Question 1

A client who is being treated for cancer tells the nurse that she is still having trouble getting to the toilet without experiencing significant pain.The nurse plans care for this client based on which goal?

Accepted Answer

The goal of allowing the client to perform activities of daily living addresses the client's specific concern of pain with toileting and aims to promote her ability to function independently. While pain management is an important aspect of care, the goal is not complete pain elimination in clients with chronic pain. Preventing addiction and assessing treatment success are important goals, but they are not as immediately relevant to this client's current issue.

Question 2

What is the mechanism of action that differentiates opioid agonists from opioid agonist-antagonists?

Accepted Answer

Opioid agonists activate both mu and delta receptors, while opioid agonist-antagonists occupy the mu receptor but also partially block it, leading to a diminished response. This is known as a partial agonist or mixed agonist-antagonist effect.

Question 3

Somatic pain is a type of nociceptor pain that is usually experienced in which area?

Accepted Answer

Somatic pain is pain that originates from muscles, bones, joints, skin, or other connective tissues. It is also known as musculoskeletal pain. Therefore, the correct answer is C.

Question 4

Pain transduction begins when which event occurs?

Accepted Answer

Pain transduction begins when local tissue injury causes the release of chemical mediators of inflammation, such as prostaglandins and bradykinin, which activate nociceptors (pain receptors) in the affected area. This leads to the generation of electrical impulses, which travel along nerves to the spinal cord and up to the brain.

Question 5

How is acute pain defined?

Accepted Answer

Acute pain is defined as pain that is associated with an injury or surgery, and typically lasts for a limited amount of time, usually less than 3 to 6 months. It is generally considered to be a protective mechanism that alerts the body to potential or actual damage.

Question 6

When administering opioid drugs,the nurse should have an opioid antagonist readily available in case the client experiences which effects?

Accepted Answer

Opioid drugs can cause hypoventilation, which may decrease the oxygen level in the body leading to respiratory distress, and may require opioid antagonists such as naloxone or naltrexone to reverse the effects. Nausea and vomiting are common side effects of opioids, but do not require a naloxone intervention. Hyperventilation and hypovolemia are not typically caused by opioid drugs.

Question 7

The client asks the nurse why he is receiving combination therapy of opioid and nonopioid drugs to manage his pain.The nurse should explain which benefit of combination therapy?

Accepted Answer

Using a combination of opioid and non-opioid drugs can have a synergistic effect in relieving pain and may also decrease the risk of side effects. This approach is tailored to individual clients based on their needs and is not a standard therapy for all pain management clients. Combination therapy does not prevent addiction to opioids and may require follow-up laboratory monitoring.

Question 8

The client is experiencing pain after orthopedic surgery,and is prescribed opioid analgesic medication.The client complains to the nurse that the surgical joint is still uncomfortable,despite around-the-clock medication.What is the nurse's best response?

Accepted Answer

Cold packs can be effective in reducing pain and inflammation after surgery, providing an additional non-pharmacological method of pain control. This approach is often recommended alongside medication for post-operative care.

Question 9

Clients and health care providers often have beliefs about pain that can interfere with successful pain management.What is a common myth related to pain?

Accepted Answer

Vital signs are not reliable indicators of pain. Clients may demonstrate opposite vital signs from what is expected with pain, like decreased heart rate, because of substances that reduce biological stress. Pain is highly subjective and can only be evaluated through client self-report.

Question 10

Nociceptor pain responds well to which type of drug therapy?

Accepted Answer

Nociceptor pain, which is pain resulting from tissue damage or inflammation, can be effectively treated with analgesic drugs such as nonsteroidal anti-inflammatory drugs (NSAIDs) or opioids. These drugs work by blocking pain signals within the nervous system. Serotonin receptor blockers and antidepressant medications are typically used to treat neuropathic pain, which is caused by damage to the nervous system itself. Nonanalgesic drugs would not be effective in treating nociceptor pain.

Question 11

A client is prescribed an opioid-nonopioid drug combination.The nurse explains that the drug is composed of hydrocodone and acetaminophen.The client says,"Why am I getting this? I don't have a fever,and I don't think that will be enough for my pain." Which is the best response from the nurse?

