Question 1

The client has pain in the lower back that radiates down the leg as the result of a herniated disk compressing the sciatic nerve. The pain began 2 months ago. When documenting this client's pain, which term will the nurse use?

A) Acute somatic pain
B) Acute visceral pain
C) Chronic neuropathic pain
D) Acute neuropathic pain

Accepted Answer

1. The pain is considered acute because it has lasted less than 3 months. It is neuropathic pain because it is caused by damage to the sciatic nerve.
2. The pain is considered acute because it has lasted less than 3 months. It is neuropathic pain because it is caused by damage to the sciatic nerve.
3. The pain is considered acute because it has lasted less than 3 months. It is neuropathic pain because it is caused by damage to the sciatic nerve.
4. The pain is considered acute because it has lasted less than 3 months. It is neuropathic pain because it is caused by damage to the sciatic nerve.

Question 2

The nurse overhears a colleague plan to make a client wait for pain medication because of the fear of drug-seeking behavior. Which action by the nurse is the most appropriate in this situation?&#10;A) Ignoring the situation because the client in question is not this nurse's responsibility&#10;B) Entering the nurses' station, reprimanding the nurse, and completing an incident or variance report&#10;C) Pulling the second nurse aside and providing a reminder that the sensation of pain is subjective, and that professionals have a duty to believe clients' reports of their symptoms&#10;D) Informing the charge nurse of what was overheard

Accepted Answer

1. It is every nurse's responsibility to speak up and advocate for the client when situations arise that place the client at risk of incorrect treatment. However, the nurse would address the situation privately, and not in front of others at the nurses' station. Informing the charge nurse would only be necessary if the nurse who was overheard did not respond constructively to the correction.
2. It is every nurse's responsibility to speak up and advocate for the client when situations arise that place the client at risk of incorrect treatment. However, the nurse would address the situation privately, and not in front of others at the nurses' station. Informing the charge nurse would only be necessary if the nurse who was overheard did not respond constructively to the correction.
3. It is every nurse's responsibility to speak up and advocate for the client when situations arise that place the client at risk of incorrect treatment. However, the nurse would address the situation privately, and not in front of others at the nurses' station. Informing the charge nurse would only be necessary if the nurse who was overheard did not respond constructively to the correction.
4. It is every nurse's responsibility to speak up and advocate for the client when situations arise that place the client at risk of incorrect treatment. However, the nurse would address the situation privately, and not in front of others at the nurses' station. Informing the charge nurse would only be necessary if the nurse who was overheard did not respond constructively to the correction.

Question 3

Which can the nurse safely assign to the assistive personnel (AP)?&#10;A) Initial assessment of pain&#10;B) Regular reassessment of pain&#10;C) Providing a massage and repositioning the client in pain&#10;D) Administration of an oral analgesic

Accepted Answer

1. Assessment is never assigned to the AP. An AP cannot administer oral analgesics. The AP can safely provide a massage and reposition the client.
2. Assessment is never assigned to the AP. An AP cannot administer oral analgesics. The AP can safely provide a massage and reposition the client.
3. Assessment is never assigned to the AP. An AP cannot administer oral analgesics. The AP can safely provide a massage and reposition the client.
4. Assessment is never assigned to the AP. An AP cannot administer oral analgesics. The AP can safely provide a massage and reposition the client.

Question 4

The assistive personnel (AP) informs the nurse that the client is complaining of severe postoperative pain and requests pain medication. Which action should the nurse take?&#10;A) Give the client an analgesic.&#10;B) Assess the client's pain and respond as indicated.&#10;C) Ask the AP for more data regarding the client's pain.&#10;D) Tell the AP to inform the client that the nurse will be in as soon as possible.

Accepted Answer

1. When the AP reports a problem, the nurse should assess the client thoroughly before acting. Giving the client an analgesic without a thorough assessment by the nurse would be dangerous. Asking the AP for more information is not efficient because the nurse should talk directly to the client. Delaying response to the client's needs would not be effective nursing practice.
2. When the AP reports a problem, the nurse should assess the client thoroughly before acting. Giving the client an analgesic without a thorough assessment by the nurse would be dangerous. Asking the AP for more information is not efficient because the nurse should talk directly to the client. Delaying response to the client's needs would not be effective nursing practice.
3. When the AP reports a problem, the nurse should assess the client thoroughly before acting. Giving the client an analgesic without a thorough assessment by the nurse would be dangerous. Asking the AP for more information is not efficient because the nurse should talk directly to the client. Delaying response to the client's needs would not be effective nursing practice.
4. When the AP reports a problem, the nurse should assess the client thoroughly before acting. Giving the client an analgesic without a thorough assessment by the nurse would be dangerous. Asking the AP for more information is not efficient because the nurse should talk directly to the client. Delaying response to the client's needs would not be effective nursing practice.

Question 5

The nurse assesses a client experiencing chronic pain. Which finding should indicate to the nurse that the pain has affected the client's mental status? Select all that apply.&#10;A) Client appears fatigued.&#10;B) Client reports feeling sad.&#10;C) Client states not looking forward to anything in life.&#10;D) Client demands pain medication as soon as possible.&#10;E) Client is tired of constantly worrying about the pain.

Accepted Answer

1. Fatigue is an emotional response to pain and increases pain perception.
2. A client in chronic pain will have mood changes because of the sadness of not being able to do enjoyable activities.
3. A client in chronic pain may feel helpless and hopeless and stop looking forward to life.
4. A client who demands pain medication has had previous unsuccessful attempts at pain control.
5. Anxiety and worry about the pain may escalate to the point of panic.

Question 6

A client with chronic pain has following multimodal pain management. Which outcome should indicate that this approach has been effective? Select all that apply.&#10;A) Sleeps 4 hours a night&#10;B) Stays indoors most of the time&#10;C) Attends yoga classes twice a week&#10;D) Takes acetaminophen every 6 hours&#10;E) Has not used an opioid analgesic for three days

Accepted Answer

1. Sleeping 4 hours a night might be because of uncontrolled pain. This would indicate that the multimodal approach has not been effective.
2. Staying indoors most of the time could indicate sadness or depression. This behavior would indicate that the multimodal approach has not been effective.
3. Multimodal pain management incorporates pharmacologic and nonpharmacologic approaches. Attending yoga classes twice a week indicates an active involvement in the program.
4. Using nonopioid analgesics for pain management indicates active involvement in the program.
5. Not using opioid analgesics for 3 days indicates pain is being controlled through other approaches.

Question 7

A client wants to use a multimodal approach to control chronic nerve pain. Which nonpharmacologic approaches should the nurse review with this client? Select all that apply.&#10;A) Massage&#10;B) PCA pump&#10;C) Biofeedback&#10;D) Acupuncture&#10;E) Physical therapy

Accepted Answer

1. Massage is a nonpharmacologic intervention used in multimodal pain management.
2. A PCA pump delivers a narcotic for pain management.
3. Biofeedback is a nonpharmacologic intervention used in multimodal pain management.
4. Acupuncture is a nonpharmacologic intervention used in multimodal pain management.
5. Physical therapy is a nonpharmacologic intervention used in multimodal pain management.

Deck 9: Pain Assessment and Management