Deck 31: Pain Comfort and Sleep

Question 1

The patient with a recent abdominal incision has an abdominal binder applied. The nurse explains that this appliance helps reduce pain by:

A) increasing warmth to the incision site.
B) keeping sutures and staples in place.
C) supporting surface and internal tissues.
D) adding back support to enhance early ambulation.

Answer 1

supporting surface and internal tissues.

Question 2

A patient is beginning treatment for pain with a transcutaneous electrical nerve stimulator (TENS) unit. The nurse will initially:

A) apply conductive jelly to uncoated electrodes.
B) turn the unit on before attaching it to the patient.
C) place electrodes on all four extremities.
D) adjust the settings below the level at which a tingling sensation is felt.

Answer 2

apply conductive jelly to uncoated electrodes.

Question 3

The nurse takes into consideration that when the patient has an order for a patient-controlled analgesia (PCA) the pump will be programmed by the:

A) registered nurse.
B) primary care provider.
C) LPN/LVN.
D) pharmaceutical company.

Answer 3

registered nurse.

Question 4

A nurse caring for a patient who suffered a severe sprain and has an order for a cold pack application to the injured area would prevent patient injury by:

A) using heavy pressure on the cold pack for greater effectiveness.
B) preparing to apply heat instead if cold is not effective.
C) leaving the pack in place for over 30 minutes at a time.
D) placing a towel between the pack and the skin.

Question 5

A sleeping patient has periodic pauses in breathing, then starts to breathe again. The nurse recognizes this sleep pattern is consistent with:

A) insomnia.
B) sleep apnea.
C) narcolepsy.
D) excessive NREM sleep.

Question 6

A patient is receiving an ice massage for relief of muscle spasms in the neck. The patient complains that the ice is making the pain worse. Most helpful response from the nurse would be:

A) "I know it is uncomfortable right now, but it will get better in a few minutes."
B) "I will go get an ice pack to pace on your neck."
C) "The alteration of hot and cold application is very helpful for your spasms."
D) "I will stop these cold applications. Not everyone is helped by them."

Question 7

The nurse assesses a patient's sleep for NREM (non-rapid eye movement) sleep because this sleep has the characteristics of:

A) daytime activity.
B) offering the most rest.
C) irregular respirations.
D) increased heart rate.

Question 8

The nurse recommends that normal sleepatchesp patterns can best be acquired by suggesting to the patient that they:

A) smoke cigarettes.
B) drink wine.
C) take a nap during the day.
D) exercise in the mornings.

Question 9

The most helpful intervention by the nurse for a hospitalized child who is having difficulty falling asleep would be to:

A) keep a night light on in the room.
B) turn off all the lights in the room.
C) have the parents bring a favorite blanket or pillow from home.
D) give of juice and cookies before being put to bed.

Question 10

The nurse appreciates the principal advantage in using patient-controlled analgesia (PCA) is that it:

A) reduces patient anxiety about pain by giving the patient more control in its management.
B) reduces the workload of the nurse, because it does not have to be checked often.
C) eliminates the risk of adverse drug effects from the medication.
D) completely eliminates any pain the patient is experiencing.

Question 11

A nurse is assisting in the care of a patient who is receiving pain medication by the epidural route. It is most important to monitor this patient for which adverse drug effects?

A) Constipation
B) Headache
C) Nausea
D) Hypoventilation

Question 12

A nurse evaluating the effectiveness of an Aquathermia K pad for the leg is aware that the patient who has the least risk for burn injury from this device would be the patient with:

A) impaired peripheral circulation.
B) severely sprained ankle.
C) decreased level of consciousness from a stroke.
D) neuritis secondary to diabetes.

Question 13

A patient with an epidural catheter needs to have the dressing at the insertion site changed. When cleaning the insertion site with povidone iodine swabs, the nurse should:

A) use a circular motion working from the insertion site outward.
B) use a circular motion working from the outside to the insertion site.
C) start above the insertion site and swab in a downward motion.
D) start below the insertion site and swab in an upward motion.

Question 14

The suggestion by the nurse which is most helpful to a patient who complains of chronically not feeling rested after sleep would be:

A) avoid going to bed hungry or overly full.
B) try to exercise just before going to bed.
C) sleep late the next morning if possible if you are tired on awakening.
D) take a nap during the day to help relieve overall fatigue.

Question 15

A patient experiencing pain states that guided imagery has made the pain more manageable in the past. To assist this patient, the nurse should:

A) find a focal point in the room.
B) bring a newspaper or deck of cards according to patient choice.
C) obtain skin lotion and a towel to give a back rub.
D) read from a script that helps the patient visualize a restful place.