Accepted Answer

Option D provides a clear and accurate explanation of why the client is receiving the opioid-nonopioid drug combination. It helps the client understand how the two drugs work together to relieve their pain. Option A is inappropriate as it does not address the client's concerns and may even lead to confusion or mistrust of the nurse. Option B is incorrect as the client is not being given the medication to prevent a fever, and option C is also not appropriate as it assumes the client is allergic to acetaminophen, which may not be the case.

Question 12

Gate control therapy proposes a mechanism to explain which phenomenon?

Accepted Answer

The answer of Gate control therapy proposes a mechanism to...

Question 13

The client is being treated for severe pain with opioid analgesics.The pain has neuropathic qualities.The nurse chooses a prn order for which type of analgesic to aid the client's pain management?

Accepted Answer

Adjuvant analgesics are medications that are not primarily designed for pain relief, but can enhance pain management when used in combination with analgesics. In cases of neuropathic pain, adjuvant analgesics such as anticonvulsants, antidepressants, or local anesthetics may be used to supplement the opioid analgesic and provide better pain relief. Nonopioid analgesics and patient-controlled analgesics may not be effective for neuropathic pain, while parenteral opioids carry a higher risk of side effects and addiction.

Question 14

Which objective method should the nurse use to assess the client's pain level?

Accepted Answer

Using a pain rating scale such as the numeric rating scale is the most objective method for assessing a client's pain level. Asking the client to describe the pain sensation can be subjective and influenced by individual factors such as culture and language. Assessing pain only when the client complains of pain may miss pain that the client does not verbalize. Observing whether the client appears to be in pain or appears comfortable can also be subjective and influenced by individual factors such as stoicism and pain tolerance.

Question 15

The client is experiencing mild pain secondary to a minor ankle sprain.Which is the drug class of choice for the client's pain?

Accepted Answer

Nonopioid analgesics such as acetaminophen or nonsteroidal anti-inflammatory drugs (NSAIDs) should be the drug class of choice for mild pain, such as that experienced with a minor ankle sprain, due to their effectiveness and low risk of adverse effects. Opioid analgesics, adjuvant analgesics, and patient-controlled analgesics are typically reserved for moderate to severe pain or pain not well managed by nonopioid analgesics.

Question 16

How is pain perception best defined?

Accepted Answer

Pain perception is the conscious experience of pain that occurs in the brain. It is not solely based on culture or previous experiences with pain, and it is not an unconscious experience. Pain scores are a measurement tool for pain, but they do not define pain perception.

Question 17

When clients are aware that health care providers are actively engaged in pain management,research shows that the clients often respond in which manner?

Accepted Answer

The answer of When clients are aware that health care...

Question 18

A client who has neuropathy of the lower extremities is prescribed an opioid analgesic for pain.The provider adds a tricyclic antidepressant medication (TCA)for pain management.The client asks the nurse,"Why am I getting this new drug? I am not depressed,my feet just burn." What is the best response from the nurse?

Accepted Answer

Tricyclic antidepressants have been found to be effective in treating neuropathic pain. They work by increasing the concentration of neurotransmitters in the brain that decrease the intensity of pain signals. The nurse can explain to the client that although TCAs are often used to treat depression, they can also be effective in managing pain by acting on the nervous system.

Question 19

What is one of the benefits of the use of nonpharmacologic interventions in pain management?

Accepted Answer

Nonpharmacologic interventions can complement pharmacologic interventions and allow for lower doses and fewer drug-related adverse effects of pain medications. While nonpharmacologic interventions may provide some pain relief on their own, they are often used in combination with pain medications as part of a multimodal approach to pain management. Nonpharmacologic interventions can include things like massage, acupuncture, cognitive-behavioral therapy, and physical therapy.

Question 20

To increase the awareness of pain treatment among health care professionals,the American Pain Society coined which phrase?

Accepted Answer

The American Pain Society coined the phrase "Pain: The fifth vital sign" to increase the awareness of pain treatment among health care professionals. This phrase emphasizes the importance of pain assessment and management along with the traditional vital signs of temperature, heart rate, blood pressure, and respiratory rate.

Quiz 25: Pharmacotherapy of Severe Pain and Migraines