Deck 27: Pain Management

Question 1

When a nurse asks a client to describe what a particular pain feels like,the nurse is attempting to identify which of these aspects of the client's pain experience?

A)aggravating factors
B)intensity
C)onset and duration
D)quality

Answer 1

quality

Question 2

When assessing an older adult client for pain,the nurse should recognize which of these statements as TRUE?

A)Older clients often do not report pain for fear of being considered "complainers."
B)Older clients request pain medication more frequently to prevent complications.
C)Older clients believe that taking pain medication will hasten death.
D)Older clients have little experience with the increased efficacy of current pain medications.

Answer 2

Older clients often do not report pain for fear of being considered "complainers."

Question 3

A client returns from surgery with a PRN order for pain medication.The nurse recognizes the client will be experiencing pain for at least the first day or two after surgery and should take which of these actions?

A)Administer the PRN medication around the clock (ATC)within the time constraints of the order.
B)Administer the medication whenever the client asks for it.
C)Administer the PRN medication within the time constraints of the order during the day,and at night if pain awakens the client.
D)Ask the client if pain medication is desired,when making regular postoperative assessments.

Answer 3

Administer the PRN medication around the clock (ATC)within the time constraints of the order.

Question 4

A client's estimate of the severity of pain,which allows the nurse to evaluate the effectiveness of pain relief measures by comparing these estimates before and after pain management interventions,describes which of the following aspects of the pain experience?

A)aggravating factors
B)intensity
C)onset and duration
D)quality

Question 5

Which theory of pain proposes that pain can be relieved by blocking the transmission of pain impulses to the brain by physical modalities and altering the individual's thought processes,emotions,or other behaviors?

A)gate control theory
B)Kussmaul's theory
C)perception modulation
D)transduction

Question 6

Who is the MOST consistent health team member involved in client pain management?

A)anesthesiologist
B)nurse
C)pharmacist
D)physician

Question 7

A client returns to the unit following abdominal surgery.The client has an order for Demerol IM PRN for severe pain or Tylenol #3 PO PRN for mild to moderate pain.The nurse asks the client whether she is experiencing pain now,and the client says,"Yes,I am." Which of these actions should the nurse take next?

A)Administer Demerol,since the client is less than 24 hours postoperative.
B)Administer Tylenol #3,and if pain is not relieved,administer Demerol.
C)Assess the client further as to the location and degree of pain.
D)Reposition the client,and suggest performing some relaxation exercises.

Question 8

For the client with cancer pain,what is the preferred route of providing pain medication?

A)intramuscular
B)intravenous
C)oral
D)transdermal

Question 9

Which of these statements about chronic pain is TRUE?

A)It is accompanied by elevated heart rate,respiratory rate,and blood pressure.
B)It occurs for at least 6 months.
C)It is usually described as sharp but is difficult to pinpoint.
D)Its signs and symptoms are often similar to depression.

Question 10

A client who had a myocardial infarction yesterday has pain medication ordered PRN for discomfort or agitation.The evening nurse's initial assessment indicates the client has not received any pain medications all day.Vital signs are within normal limits,but the client is sweating profusely.Smiling,the client informs the nurse that he has been experiencing some pain since early morning.Which of these actions should the nurse take?

A)Administer the largest dose of pain medication allowed,since the client has not received it all day.
B)Administer the minimum dose of pain medication,and reassess the client's level of pain 30 minutes after administration and again at the minimal time interval for repeat dosing.
C)Continue to withhold the ordered pain medication because vital signs are within normal limits and the client is smiling.
D)Encourage the client to continue to do without ordered pain medication to avoid addiction.

Question 11

A client whose dislocated shoulder was reduced today is experiencing moderate pain at the site of injury and across the back.The nurse administers a prescribed oral pain medication,repositions the client,and applies an ice pack to the shoulder.The client still complains of pain and requests a cup of hot water to drink to "wash the pain" from the system.Which of these actions should the nurse take?

A)Call the health care provider to request an order for the water.
B)Give the client the water.
C)Inform the nursing supervisor that a client may need a psychiatric consultation.
D)Tell the client that water will not bring pain relief.

Question 12

Which of these data provide the MOST accurate information about the pain a client is experiencing?

A)objective changes in vital signs such as increased respiratory rate,heart rate,and blood pressure
B)the amount of tissue damage actually occurring or already present
C)facial expressions and level of mobility
D)self-report

Question 13

According to The Joint Commission,which of these statements about pain and its management is TRUE?

