Question 1

A nurse is caring for a patient who recently had an abdominal hysterectomy and states that she is experiencing severe pain.The patient's blood pressure is 110/60,and her heart rate is 60.In addition,the patient does not appear to be in any distress.Which response by the nurse is most therapeutic?

Accepted Answer

A) "Your vitals do not show that you are having pain;can you describe your pain?" 
B) "You do not look like you are in pain." 
C) "OK,I will go get you some narcotic pain relievers immediately." 
D) "What would you like to try to alleviate your pain?"

Question 2

A nurse is providing discharge teaching for a patient with a fractured humerus.The patient is going home with hydrocodone bitartrate and acetaminophen (Vicodin).What important patient education does the nurse provide?

Accepted Answer

A) "Be sure to eat a meal high in fat before taking the medication,to avoid a stomach ulcer." 
B) "Narcotics can be addictive,so do not take them unless you are in severe pain." 
C) "You need to drink plenty of fluids and eat a diet high in fibre." 
D) "As your pain severity lessens,you will begin to give yourself once-daily intramuscular injections."

Question 3

Which of the following statements made by the patient indicates to the nurse that teaching on a patient-controlled analgesia (PCA)device has been effective?

Accepted Answer

A) "This is the only pain medication I will need to be on." 
B) "I can administer the pain medication as frequently as I need to." 
C) "I feel less anxiety about the possibility of overdosing." 
D) "I will need the nurse to notify me when it is time for another dose."

Question 4

A 24-year-old Asian woman is in labour and refuses to receive any sort of anaesthetic.Which alternative treatment is best for this patient?

Accepted Answer

A) Relaxation and guided imagery. 
B) Transcutaneous electrical nerve stimulation (TENS). 
C) Herbal supplements with analgesic effects. 
D) Pudendal block.

Question 5

What nursing intervention is most effective in preventing injury to a patient after administration of epidural anaesthetic?

Accepted Answer

A) Keeping the reversal agent in a syringe in the patient's bedside table. 
B) Applying a gauze dressing to the epidural catheter insertion site. 
C) Labelling the tubing that leads to the epidural catheter. 
D) Asking the nursing assistive personnel to check on the patient at least once every 2 hours.

Question 6

Which of the following is the best way for the nurse to manage pain for a patient with chronic pain from arthritis?

Accepted Answer

A) Administer pain medication before any activity. 
B) Provide intravascular bolus as needed for breakthrough pain. 
C) Give medications around-the-clock. 
D) Administer pain medication only when nonpharmacological measures have failed.

Question 7

The nurse is assessing a patient for opioid tolerance.Which finding supports the nurse's assessment?

Accepted Answer

A) Increasingly higher doses of opioid are needed to control pain. 
B) The patient needed a substantial dose of naloxone (Narcan). 
C) The patient asks for pain medication close to the time it is due around the clock. 
D) The patient no longer experiences sedation from the usual dose of opioid.

Question 8

The nurse is evaluating the effectiveness of guided imagery for pain management as used for a patient who has second- and third-degree burns and needs extensive dressing changes.Which situation best indicates that guided imagery is controlling the patient's pain effectively during dressing changes?

Accepted Answer

A) The patient's need for analgesic medication decreases during the dressing changes. 
B) The patient rates pain during the dressing change as a 6 on a scale of 0 to 10. 
C) The patient's facial expressions are stoic during the procedure. 
D) The patient can tolerate more pain,so dressing changes can be performed more frequently.

Question 9

The nurse is caring for a patient who suddenly experiences chest pain.What is the nurse's first priority?

Accepted Answer

A) Call the rapid response team. 
B) Ask the patient to rate and describe the pain. 
C) Raise the head of the bed. 
D) Administer pain relief medications.

Question 10

Which statement made by a nursing educator best explains why it is important for nurses to determine a patient's medical history and recent drug use?

Accepted Answer

A) "Health care providers have a responsibility to prevent drug seekers from gaining access to drugs." 
B) "This information is useful in determining what type of pain interventions will most likely be effective in providing pain relief." 
C) "Some recreational drugs have pharmaceutical counterparts that may be more effective in managing pain." 
D) "Getting this information gives the nurse an opportunity to provide patient teaching about drug abstinence."

Question 11

A patient who had a motor vehicle accident 2 days ago is experiencing pain and is receiving patient-controlled analgesia (PCA).How does the nurse know that the patient is experiencing effective pain management with the PCA?

Accepted Answer

A) The patient is sleeping and is difficult to arouse. 
B) The patient rates pain at an acceptable level of 3 on a 0-to-10 scale. 
C) Sufficient medication is left in the PCA syringe. 
D) The patient presses the control button to deliver pain medication.

Question 12

A nurse has brought the patient his scheduled pain medication.The patient asks the nurse to wait to give pain medication until the time for the dressing change,which is 2 hours away.Which response by the nurse is most therapeutic?

Accepted Answer

A) "This medication will still be providing you relief at the time of your dressing change." 
B) "OK,swallow this pain pill,and I will return in a minute to fill your wound." 
C) "Would you like medication to be given for dressing changes on top of your regularly scheduled medication?" 
D) "Your medication is scheduled for this time,and I can't adjust the time for you.I'm sorry,but you must take your pill right now."

Question 13

The nurse is caring for an infant in the intensive care unit.Which of the following is the most accurate description of factors that will influence the perception and management of pain for this patient?

Accepted Answer

A) Infants cannot tolerate analgesics owing to an underdeveloped metabolism. 
B) Infants have an increased sensitivity to pain in comparison with older children. 
C) Pain cannot be accurately assessed in infants. 
D) Infants respond behaviourally and physiologically to painful stimuli.

Question 14

A nurse is providing medication education to a patient who just started taking ibuprofen,a nonselective nonsteroidal anti-inflammatory drug (NSAID).Which statement made by the nurse best indicates how ibuprofen works?

Accepted Answer

A) "Ibuprofen helps to remove factors that cause or stimulate pain." 
B) "Ibuprofen reduces anxiety,which will help you better cope with your pain." 
C) "Ibuprofen helps to decrease the production of prostaglandins." 
D) "Ibuprofen binds with opiate receptors to reduce your pain."

Question 15

The nurse is administering ibuprofen (Advil)to an older patient.Which of the following assessment data causes the nurse to withhold the medication? (Select all that apply. )

Accepted Answer

A) Past medical history of gastric ulcer. 
B) Patient states last bowel movement was 4 days ago. 
C) Stated allergy to aspirin. 
D) Patient states has intermittent joint pain rated 2 on a 0-to-10 scale. 
E) Patient experienced respiratory depression after administration of an opioid medication.

Exam 31: Pain Assessment and Management

A nurse is caring for a patient who recently had an abdominal hysterectomy and states that she is experiencing severe pain.The patient's blood pressure is 110/60,and her heart rate is 60.In addition,the patient does not appear to be in any distress.Which response by the nurse is most therapeutic?

A nurse is providing discharge teaching for a patient with a fractured humerus.The patient is going home with hydrocodone bitartrate and acetaminophen (Vicodin) .What important patient education does the nurse provide?

Which of the following statements made by the patient indicates to the nurse that teaching on a patient-controlled analgesia (PCA) device has been effective?