Deck 34: Pain Management

Question 1

Which medication order will provide the most immediate relief of the patient's acute pain?

A) Morphine sulfate 5 mg PO
B) Hydromorphone 0.5 mg IV
C) Buprenorphine transdermal patch 10 mg
D) Oxymorphone 30 mg extended release

Answer 1

Hydromorphone 0.5 mg IV

Question 2

Which medication order will provide the most consistent control of the patient's chronic pain?

A) Fentanyl transdermal patch 25 mcg
B) Hydromorphone 0.5 mg IV
C) Fentanyl oral lozenge 200 mcg
D) Morphine sulfate liquid 10 mg

Answer 2

Fentanyl transdermal patch 25 mcg

Question 3

Which is the highest priority nursing diagnosis for a patient with a spinal cord injury and no pain sensation below the waist?

A) Potential for injury related to lack of sensation and protective reflexes
B) Disturbed body image related to loss of body function and sensation
C) Readiness for enhanced self-care related to desire for increased independence
D) Risk for loneliness related to discomfort in social situations due to disability

Answer 3

Potential for injury related to lack of sensation and protective reflexes

Question 4

Which is an appropriate goal for a patient's preoperative teaching?

A) The nurse will provide written materials about nonpharmacological pain-management techniques.
B) The patient will verbalize understanding of the pain-management techniques to be used after surgery.
C) The nurse will demonstrate correct use of the patient-controlled anesthesia (PCA)pump.
D) The patient will rate current pain of less than 3 out of 10 on the descriptive pain intensity scale.

Question 5

The nurse is caring for a patient who is having a heart attack.The patient tells the nurse that the pain is down his left arm rather than in his chest.What type of pain is the patient experiencing?

A) Referred
B) Psychogenic
C) Peripheral
D) Chronic

Question 6

Which is an example of an adjuvant medication for pain management?

A) Naloxone
B) Gabapentin
C) Morphine sulfate liquid
D) Fentanyl transdermal patch

Question 7

The nurse is caring for a patient who just underwent knee-replacement surgery.The patient complains of pain at the operative site but it is too soon for the nurse to administer the next dose of pain medication.What is the appropriate action of the nurse?

A) Give the next dose of prescribed pain medication early.
B) Contact the surgeon immediately to assess the patient's knee.
C) Caution the patient about the risk of addiction to pain medications.
D) Apply an ice pack to the knee and elevate the patient's knee on pillows.

Question 8

The patient expresses frustration about not being able to function as the family breadwinner any longer due to chronic severe pain.Which psychosocial nursing diagnosis is most appropriate for this patient's concern?

A) Risk for loneliness related to need for prescription pain medications
B) Interrupted family processes related to changes in assigned roles
C) Disturbed sensory perception related to insufficient environmental stimuli
D) Moral distress related to time constraints for ethical decision making

Question 9

Which assessment finding leads the nurse to clarify the patient's order for morphine sulfate controlled release 60 mg PO every 12 hours?

A) The patient cannot swallow pills.
B) The patient is allergic to latex and NSAIDs.
C) The patient's platelet count is 200,000/mm³.
D) The patient does not have an intravenous line.

Question 10

A patient has a morphine sulfate patient-controlled analgesia (PCA)to control postoperative pain.When the nurse enters the room,the patient complains of pain.The nurse's first response is which of the following?

A) Ask the patient to rate the pain on a 0-to-10 scale.
B) Check the patency of the patient's intravenous line.
C) Call the physician or health care provider immediately.
D) Speak to the patient in a calming tone to reduce anxiety.

Question 11

Which instruction will the nurse give to the patient about proper use of patient-controlled analgesia (PCA)?

A) "Wait until the pain becomes severe before pushing the PCA button."
B) "The PCA will deliver medication through the IV until the pain is all gone."
C) "You or a designated family member are the only one who gets to push the PCA button-nobody else may do so."
D) "The PCA will give additional pain medication whenever the button is pushed."

Question 12

Why is acute pain particularly dangerous for a patient having a heart attack?

A) Release of endorphins causes dangerous elevation of blood pressure.
B) Release of substance P narrows the airways and leads to hypoxemia.
C) Release of prostaglandins lowers the patient's heart rate and blood pressure.
D) Stimulation of the sympathetic nervous system will increase cardiac workload.

