Question 1

The nurse is caring for a patient who recently had surgery to repair a hernia.The patient's pain was 7 out of 10 before receiving pain medication.One hour after receiving an oral opioid,the patient ranks his pain at 3 out of 10.The patient asks the nurse why he isn't receiving more pain medication.Which is the nurse's best response?

Accepted Answer

A)  "This medication can be given only every 4 hours. It is not time for you to have any other pain medication right now." 
B)  "I will notify the health care provider to come perform an assessment if your pain doesn't improve in 30 minutes." 
C)  "If the pain becomes severe, we may need to transfer you to an intensive care unit." 
D)  "It can take 2 hours for oral pain medication to work, and your pain is going down. Let's try boosting you up in bed and putting an ice pack on the incision to see if that helps."

Question 2

A nurse is assessing a patient who started to have severe pain 3 days ago.When the nurse asks the patient to describe the pain,the patient states,"The pain feels like it is in my stomach.It is a burning pain,and it spreads out in a circle around the spot where it hurts the most." What type of pain does the nurse document that the patient is having at this time?

Accepted Answer

A)  Superficial pain 
B)  Idiopathic pain 
C)  Chronic pain 
D)  Visceral pain

Question 3

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 4

Which of the following statements made by a patient reflects that the patient understands the relationship between the gate control theory of pain and the use of meditation to relieve pain?

Accepted Answer

A)  "Meditation controls pain by blocking pain impulses from coming through the gate." 
B)  "Meditation will help me sleep through the pain because it opens the gate." 
C)  "Meditation stops the occurrence of pain stimuli." 
D)  "Meditation alters the chemical composition of pain neuroregulators, which closes the gate."

Question 5

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 6

The nurse is administering pain medication for several patients.Which patient does the nurse administer medication to first?

Accepted Answer

A)  The patient who needs to take a scheduled dose of maintenance pain medication 
B)  The patient who needs to be premedicated before walking 
C)  The patient with a PCA running who needs to have the syringe replaced 
D)  The patient who is experiencing 8/10 pain and has a STAT order for pain medication

Question 7

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 8

The nurse is administering ibuprofen (Advil)to an older patient.Which of the following assessment data causes the nurse to hold the medication?

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 2/10 intermittent joint pain 
E)  Patient experienced respiratory depression after administration of an opioid medication

Question 9

The nurse is teaching a student nurse about pain assessment scales.Which statement by the student indicates correct understanding?

Accepted Answer

A)  "You cannot use a pain scale to compare the pain of my patient with the pain of your patient." 
B)  "When patients say they don't need pain medication, they aren't in pain." 
C)  "Pain assessment scales determine the quality of a patient's pain." 
D)  "A patient's behavior is more reliable than the patient's report of pain."

Question 10

A nurse is providing discharge teaching for a patient with a fractured humerus.The patient is going home with Vicodin (5/325).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 fiber." 
D)  "As your pain severity lessens, you will begin to give yourself once-daily intramuscular injections."

Question 11

A patient who has had type 2 diabetes for 26 years is beginning to experience peripheral neuropathy in the feet and lower legs,which is causing the patient to have a decreased ability to feel pain in the lower extremities.The nurse is providing education to the patient to prevent injury to the feet.The nurse tells the patient to always wear shoes or slippers when walking.Which of the following statements made by the nurse best explains the rationale for this instruction?

Accepted Answer

A)  "Wearing shoes blocks pain perception and helps you adapt to pain, which ends up protecting your feet." 
B)  "Shoes provide nonpharmacological pain relief to people with diabetes and peripheral neuropathy." 
C)  "Since you cannot feel pain as much in your feet, you need to open your neurological gates to allow pain sensations to come through. Wearing shoes helps to open those gates, which protects your feet." 
D)  "You have lost the ability to withdraw from pain because of your peripheral neuropathy. If you step on something and are not wearing shoes, you will not feel it; this could possibly cause injury to your foot."

Question 12

A nurse is caring for a patient who recently had spinal surgery.The nurse knows that patients usually experience acute pain following this type of surgery.The patient refuses to get up and walk and is not moving around in the bed.However,the patient is stoic and denies experiencing pain at this time.What most likely explains this patient's behavior and response to surgery?

Accepted Answer

A)  The surgery successfully cured the patient's pain. 
B)  The patient's culture is possibly influencing the patient's experience of pain. 
C)  The patient is experiencing urinary retention because of manipulation of the spine during surgery; this is preventing the patient from experiencing pain. 
D)  The nurse is allowing personal beliefs about pain to influence pain management at this time.

Question 13

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 14

A nurse is caring for a patient who is experiencing pain following abdominal surgery.What information is important for the nurse to tell the patient when providing patient education about effective pain management?

Accepted Answer

A)  "To prevent overdose, you need to wait to ask for pain medication until you begin to experience pain." 
B)  "You should take your medication after you walk to make sure you do not fall while you are walking." 
C)  "We should work together to create a regular schedule of medications that does not allow for breakthrough pain." 
D)  "You need to take oral pain medications when you experience severe pain."

Question 15

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

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)  Labeling 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

Exam 91: Pain Management