Deck 9: Pain and Pain Management

Question 1

The patient has received ketamine for its analgesic effects.The patient suddenly states,"I feel like I am floating and can see everything you are doing.I am not in control." The nurse is aware that this is caused by the ketamine and is known as the

A) hallucination state.
B) guided imagery and will help relieve pain.
C) dissociative state.
D) recommended effect of ketamine.

Answer 1

dissociative state.

Question 2

Using a specific pain intensity scale in the CCU

A) eliminates the need for the subjectivity of the patient.
B) allows for one tool for all patient types.
C) provides consistency of assessment and documentation.
D) is not necessary because all pain is treated equally in the CCU.

Answer 2

provides consistency of assessment and documentation.

Question 3

A patient underwent a thoracotomy 12 hours ago.The patient currently has an epidural catheter in place and is receiving continuous epidural analgesia with morphine.In addition to closely monitoring the patient for side effects and complications,which of the following interventions might enhance her pain control?

A) Maintain her flat in bed during the infusion.
B) Position her on her right side to encourage flow of the medication across the dura.
C) Limit visitors and remove any distractions such as television and music.
D) Consider administration of adjunct medication such as antidepressants or NSAIDs.

Answer 3

Consider administration of adjunct medication such as antidepressants or NSAIDs.

Question 4

A patient complains of pain at his incision site.The nurse is aware that four processes are involved in nociception.The proper order of the processes is

A) transmission, perception, modulation, and transduction.
B) perception, modulation, transduction, and transmission.
C) modulation, transduction, transmission, and perception.
D) transduction, transmission, perception, and modulation.

Question 5

The use of PCA infusion pumps allows the patient to

A) act preemptively by administering a bolus of medication when pain begins.
B) choose between the use of opioids or NSAID medication to control pain.
C) decrease the risk of respiratory depression.
D) control pain medication in 2-hour increments.

Question 6

Which of the following patients is MOST likely to be experiencing a life-threatening opioid side effect?

A) Patient with respiratory rate of 10 breaths/min who is breathing deeply
B) Patient with a respiratory rate of 8 breaths/min who is snoring
C) Patient with blood pressure of 150/75 mm Hg and heart rate of 102 beats/min
D) Patient with a temperature of 100.5°F who is asleep but easily roused

Question 7

A patient states that he has been taking Demerol 50 mg tablets four times a day for the past 5 years,but they are not working like they use to.The nurse is concerned that the patient has developed

A) addiction to Demerol.
B) physical dependence and tolerance.
C) physical dependence and addiction.
D) a method to withdraw himself off the medication.

Question 8

A patient underwent a thoracotomy 12 hours ago.The patient currently has an epidural catheter in place and is receiving continuous epidural analgesia with morphine.In addition to respiratory depression,the patient should be monitored for which of the following complications?

A) Urinary retention, undue somnolence, itching, nausea, and vomiting
B) Urinary incontinence, photophobia, headache, and skin rash
C) Apprehension, anxiety, restlessness, sadness, anger, and myoclonus
D) Gastric bleeding, nasal discharge, cerebrospinal fluid leak, and calf pain

Question 9

Which of the following assessment findings might indicate respiratory depression after opioid administration?

A) Flushed, diaphoretic skin
B) Shallow respirations with a rate of 24 breaths/min
C) Tense, rigid posture
D) Snoring

Question 10

C fibers are small-diameter,unmyelinated fibers that transmit what type of pain?

A) C fibers transmit diffuse, dull, aching pain.
B) C fibers conduct the rapid acute pain sensation described as prickling, sharp, and fast.
C) C fibers conduct diffuse, dull, aching pain.
D) C fibers transmit rapid acute pain sensation described as prickling, sharp, and fast.

Question 11

The subjective characteristic implies that pain is

A) an uncomfortable experience present only in the patient with an intact nervous system.
B) an unpleasant experience accompanied by crying and tachycardia.
C) activation of the sympathetic nervous system from an injury.
D) whatever the patient experiencing it says it is, occurring when that patient says it does.

Question 12

Which of the following statements are true regarding pain assessment and management?

A) The single most important assessment tool available to the nurse is the patient's self-report.
B) The only way to assess pain in patients unable to verbalize because of mechanical ventilation is through observation of behavioral indicators.
C) The concept of equianalgesia uses morphine as a basis for dosage comparison for other medications.
D) Transcutaneous electrical nerve stimulation and application of heat or cold therapy stimulate the nonpain sensory fibers.
E) Meperidine, a synthetic form of morphine, is much stronger and is given at lower doses at less frequent intervals.

Question 13

The neural processes of encoding and processing noxious stimuli necessary but not sufficient for pain is known as

A) perception.
B) nociception.
C) transduction.
D) transmission.

Question 14

Relaxation,distraction,guided imagery,and music therapy are all examples of

A) physical techniques for pain management.
B) cognitive-behavioral techniques for pain management.
C) PCA management of pain.
D) equianalgesic management of pain.

Question 15

The patient is sedated and breathing with the use of mechanical ventilation.The patient is unable to communicate any aspects of his pain to the nurse.The nurse knows that the best tool for pain assessment for this patient is

A) FLACC.
B) Wong-Baker FACES.
C) BIS.
D) BPS or CPOT.

Question 16

The patient is admitted to the CCU with hemodynamic instability and an allergy to morphine.The nurse anticipates that the physician will order which medication for severe pain?

A) Hydromorphone
B) Codeine
C) Fentanyl
D) Methadone

Question 17

A nurse is administering naloxone to a patient experiencing respiratory depression.Which of the following interventions must be observed when using naloxone?

A) Naloxone is normally given rapidly via IV.
B) Naloxone is discontinued as soon as a patient is responsive to physical stimulation and able to take deep breaths.
C) Naloxone has a shorter duration than most opioids, so the nurse may need to repeat naloxone as early as 30 minutes after the first dose.
D) The patient's pain control is easily established after receiving naloxone.
E) Naloxone is not recommended after prolonged analgesia because it can induce withdrawal and may cause nausea and dysrhythmias.

Question 18

Which of the following combinations of drugs has been found to be effective in managing the pain associated with musculoskeletal and soft tissue inflammation?

A) Nonsteroidal anti-inflammatory drugs (NSAIDs) and opioids
B) NSAIDs and antidepressants
C) Opioid agonists and opioid antagonists
D) Adjuvants and partial agonists

Question 19

The nurse is aware that the use of a pain flow sheet in the critical care setting allows for

A) visible and ongoing pain assessment and management of pain.
B) pain assessment and control in postoperative patients treated in the ICU.
C) evaluation of analgesic treatments.
D) recording vital signs.

Question 20

Acute pain usually corresponds to

A) the healing process but should not exceed 9 months.
B) the healing process but should not exceed 6 months.
C) persistent pain more than 6 months after the healing process.
D) damage to the patient's nervous system unrelated to the initial injury.