Question 1

When considering how a patient is likely to respond to a nonpharmaceutical treatment for pain, a nurse understands that according to gate control theory,

Accepted Answer

According to gate control theory, endorphins can help to close the gate, thus reducing pain. The theory proposes that pain signals must pass through a "gate" in the spinal cord before reaching the brain, and that various factors, including endorphins, can affect whether the gate is open or closed. While stress and anxiety can play a role in pain perception, they are not directly related to the gate control theory. Stimulation of the narrow nerve fibers is believed to increase pain signals, not decrease them. Rubbing an injured body part can also potentially stimulate these fibers and increase pain, but this is not a central tenet of the gate control theory.

Question 2

A patient complains that regardless of the methods of alternative pain control that have been used, her pain remains a 7 on a scale of 10. The nurse suggests that her pain may be ____ pain.

Accepted Answer

Intractable pain is pain that is resistant to therapy and persists despite a variety of interventions. The patient's description of her pain remaining a 7 out of 10 despite various methods of alternative pain control suggests that her pain is intractable.

Question 3

A 52-year-old Chinese American patient is admitted to hospice care because of terminal cancer. The nurse understands that this patient may hold that pain

Accepted Answer

Cultural beliefs and practices can significantly influence how individuals express and manage pain. In some Asian cultures, including Chinese, there is a tendency to endure pain in silence and avoid verbal complaints or outward expressions of discomfort. This stoicism is often rooted in cultural values that prioritize self-control and the avoidance of burdening others.

Question 4

A patient has a sore, injured hip. If rising out of a chair causes the patient's back and upper leg to hurt as well, then a nurse would document the pain as

Accepted Answer

Radiating pain is pain that spreads from the original site to another part of the body, which is consistent with the description of the patient's symptoms spreading from the hip to the back and upper leg.

Question 5

At a health fair, a nurse explains to a participant, who is complaining of nagging pain, that it is important to report the pain to the primary care physician rather than ignoring it because

Accepted Answer

Pain is often an indication that tissue damage has occurred, and ignoring it can lead to further damage or complications. Therefore, it is important to report any nagging pain to a primary care physician to determine the underlying cause and appropriate treatment.

Question 6

A patient who is suffering from terminal cancer asks a nurse how massage decreases his pain. The nurse explains that in theory,

Accepted Answer

Massage is thought to stimulate the release of endorphins, which are natural painkillers produced by the body. Endorphins are believed to block the transmission of pain signals to the brain and are responsible for feelings of euphoria or a "runner's high" after exercise.

Question 7

A nurse could appropriately respond to a patient's complaint that he awakens frequently during the night by saying:

Accepted Answer

This response provides helpful and factual information about a potential cause of night waking (alcohol consumption), without making assumptions about the patient's habits or behaviors. It also opens the door for further discussion about the patient's sleeping patterns and potential lifestyle changes that may improve sleep quality. Option A suggests an assumption about the patient's sleep habits, while Option B is not evidence-based and Option D could potentially have the opposite effect on some people's ability to fall asleep.

Question 8

A patient tells her nurse that she has had chronic pain for approximately 2 years and that her primary care physician is talking about ordering her a transcutaneous electrical nerve stimulator (TENS) unit. When asked how a TENS unit helps pain, the nurse explains that it

Accepted Answer

A TENS unit delivers electrical stimulation to the skin surface, which stimulates the broad nerve fibers. Activation of these fibers can help reduce pain by blocking pain signals.

Question 9

A nurse explains to a patient with chronic pain that exercise may relieve some pain. The nurse goes on to explain that based on the gate control theory, exercise

Accepted Answer

The gate control theory of pain suggests that non-painful input closes the "gates" to painful input, which prevents pain sensation from traveling to the central nervous system. Exercise stimulates broad (large) nerve fibers, which according to this theory, helps to shut the gate, thereby reducing the perception of pain.

Question 10

A critically ill patient may have difficulty in getting the restorative sleep necessary for healing. A nurse will

Accepted Answer

Dimming the lights and closing the door can create a calm and restful environment for the patient, which can aid in promoting restorative sleep. Encouraging exercise, refraining from waking the patient, and silencing alarms may also be helpful, depending on the patient's specific condition and needs, but are not necessarily the best option in every situation.

Question 11

An elderly patient with a compression fracture of the spine says, "I've had plenty of pain in my lifetime, but never anything like this. I feel like I'm being stabbed." A nurse could correctly respond:

Accepted Answer

The symptoms described by the patient suggest that they are experiencing neuropathic pain. Neuropathic pain is typically described as a stabbing, shooting, or burning pain caused by pressure or damage to a nerve, rather than pain in the surrounding tissue.

Question 12

A patient complains of pain at 9 on a scale of 10 and requests pain medication. Understanding that it is important to quickly treat severe pain, a nurse will expect to administer

Accepted Answer

An opiate/opioid analgesic is the best choice to quickly treat severe pain that the patient rates at 9 on a scale of 10. NSAIDs and nonopiate analgesics are not as effective for severe pain, and adjuvant analgesics are used in conjunction with the primary analgesic.

Question 13

A patient who had an amputation just below the knee several days ago expresses confusion about why a foot that has been amputated is still causing intense pain. A nurse explains that the type of pain experienced by the patient is

Accepted Answer

Neuropathic pain is caused by damage or dysfunction of the nervous system and can be experienced even after amputation because the nerve endings at the amputation site continue to send pain signals to the brain. This type of pain is often described as burning or shooting and can be difficult to treat with traditional pain medications.

Question 14

A patient who was admitted with severe back pain is watching TV and smiling. The patient received pain medication 4 hours ago and rates his pain at an 8. Knowing that the patient's pain medication may be given every 4 to 6 hours, the nurse will

Accepted Answer

The patient's pain is rated at 8 and the medication can be given every 4 to 6 hours. It is appropriate to administer pain medication now based on the patient's pain level and the medication schedule.

Question 15

A patient asks the nurse, "Why has my primary care physician ordered an antidepressant for me? I'm not depressed. I'm just in pain." The nurse could appropriately explain:

Accepted Answer

Antidepressants are sometimes used in the treatment of chronic pain because they can potentiate the effects of pain medications.

Question 16

As a result of major surgery, a patient feels deep pain. The nurse correctly documents this pain as

Accepted Answer

The answer of As a result of major surgery, a...

Question 17

A nurse would recognize that further instruction was needed if a nursing student expressed the assumption that a patient

Accepted Answer

A patient can still experience pain while sleeping. Sleep does not necessarily mean that a patient is pain-free. As healthcare professionals, we need to assess and manage pain regardless of the patient's state of consciousness.

Question 18

When teaching a patient about restorative rest, the nurse explains that

Accepted Answer

Non-rapid eye movement (NREM) sleep is considered the most restful cycle as it allows for physical rest and restoration. Rapid eye movement (REM) sleep, while important for cognitive restoration and processing emotions, is not considered as restful for the body as NREM sleep.

Question 19

Culture plays a strong role in determining whether a patient will be willing to communicate if he or she is in pain or how severe the pain may be. Therefore, a nurse understands that extra time may need to be taken to determine the pain level of

Accepted Answer

The answer of Culture plays a strong role in determining...

Question 20

A mother, concerned that her toddler is not getting enough rest, asks a nurse what the average amount of sleep is for a 4-year-old. The nurse replies:

Accepted Answer

At the age of 4, children typically need about 11 to 12 hours of sleep per day, which may include a nap. Choices A and C suggest more sleep than is generally recommended, and choice B suggests less.

Quiz 19: Pain Management, Rest, and Restorative Sleep