Question 13

The nurse is caring for a patient who continues to have severe pain at the site of a fracture long after it healed.The patient's physicians can find no rationale for the pain.What is the most likely cause of the patient's discomfort?

A) The patient is trying to obtain unneeded pain medications.
B) The patient has developed a complex regional pain syndrome.
C) The patient is in denial that the fracture has healed completely.
D) The patient is experiencing referred pain from a fracture elsewhere.

Question 14

Which is an example of nociceptive pain?

A) Neuropathy due to uncontrolled diabetes
B) Phantom pain after amputation of a limb
C) Pain from rheumatoid arthritis joint damage
D) Chronic nerve pain after shingles infection

Question 15

Which pain relieving option should be avoided by a patient with chronic back pain who must continue to work as a truck driver?

A) Transcutaneous electrical nerve stimulation (TENS)unit
B) Naproxen sodium 200 mg PO every 12 hours
C) Tramadol extended release 200 mg PO daily
D) Application of hot and cold packs to the lower back area

Question 16

The patient takes morphine sulfate controlled release every 12 hours for chronic severe cancer pain.The last dose was 8 hours ago.The patient is presently moaning and states that the pain is very bad.Which is the best action of the nurse?

A) Give the next scheduled dose of morphine sulfate controlled release now.
B) Wait for the last dose of morphine sulfate controlled release to start taking effect.
C) Carefully reposition the patient and reassess the pain in 1 hour.
D) Contact the physician for a breakthrough pain medication order.

Question 17

The nurse observes a postoperative patient trying to take a friend's oxycodone pain pills in addition to the pain medication administered by the nurse.Which is the priority nursing diagnosis for this patient?

A) Risk for poisoning
B) Situational low self-esteem
C) Ineffective impulse control
D) Readiness for enhanced comfort

Question 18

Which is the appropriate goal for a nonverbal,confused patient with the nursing diagnosis chronic pain related to widespread tissue damage?

A) The patient's pain will be reduced to a minimal level.
B) The nurse will assess the patient's pain every 2 hours.
C) The patient will not demonstrate moaning or grimacing.
D) The patient will use a 0-to-10 pain scale to identify pain levels.

Question 19

Which nonpharmacological pain-relief technique is appropriate for a confused,nonverbal patient?

A) Tai chi
B) Biofeedback
C) Massage therapy
D) Guided imagery

Question 20

Which assessment question enables the nurse to determine provocative factors of the patient's pain?

A) "What does your pain feel like?"
B) "Does anything make your pain worse?"
C) "Can you show me where the pain is?"
D) "Is the pain constant or does it come and go?"

Question 21

Which is the priority nursing diagnosis for a patient with a continuous epidural infusion of fentanyl and bupivacaine?

A) Risk for impaired gas exchange related to respiratory suppression
B) Activity intolerance related to generalized weakness and bed rest
C) Impaired physical mobility related to presence of epidural catheter
D) Delayed surgical recovery related to need for continuous pain management

Question 22

Which medications are appropriate for a patient with chronic pain and cannot swallow pills?

A) Morphine sulfate liquid
B) Crushed extended-release morphine sulfate
C) Fentanyl nasal spray
D) Acetaminophen suppository
E) Fentanyl transdermal patch

Question 23

Which medications are classified as nonsteroidal antiinflammatory medications?

A) Tramadol
B) Acetaminophen
C) Aspirin
D) Ibuprofen
E) Codeine

Question 24

Which assessment findings lead the nurse to clarify the order for ibuprofen 600 mg PO every 8 hours?

A) The patient has a gastrointestinal bleed.
B) The patient has allergies to shellfish,strawberries,and iodine.
C) The patient takes 30 mg morphine sulfate daily.
D) The patient has a history of diabetes and early renal failure.
E) The patient has severe joint pain due to aggressive arthritis.

Question 25

Which nursing diagnosis is the highest priority for a patient who just received local anesthesia to the back of the throat for a diagnostic procedure?

A) Feeding self-care deficit related to pain and discomfort
B) Risk for aspiration related to depressed gag reflex
C) Impaired social interaction related to slurred speech
D) Impaired oral mucus membrane related to dry mouth