Question 1

A prescription for morphine sulfate (0.5 gr IM PRN)was ordered for pain for an 80-year-old patient with emphysema who weighs 100 pounds.The most appropriate action for the licensed practical/vocational nurse (LPN/LVN)is to:

Accepted Answer

A)   Transcribe the order and wait to see if the patient needs it.
B)   Transcribe the order for an oral dose instead of IM dose.
C)   Call the physician and clarify the order.
D)   Tell the RN about the order. D

Question 2

The nurse attempts to evaluate the presence of pain in a patient who is cognitively impaired by assessing for:

Accepted Answer

A)   Amount of time spent sleeping during the day
B)   Consistent stoic facial expression
C)   Increased social interaction
D)   Increasing confusion D

Question 3

The nurse explains the standards for pain management published by The Joint Commission ( TJC ).The nurse will: (Select all that apply.)

Accepted Answer

A)   Perform organized pain assessment.
B)   Record results of analgesia.
C)   Give adequate discharge instruction about pain relief.
D)   Recognize the right of a patient to manage pain.
E)   Teach patients about pain control methods.F)  None of above A,B,C,D,E

Question 4

The nurse is administering morphine IM,ordered for a patient reporting severe pain.To evaluate the patient's response to this drug,the nurse will assess primarily for:

Accepted Answer

A)   Cardiac rhythms for tachycardia
B)   Respiratory rate for tachypnea
C)   Increased bowel sounds in the gastrointestinal (GI)  system.
D)   Sedative effects in the neurologic system.

Question 5

The nurse has assessed that prolonged and unrelieved pain will:

Accepted Answer

A)   Release endorphins
B)   Lower the pain threshold
C)   Stimulate gate control
D)   Lower the blood pressure

Question 6

The sensation of pain has been defined by the International Association for the Study of Pain as:

Accepted Answer

A)   Unpleasant sensory and emotional experience
B)   Whatever the person experiencing it says it is
C)   Psychogenic response to tissue injury
D)   Physical and psychogenic response to the need for drugs

Question 7

The physician has ordered both heat and cold treatments for the older adult patient with a leg injury.The nursing care plan reflects secondary diagnoses of peripheral vascular disease (PVD),diabetes,and an allergy to latex.Which of the ordered treatments would the nurse prefer to administer and why?

Accepted Answer

A)   The nurse will use cold treatment because patients with diabetes and a latex allergy cannot tolerate heat.
B)   The nurse will use cold treatment for this patient with a fracture because cold will help set the cast.
C)   The nurse will use heat treatment because cold is contraindicated for patients with PVD.
D)   The nurse will use heat treatment because heat will increase circulation and increase the threat of infection in the injured part.

Question 8

A patient who is obviously in pain refuses the morphine that has been ordered for pain control because of a fear of addiction.The nurse explains that the percentage of patients taking prescribed pain protocols who become addicted is estimated at:

Accepted Answer

A)   Less than 1%
B)   10% to 25%
C)   30% to 50%
D)   80% to 90%

Question 9

The nurse is alert for sympathetic responses to pain such as:

Accepted Answer

A)   Increased blood pressure, increased pulse, and increased respiratory rate
B)   Decreased blood pressure, decreased pulse, and increased respiratory rate
C)   Increased blood pressure, decreased pulse, and increased respiratory rate
D)   Decreased blood pressure, decreased pulse, and decreased respiratory rate

Question 10

The nurse using the gate-control methods of pain relief would help the patient control pain by:

Accepted Answer

A)   Assisting the patient to ambulate.
B)   Giving a massage.
C)   Providing an ice cold beverage.
D)   Instructing the patient in stretching exercises.

Question 11

The nurse notices that the patient seems calm and peaceful despite an assessment that the patient's injuries might be causing severe pain.The patient tells the nurse that using yoga,meditation,and __________________ lessens the perceptions of pain to tolerable levels.

Accepted Answer

A)   Indulging in a favorite food
B)   Music by a favorite artist
C)   Reading exciting science fiction
D)   Self-administration of drugs

Question 12

The nurse explains that afferent pathways are activated by pain receptors called ____________________.

Accepted Answer

The answer of The nurse explains that afferent pathways are...

Question 13

Every time the right arm is raised,the patient reports to the nurse that pain is triggered in the right shoulder.The nurse charts this description as an example of a(n):

Accepted Answer

A)   Referred pain
B)   Aggravating factor
C)   Alleviating factor
D)   Past experience with the pain

Question 14

In performing a pain assessment,the LPN/LVN would follow which steps?

Accepted Answer

A)   Assess vital signs, status of pain, and aggravating factors.
B)   Assess location, quality, and intensity on an identified scale.
C)   Assess the intensity on an identified scale and record findings.
D)   Assess vital signs and location, and report to the RN.

Question 15

When the patient with sciatica seats himself in a chair,he gasps and complains of a burning and shooting pain in his hip.The nurse assesses that this is _______________ pain.

Accepted Answer

A)   Referred
B)   Neuropathic
C)   Visceral
D)   Acute

Question 16

The nurse is notified when the patient,newly admitted with liver and gallbladder disease,complains of pain in the right middle back and asks for some pain medication.As the basis for the assessment,the nurse uses knowledge of pain to determine that the patient:

Accepted Answer

A)   Is just complaining to see whether the staff will give out pain medications.
B)   Has referred pain sensations. The nurse should follow orders for administering pain medication.
C)   Has an injury on the back from an unknown cause that needs immediate assessment.
D)   Is a chronic complainer with anxieties about his condition.

Question 17

The patient with an extensive abdominal operation is assessed by the nurse as having predictable pain.Analgesics for this patient will be most effective when administered:

Accepted Answer

A)   As needed (PRN) 
B)   Once a day
C)   Twice a day
D)   Around the clock

Question 18

The nurse administers nalbuphine (Nubain),an opioid agonist-antagonist to a 78-year-old patient.The family is worried about the patient and thinks that this drug is too strong and will cause harm.The nurse assures the family that this drug:

Accepted Answer

A)   Does not accumulate in the body.
B)   Blocks the side effects observed in opioid agonists.
C)   Does not affect the CNS.
D)   Can only be given orally.

Question 19

The nurse explains to a patient that the gate-control theory of pain claims that pain is perceived as a stimulation of receptors in the:

Accepted Answer

A)   Large arteries
B)   Vena cava
C)   Large nerve fibers
D)   Small nerve fibers

Question 20

A patient who had a myocardial infarction 2 days earlier has been eating well,is ambulating with assistance,and is receiving antibiotics and morphine by intravenous (IV)drip.The patient complains of constipation this morning.The nurse assesses the probable cause of the constipation as:

Accepted Answer

A)   Inadequate fluid intake
B)   Lack of exercise
C)   Administration of antibiotics
D)   Administration of an analgesic medication

Exam 15: Pain Management

A prescription for morphine sulfate (0.5 gr IM PRN) was ordered for pain for an 80-year-old patient with emphysema who weighs 100 pounds.The most appropriate action for the licensed practical/vocational nurse (LPN/LVN) is to: