Deck 15: Pain

Question 1

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

A)generally pain control is less effective than in younger adults.
B)this cohort is less pain sensitive than younger adults.
C)older adults are more likely to verbally express pain than younger adults.
D)pain is undertreated in this cohort compared to the younger adults.

Answer 1

pain is undertreated in this cohort compared to the younger adults.

Question 2

An older adult client has been prescribed an opioid to manage chronic pain resulting from a shoulder injury.To eliminate a common barrier to opioid drug compliance, the nurse:

A)encourages the client to use the opioid only as prescribed.
B)educates the client to the appropriate management of constipation.
C)assures the client that dizziness will decrease as therapeutic levels are reached.
D)suggests the client take the medication with meals or a snack.

Answer 2

educates the client to the appropriate management of constipation.

Question 3

The nurse is performing a pain assessment when the older adult client reports pain in his left shoulder that radiates down into his forearm.The nurse immediately:

A)recognizes that the client is experiencing cardiac distress.
B)alerts the rapid response team to provide emergency care.
C)asks whether he has ever experienced this pain before.
D)questions the client about additional related symptoms.

Answer 3

asks whether he has ever experienced this pain before.

Question 4

The nurse caring for an older adult client experiencing carpal tunnel syndrome anticipates the client will best achieve pain control when prescribed a(n):

A)narcotic (e.g., fentanyl).
B)opioid (e.g., oxycodone).
C)tricyclic antidepressant (e.g., amitriptyline [Elavil]).
D)nonpharmacologic strategy (e.g., wrist bracing).

Question 5

The nurse is caring for an older adult client with terminal cancer and is receiving medication via patient-controlled analgesic ( PCA ) pump.The nurse shows an understanding of primary end-of-life concerns when asking the client:

A)"Do you have any concerns about receiving your medication by needle?"
B)"Are you satisfied with the way your pain is being managed?"
C)"Are you worried about becoming addicted to the narcotic analgesics?"
D)"Do you have any questions concerning how to use the PCA properly?"

Question 6

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.

A)Maintain mobility.
B)Promote autonomy.
C)Manage any chronically painful condition.
D)Provide economical sensitive pain relief.
E)Support the client's right to be pain-free.

Question 7

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

A)observing for facial grimacing when the client uses a fork to eat.
B)being alert for signs of agitation when washing the client's hands.
C)listening to detect moaning when client makes a fist.
D)watching for signs that the client is reluctant to shake hands.

Question 8

The nurse is discussing pain control with an older client who has been prescribed an opiate.When the client expresses concerns about the diminishing effect that the medication has had on the pain, the nurse responds:

A)"It appears that the dosage you take needs to be adjusted upward."
B)"We need to be concerned about you developing a drug tolerance."
C)"This drug category is well known for its low ceiling effect."
D)"Opiate addiction is a concern when tolerance occurs."

Question 9

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

A)applying ice packs to the area three to four times a day.
B)placing a moderately warm heating pad to the shoulder.
C)arranging for a professional massage on a weekly basis.
D)discussing electrical nerve stimulation with the physician.

Question 10

The nurse shows an understanding of the most reported side effects of nonsteroidal anti-inflammatory drug ( NSAID ) therapy when asking a 74-year-old client being treated for arthritic pain:

A)"Have you noticed your heart skipping beats since you began taking this drug?"
B)"Did you know you should not to stand up too quickly?"
C)"Are you aware that you should take your pain medication with food?"
D)"Have you had any episodes of shortness of breath since starting this medicine?"

Question 11

Acetaminophen is prescribed for a 70-year-old with chronic pain.When the client reports to the nurse that she is taking the maximum daily dose of medication each day but the pain is still not controlled, the nurse responds:

A)"Breakthrough pain can be managed with the addition of another analgesic."
B)"Transcutaneous electrical nerve stimulation (TENS) is often helpful."
C)"It sounds as though you have developed a tolerance for acetaminophen."
D)"We will need to get your physician to prescribe another analgesic for you."

Question 12

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

A)regular pain assessments.
B)prompt response to reports of pain.
C)pain consults.
D)relaxation techniques.

Question 13

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 propoxyphene (Darvon).The nurse is concerned with this treatment plan, primarily because:

A)there are less expensive alternative analgesics available.
B)this medication can cause renal damage when used long term.
C)aspirin would likely be as effective in managing the pain.
D)the knee should not still be causing pain for the client.

Question 14

The nurse is caring for a 78-year-old with a history of chronic depression who is currently reporting persistent left shoulder pain when syncope caused her to fall.To best address the client's pain, the nurse initially determines:

A)if she is still at risk for falls.
B)the severity of the shoulder injury.
C)how effectively her depression is being managed.
D)the client's ability to effectively cope with pain.

Question 15

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

A)discusses the effects of untreated pain on the client's general wellness.
B)offers the client a prescribed PRN analgesic.
C)asks the client why he is denying the presence of pain.
D)documents the symptoms that the client is exhibiting.