Deck 8: Pain and Pain Management

Question 1

The nurse is caring for a patient with liver dysfunction.What is the maximum dose of acetaminophen the patient should receive in 24 hours?

A) 1 grams
B) 2 grams
C) 4 grams
D) 500 milligrams

Answer 1

2 grams

Question 2

Which statement best describes the concept of pain?

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

Answer 2

Pain is whatever the patient experiencing it says it is, occurring when that patient says it does.

Question 3

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

A) Aching
B) Sharp
C) Prickling
D) Concentrated

Answer 3

Aching

Question 4

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

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

Question 5

What are the neural processes of encoding and processing noxious stimuli associated with pain called?

A) Perception
B) Nociception
C) Transduction
D) Transmission

Question 6

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.What tool should the nurse use to assess the patient's pain?

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

Question 7

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 8

A patient underwent a thoracotomy 12 hours ago and has continuous epidural analgesia with morphine.In addition to respiratory depression,the patient should be monitored for which 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

A patient has been taking Demerol 50 mg tablets three times a day for the past 5 years for chronic back pain; however,the patient complains that the medication is not providing the same level of pain relief as it once did.Based on this statement the nurse suspects that the patient has developed what problem?

A) Addiction
B) Tolerance
C) Physical dependence
D) Physical withdrawal

Question 10

Which statement accurately describes the duration of acute pain?

A) Acute pain is associated with the injury to the joints and lasts about 9 months.
B) Acute pain is associated with the healing process and should not exceed 6 months.
C) Acute pain is persistent pain of more than 6 months after the healing process.
D) Acute pain is associated with damage to the nervous system and is of infinite duration.

Question 11

Which 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 12

A patient complains of pain at his incision site.The nurse is aware that four processes are involved in nociception.In what order do the processes occur?

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 13

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." What is this response called?

A) Hallucination state
B) Guided imagery
C) Dissociative state
D) Adverse event

Question 14

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 15

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

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

Question 16

Why use a specific pain intensity scale in the critical care unit?

A) It eliminates the subjective component from the assessment.
B) It focuses on the objective component of the assessment.
C) It provides consistency of assessment and management.
D) It provides a way to interpret physiologic indicators.

Question 17

Which 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 18

Relaxation,distraction,guided imagery,and music therapy are all examples what type of pain management?

A) Physical techniques
B) Cognitive-behavioral techniques
C) Nonopioid analgesia
D) Equianalgesia

Question 19

A patient underwent a thoracotomy 12 hours ago and has continuous epidural analgesia with morphine.In addition to closely monitoring the patient for side effects and complications,which intervention might enhance the patient's 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 a nonsteroidal antiinflammatory agent.

Question 20

The nurse is caring for a patient with a patient-controlled analgesia (PCA).The patient's spouse asks about the advantages of using this type of pain management therapy.What should the nurse say to the spouse?

A) "The method allows the patient to act preemptively by administering a bolus of medication when pain begins."
B) "This method allows the patient to choose between an opioid and a nonopioid medication to control pain."
C) "This method decreases the risk of respiratory depression and other side effects."
D) "This method allows for the rise and fall of the blood level of the opioid."