that apply.)

Accepted Answer

A)  Use of guided imagery
B)  Taking medication around the clock
C)  Watching television for distraction
D)  Biofeedback technique
E)  Application of heat 6.Application of a Duragesic patch

Exam 10: Nursing Care of Patients in Pain