Question 1

A patient is complaining of severe knee pain after twisting it during a basketball game and is requesting pain medication.Which action by the nurse is appropriate?

Accepted Answer

According to the American Pain Society (1992),"In cases in which the cause of acute pain is uncertain,establishing a diagnosis is a priority,but symptomatic treatment of pain should be given while the investigation is proceeding.With occasional exceptions,(e.g.,the initial examination of the patient with an acute condition of the abdomen),it is rarely justified to defer analgesia until a diagnosis is made.In fact,a comfortable patient is better able to cooperate with diagnostic procedures."

Question 2

The nurse is reviewing the principles of nociception.During which phase of nociception does the conscious awareness of a painful sensation occur?

Accepted Answer

Perception is the third phase of nociception and indicates the conscious awareness of a painful sensation.During this phase,the sensation is recognized by higher cortical structures and identified as pain.

Question 3

The nurse knows that which statement is true regarding the pain experienced by infants?

Accepted Answer

If a procedure or disease process causes pain in an adult,then it will also cause pain in an infant.Physiologic changes cannot be exclusively used to confirm or deny pain because other factors,such as medications,fluid status,or stress may cause physiologic changes.The FPS-R can be used starting at age 4 years.

Question 4

A patient has had arthritic pain in her hips for several years since a hip fracture.She is able to move around in her room and has not offered any complaints so far this morning.However,when asked,she states that her pain is "bad this morning" and rates it at an 8 on a 1-to-10 scale.What does the nurse suspect? The patient:

Accepted Answer

Persons with chronic pain typically try to give little indication that they are in pain and,over time,adapt to the pain.As a result,they are at risk for underdetection.

Question 5

A 60-year-old woman has developed reflexive sympathetic dystrophy after arthroscopic repair of her shoulder.A key feature of this condition is that the:

Accepted Answer

A key feature of reflexive sympathetic dystrophy is that a typically innocuous stimulus can create a severe,intensely painful response.The affected extremity becomes less functional over time.

Question 6

During assessment of a patient's pain,the nurse is aware that certain nonverbal behaviors are associated with chronic pain.Which of these behaviors are associated with chronic pain? Select all that apply.

Accepted Answer

Behaviors that have been associated with chronic pain include bracing,rubbing,diminished activity,sighing,and changes in appetite.In addition,those with chronic pain may sleep in an attempt at distraction.The other behaviors are associated with acute pain.

Question 7

Which statement indicates that the nurse understands the pain experienced by an older adult?

Accepted Answer

Pain indicates a pathologic condition or an injury and should never be considered something that an older adult should expect or tolerate.Pain is not a normal process of aging,and no evidence suggests that pain perception is reduced with aging.

Question 8

The nurse is assessing a patient's pain.The nurse knows that the most reliable indicator of pain would be the:

Accepted Answer

The subjective report is the most reliable indicator of pain.Physical examination findings can lend support,but the clinician cannot exclusively base the diagnosis of pain on physical assessment findings.

Question 9

When assessing the intensity of a patient's pain,which question by the nurse is appropriate?

Accepted Answer

Asking the patient "how much pain do you have?" is an assessment of the intensity of a patient's pain; various intensity scales can be used.Asking what makes one's pain better or worse assesses alleviating or aggravating factors.Asking whether pain limits one's activities assesses the degree of impairment and quality of life.Asking "what does your pain feel like" assesses the quality of pain.

Question 10

The nurse is reviewing the principles of pain.Which type of pain is due to an abnormal processing of the pain impulse through the peripheral or central nervous system?

Accepted Answer

Neuropathic pain implies an abnormal processing of the pain message.The other types of pain are named according to their sources.

Question 11

When assessing a patient's pain,the nurse knows that an example of visceral pain would be:

Accepted Answer

Visceral pain originates from the larger interior organs,such as the gallbladder,liver,or kidneys.

Question 12

When evaluating a patient's pain,the nurse knows that an example of acute pain would be:

Accepted Answer

Acute pain is short-term and dissipates after an injury heals,such as with kidney stones.The other conditions are examples of chronic pain during which the pain continues for 6 months or longer and does not stop when the injury heals.

Question 13

A patient states that the pain medication is "not working" and rates his postoperative pain at a 10 on a 1-to-10 scale.Which of these assessment findings indicates an acute pain response to poorly controlled pain?

Accepted Answer

Responses to poorly controlled acute pain include tachycardia,elevated blood pressure,and hypoventilation.Confusion and depression are associated with poorly controlled chronic pain (see Table 10-1).

Question 14

A 4-year-old boy is brought to the emergency department by his mother.She says he points to his stomach and says,"It hurts so bad." Which pain assessment tool would be the best choice when assessing this child's pain?

Accepted Answer

Rating scales can be introduced at the age of 4 or 5 years.The FPS-R is designed for use by children and asks the child to choose a face that shows "how much hurt (or pain)you have now." Young children should not be asked to rate pain by using numbers.

Question 15

A patient has been admitted to the hospital with vertebral fractures related to osteoporosis.She is in extreme pain.This type of pain would be classified as:

Accepted Answer

Deep somatic pain comes from sources such as the blood vessels,joints,tendons,muscles,and bone.Referred pain is felt at one site but originates from another location.Cutaneous pain is derived from the skin surface and subcutaneous tissues.Visceral pain originates from the larger,interior organs.

Question 16

During an admission assessment of a patient with dementia,the nurse assesses for pain because the patient has recently had several falls.Which of these are appropriate for the nurse to assess in a patient with dementia? Select all that apply.

Accepted Answer

Patients with dementia may have difficulty communicating pain verbally, so non-verbal cues such as breathing patterns, vocalizations, and body language should be assessed.

Question 17

When assessing the quality of a patient's pain,the nurse should ask which question?

Accepted Answer

To assess the quality of a person's pain,the patient is asked to describe the pain in his or her own words.

Quiz 10: Pain Assessment: The Fifth Vital Sign