A)Clients are assumed to experience some degree of pain at all times.
B)Staff must take special courses to be competent in pain management.
C)Pain assessment is considered to be the "fifth" vital sign.
D)There must be evidence that the least expensive,most effective pain medications are used.

Question 14

In providing pain medication for the postoperative client,what is the preferred route of administration when the client is NPO?

A)epidural
B)intramuscular
C)intravenous
D)oral

Question 15

What purpose does pain serve for individuals?

A)to provide gate control
B)to act as a protective mechanism
C)to minimize noxious stimuli
D)to limit movement

Question 16

Which of these statements about acute pain is TRUE?

A)It is most often described as dull,diffuse,and aching.
B)Its onset is sudden and of relatively short duration.
C)It increases as healing occurs.
D)It is usually nonspecific in nature.

Question 17

A nurse's assessment of a client yields the following data: vital signs normal;client complains of exhaustion and recent weight loss;when asked,client states,"Yes,I am in pain";client appears frail and withdrawn and moves slowly,avoiding movement of upper torso.The nurse would want to assess the client further for which of these?

A)acute pain
B)anorexia
C)chronic pain
D)depression

Question 18

Which type of drug has an addictive effect to analgesics?

A)adjuvants
B)anesthesia
C)narcotics
D)opiates

Question 19

Which route of pain medication administration provides the MOST rapid onset of pain relief?

A)intramuscular
B)intravenous
C)oral
D)transdermal

Question 20

When objective and subjective data about a client's pain are in conflict,which report should the nurse consider to be the primary source?

A)objective data
B)subjective data
C)combination of objective and subjective
D)objective data and reports of family members

Question 21

Transdermal opioid administration is indicated for a client in which of the following situations?

A)The exact dosing of medication is required.
B)Oral medication cannot be tolerated.
C)Pain is predictable,as in postsurgical clients.
D)Pain is continuous,and high dosage is required.

Question 22

According to the World Health Organization (WHO),the client who is experiencing severe pain should receive which of these drugs?

A)a nonopioid
B)a nonopioid,plus or minus an adjuvant
C)a strong opioid,plus or minus an adjuvant
D)a strong opioid,plus or minus a nonopioid,plus or minus an adjuvant

Question 23

The nurse is caring for a client experiencing postoperative pain.Which of the following will affect the client's pain level? (Select all that apply. )

A)culture
B)type of housing
C)age
D)marital status
E)previous experience

Question 24

Which of these statements about patient-controlled analgesia (PCA)is TRUE?

A)Clients receiving PCA must be monitored for overdose side effects.
B)Health care professionals allocate time for setting up and maintaining PCA when in use.
C)PCA can only be administered via the epidural route.
D)PCA can safely be used in pediatric and home health settings.

Question 25

A client states,"I can't take the morphine now because I might need it later when the pain gets worse." Which of these responses by the nurse would be BEST?

A)"If you're afraid of becoming addicted,don't worry.The dose can be increased if that happens."
B)"I'm not going to stand here and let you suffer.You need to take the medication."
C)"The dose of morphine can safely be increased if the effects lessen over time.There's no need for you to suffer now."
D)"You're in charge of your pain management."

Question 26

Which of the following may occur as a side effect when administering opiates?

A)anxiety
B)diarrhea
C)palpitations
D)respiratory depression

Question 27

According to the World Health Organization (WHO),the client who is experiencing mild cancer pain should receive which of these drugs?

A)a nonopioid
B)a nonopioid and an adjuvant
C)a strong opioid
D)a weak opioid,plus or minus a nonopioid,plus or minus an adjuvant

Question 28

Which method of noninvasive pain relief focuses the client's attention on something other than the pain?

A)cutaneous stimulation
B)distraction
C)guided imagery
D)relaxation

Question 29

A client has the following order: "Apply cold or heat packs as needed for pain relief." The nurse must recognize which of the following?

A)Heat often provides faster relief.
B)Combining the two therapies might provide the best relief.
C)Either method may cause peripheral nerve damage when used over an extended time frame (i.e. ,weeks,months).
D)Cold is often better tolerated.

Question 30

Medication on demand (MOD)administration is indicated for a client in which of the following situations?

A)The client can manage his or her own medication routines.
B)Oral medication cannot be tolerated.
C)Pain is predictable,to reduce staffing time.
D)Pain is continuous,and high dosage is required frequently.