Question 1

A patient has just had surgery.What pain control strategy is best?

Accepted Answer

Giving pain medications around the clock after surgery is the best strategy to manage the pain effectively and prevent escalation of pain. This strategy prevents fluctuation of pain levels and medication peaks and troughs, providing consistent pain relief for the patient. Additionally, this strategy reduces the risk of potential complications associated with opioid administration, such as respiratory depression or constipation.

Question 2

The nurse caring for an older cognitively impaired patient with osteoarthritis in both hands assesses the patient for hand pain by

Accepted Answer

B

Question 3

The nurse is caring for four frail patients with pain.Which patient's pain medication prescription does the nurse question?

Accepted Answer

Pentazocine is a mixed opioid agonist-antagonist and can cause withdrawal symptoms and increased pain if given to patients who are already taking full opioid agonists, such as hydromorphone. Therefore, the nurse should question the prescription for the patient taking pentazocine. The other three medications (acetaminophen, ibuprofen, and hydromorphone) are appropriate for pain management in frail patients.

Question 4

When planning care for the older adult patient with a history of persistent pain,the nurse acknowledges the effects of the mind-body connection by including

Accepted Answer

The mind-body connection refers to the relationship between a person's thoughts and emotions and their physical body. Relaxation techniques, such as deep breathing, meditation, and guided imagery, can help to reduce stress and promote relaxation, which can in turn have a positive effect on pain levels. Regular pain assessments, prompt response to reports of pain, and pain consults are also important components of care for a patient with persistent pain, but they do not specifically address the mind-body connection.

Question 5

An older patient is being treated for arthritic pain with a nonsteroidal antiinflammatory drug (NSAID).Which question best assesses for side effects of this medication class?

Accepted Answer

NSAIDs can cause gastrointestinal (GI) irritation, including ulcers and bleeding. Advising patients to take these medications with food can help minimize GI side effects.

Question 6

A confused patient is admitted to the hospital after suffering a fall.When asked about pain,the patient does not respond.What action by the nurse is best?

Accepted Answer

Observing the patient's nonverbal behaviors, such as facial expressions, body language, and vital signs, can provide clues about whether the patient is experiencing pain. It is important to assess nonverbal behaviors since patients who are confused or have cognitive impairments may not be able to express their pain verbally or understand the nurse's questions. While asking the patient again using different words or pantomiming may be helpful in some cases, it is important to primarily rely on nonverbal cues when assessing pain in a confused patient. Asking family members is also an option, but it should only supplement the nurse's primary assessment of the patient's nonverbal behaviors.

Question 7

An older adult patient is prescribed an analgesic to manage the joint pain resulting from stiffness in his right shoulder.When the patient asks about alternative therapy techniques that might be helpful,the nurse suggests

Accepted Answer

Applying moderate heat can help relax and loosen tissues, and stimulate blood flow to the area, which can be beneficial for joint stiffness.

Question 8

The nurse is caring for a 78-year-old patient with a history of chronic depression.The patient currently reports persistent left shoulder pain since having a fall a year ago.To best address the patient's pain,the nurse initially determines

Accepted Answer

Depression can affect pain perception and coping mechanisms.

Question 9

The nurse caring for an older adult patient experiencing pain from a nerve injury anticipates the patient will best achieve pain control when prescribed a(n)

Accepted Answer

Tricyclic antidepressants are often used in the management of neuropathic pain, which is pain caused by nerve injury or dysfunction. They can modulate pain at the level of the central nervous system and are considered effective for this type of pain.

Question 10

The nurse is performing a pain assessment when the older adult patient reports pain in his left shoulder that radiates down into the forearm.The nurse should do which of the following first?

Accepted Answer

The answer of The nurse is performing a pain assessment...

Question 11

When planning nursing care for an older adult who is experiencing chronic pain,the nurse includes which of the following interventions? (Select all that apply. )

Accepted Answer

The answer of When planning nursing care for an older...

Question 12

An older patient who lives alone is brought to the clinic by an adult child who reports the patient has become "depressed" and no longer wants to go out of the home.What action by the nurse is best?

Accepted Answer

The answer of An older patient who lives alone is...

Question 13

A patient has constipation as a side effect of opioid analgesics.What menu choice indicates the patient understands nutritional therapy for this problem?

Accepted Answer

Oatmeal is high in fiber, which can help alleviate constipation. Choosing foods high in fiber is important for patients experiencing constipation as a side effect of opioid use.

Question 14

When planning care for the older adult experiencing pain,the nurse bases interventions on the realization that

Accepted Answer

Research has shown that pain is undertreated in older adults compared to younger adults. This may be due to misconceptions that pain is a normal part of aging or concerns about adverse effects of pain medications in this population. Older adults are as sensitive to pain as younger adults and may actually require higher doses of pain medication due to changes in metabolism and drug distribution in the body. Nurses should assess and manage pain effectively in older adults to ensure their comfort and improve their overall quality of life.

Question 15

An older patient is observed grimacing whenever walking and getting in and out of bed.When assessed,the patient regularly denies having any pain.To best provide the patient with effective pain control,the nurse initially

Accepted Answer

The answer of An older patient is observed grimacing whenever...

Question 16

An older patient is hospitalized for the first time.After giving a dose of hydromorphone what assessment takes priority?

Accepted Answer

When administering a dose of hydromorphone, the priority assessment is the respiratory rate as opioids can cause respiratory depression. It is important to monitor the respiratory rate to ensure the patient is not experiencing any adverse effects of the medication. Once respiratory safety is established, it would be appropriate to assess the patient's pain level, nausea, and urinary retention.

Question 17

An older adult who injured her knee several years ago tells the nurse that she has been managing the resulting intermittent pain with a prescription for an opioid analgesic.The nurse is concerned with this treatment plan,primarily because

Accepted Answer

The nurse is concerned because long-term use of opioids for pain management can lead to dependence, addiction, and other adverse effects. The nurse should investigate alternative pain management strategies, possibly involving non-opioid medications or non-pharmacological interventions such as physical therapy or acupuncture. Simply assuming that aspirin would be as effective or that the knee should not still be causing pain is not appropriate without further assessment and evaluation.

Question 18

Acetaminophen is prescribed for a 70-year-old patient with chronic pain.When the patient reports to the nurse that the maximum daily dose of medication does not control the pain,the nurse responds

Accepted Answer

If the maximum daily dose of acetaminophen is not controlling the patient's chronic pain, it may be necessary to undergo a comprehensive pain assessment to determine appropriate changes to the medication regimen or other interventions. Options A and B are not sufficient responses to this situation, and option C may not be an accurate assessment without further assessment.

Question 19

An older adult lives alone at home and is being treated for chronic pain.The home health care nurse notes the adult is disheveled and has dirty dishes piled up in the sink which is unusual for the patient.What action by the nurse is best?

Accepted Answer

The answer of An older adult lives alone at home...

Question 20

A director of nursing in a long-term care facility was concerned after reading that as many as 80% of residents have untreated pain.What action by the director is best?

Accepted Answer

Establishing protocols for routine assessment ensures that all residents are regularly evaluated for pain, which can help identify and address untreated pain effectively.

Quiz 13: Pain