Question 16

The nurse is aware that the new order for indomethacin (Indocin) involves the administration of a(n):

A) COX-2 inhibitor.
B) adjuvant analgesic.
C) narcotic analgesic.
D) nonsteroidal anti-inflammatory medication.

Question 17

A nurse caring for a patient with a Fentanyl patch assesses that the patient is abnormally sleepy, is slurring words and is unsteady when ambulating. The nurse should:

A) put up the side rails on the bed.
B) elevate the head of the bed 45 degrees and offer coffee or cola drink.
C) remove the patch and wipe off the skin.
D) apply ice to skin around the patch.

Question 18

A nurse is instructing a patient about relaxation techniques for pain management. The patient should:

A) keep bright lights on in the room.
B) use this technique as a way to wake up in the morning.
C) tense and relax individual muscle groups, starting with the toes and feet.
D) try to tense and relax all of the muscles of the body at the same time.

Question 19

A patient experiencing discomfort because of severe arthritis would be described as having _______ pain.

A) acute
B) chronic
C) phantom
D) episodic

Question 20

A nurse is assessing the status of a patient who is sleeping. Which assessment data indicate that the patient is most likely in stage 3 of non-rapid eye movement (NREM) sleep?

A) Rapid respirations, rapid heart rate
B) Rapid respirations, slow heart rate
C) Decreased respirations, slow heart rate
D) Decreased respirations, rapid heart rate

Question 21

Travelers can combat "jet lag" by exposure to _______ for several hours.

Question 22

The nurse performing a focused assessment on pain will assess: (Select all that apply.)

A) history of pain.
B) verbal indicators.
C) psychological factors.
D) culture.
E) contributing factors.

Question 23

A pain scale FLACC is used in assessing pain in________.

Question 24

A nurse removed a pain medication patch that has a metal clip before the patient goes to have a(n) _________.

Question 25

___________ is considered to be the fifth vital sign.

Question 26

The nurse attempts to help an 86-year-old patient describe his pain because the nurse is aware the older adult may not express pain because they: (Select all that apply.)

A) are unaware of their discomfort.
B) believe pain is a natural consequence to aging.
C) are reluctant to bother the nursing staff.
D) have been culturally trained not to complain.
E) tear taking pain medication.

Question 27

A patient who has difficulty falling asleep at night because of anxiety over family problems asks if he should start taking sedative pills from the pharmacy to sleep better. The best advice to give this patient is that these pills can be used for:

A) long periods of time, but it is best to check with the primary care provider first.
B) short periods of time, but it is best to check with the primary care provider first.
C) long periods of time without primary care provider approval, because they are nonprescription medications.
D) short periods of time without physician approval, because they are nonprescription medications.

Question 28

A nurse is preparing a patient for home care following cancer treatment. He is discussing the use of the fentanyl patch. Which of the following would be the most important instruction regarding safety?

A) Apply as directed by the primary care provider.
B) Store fentanyl patches in a locked cabinet.
C) Prepare the skin by cleaning with an antiseptic scrub solution.
D) Use as needed for break through pain.

Question 29

A nurse explains that endorphins are capable of reducing pain:

A) as a naturally occurring morphine like enzyme.
B) in conditions that are physiological only.
C) by attaching to opioid receptors.
D) when psychological stressors are the cause of pain.

Question 30

A relative complains that an older adult patient takes frequent naps late in the day and awakens frequently during the night, and wants to know if this is normal. The nurse explains that an older adult:

A) will awaken more often during the night, but may nap more often during the day.
B) needs at least 10 hours of sleep a day to prevent fatigue.
C) requires less napping during the day to sleep better at night.
D) should be given hypnotics to induce better sleep.

Question 31

A natural supplement that can enhance sleep for many people is:

A) melatonin.
B) calcium.
C) magnesium.
D) oil of lavender.

Question 32

The nurse outlines the four phases of nociceptive pain as: (Select all that apply.)

A) translation.
B) transduction.
C) transmission.
D) modulation.
E) perception.

Question 33

The nurse takes into consideration the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) standards for pain assessment and treatment include:

A) pain treatment is based on objective data collected by the nurse.
B) pain treatment ends at discharge.
C) pain is assessed only for patients who complain of pain.
D) all patients have the right to appropriate assessment of pain.

Question 34

A type of pain that is of short duration, lasting from a few hours to a few days, is known as _________ pain.

Question 35

The _______________ is based on the premise that by stimulating large diameter nerve fibers pain is diminished or totally controlled.