Deck 34: Comfort and Pain Management

Question 1

A client with cancer pain is taking morphine for pain relief. Knowing constipation is a common side effect, what would the nurse recommend to the client?

A) "Only take morphine when you have the most severe pain."
B) "Increase fluids and high-fiber foods, and use a mild laxative."
C) "Administer an enema to yourself every third day."
D) "Constipation is nothing to worry about; take your medicine."

Answer 1

"Increase fluids and high-fiber foods, and use a mild laxative."

Question 2

A client in the emergency department is diagnosed with a myocardial infarction (heart attack). The client describes pain in his left arm and shoulder. What name is given to this type of pain?

A) Cutaneous pain
B) Referred pain
C) Allodynia
D) Nociceptive

Answer 2

Referred pain

Question 3

A nurse implements a back massage as an intervention to relieve pain. What theory is the motivation for this intervention?

A) Gate control theory
B) Neuromodulation
C) Large/small fiber theory
D) Prostaglandin stimulation

Answer 3

Gate control theory

Question 4

A client tells the nurse that she is experiencing stabbing pain in her mouth, gums, teeth, and chin following brushing her teeth. These are symptoms of which of the following pain syndromes?

A) Complex regional pain syndrome
B) Postherpetic neuralgia
C) Trigeminal neuralgia
D) Diabetic neuropathy

Question 5

Which misconception is common in clients in pain?

A) "I will get addicted to pain medications."
B) "I need to ask for pain medications."
C) "The nurses are here to help relieve the pain."
D) "I do not have to fight the pain without help."

Question 6

A client who has breast cancer is said to be in remission. What does this term signify?

A) The client is experiencing symptoms of the disease.
B) The client has end-stage cancer.
C) The client is experiencing unremitting pain.
D) The disease is present but the client is not experiencing symptoms.

Question 7

A nurse is teaching an alert client how to use a PCA system in the home. How will she explain to the client what he must do to self-manage pain?

A) "You don't have to do anything. The machine does it all."
B) "I will teach your family what they need to do."
C) "When you push the button, you will get the medicine."
D) "The medicine is going into your body all the time."

Question 8

Which client would benefit from a p.r.n. drug regimen?

A) One who had thoracic surgery 12 hours ago
B) One who had thoracic surgery four days ago
C) One who has intractable pain
D) One who has chronic pain

Question 9

A client has a severe abdominal injury with damage to the liver and colon from a motorcycle crash. What type of pain will predominate?

A) Psychogenic pain
B) Neuropathic pain
C) Cutaneous pain
D) Visceral pain

Question 10

A client has been taught relaxation exercises before beginning a painful procedure. What chemicals are believed to be released in the body during relaxation to relieve pain?

A) Narcotics
B) Sedatives
C) A-delta fibers
D) Endorphins

Question 11

Of the following individuals, who can best determine the experience of pain?

A) The person who has the pain
B) The person's immediate family
C) The nurse caring for the client
D) The physician diagnosing the cause

Question 12

Pet therapy is commonly used in long-term facilities for distraction. If a client is experiencing pain and the pain is temporarily decreased while petting a visiting dog or cat, this is an example of which type of distraction technique?

A) Tactile kinesthetic distraction
B) Visual distraction
C) Auditory distraction
D) Project distraction

Question 13

How may a nurse demonstrate cultural competence when responding to clients in pain?

A) Treat every client exactly the same, regardless of culture.
B) Be knowledgeable and skilled in medication administration.
C) Know the action and side effects of all pain medications.
D) Avoid stereotyping responses to pain by clients.

Question 14

A cyclist reports to the nurse that he is experiencing pain in the tendons and ligaments of his left leg, and the pain is worse with ambulation. The nurse will document this type of pain as which of the following?

A) Somatic pain
B) Cutaneous pain
C) Visceral pain
D) Phantom pain

Question 15

Why is acute pain said to be protective in nature?

A) It warns an individual of tissue damage or disease.
B) It enables the person to increase personal strength.
C) As a subjective experience, it serves no purpose.
D) As an objective experience, it aids diagnosis.

Question 16

Which of the following clients would be classified as having chronic pain?

A) A client with rheumatoid arthritis
B) A client with pneumonia
C) A client with controlled hypertension
D) A client with the flu

Question 17

Which client would be most likely to have decreased anxiety about, and response to, pain as a result of past experiences?

A) One who had pain but got adequate relief
B) One who had pain but did not get relief
C) One who has had chronic pain for years
D) One who has had multiple pain experiences

Question 18

What is the term used to describe a pharmaceutical agent that relieves pain?

A) Antacid
B) Antihistamine
C) Analgesic
D) Antibiotic

Question 19

A middle-age client is complaining of acute joint pain to a nurse who is assessing the client's pain in a clinic. Which of the following questions related to pain assessment should the nurse ask the client?

A) Does your diet include red meat and poultry products?
B) Does your pain level change after taking medications?
C) Are your family members aware of your pain?
D) Have you thought of the effects of your condition on your family?

Question 20

Which statement accurately describes pain experienced by the older adult?

A) Boredom and depression may affect an older person's perception of pain.
B) Residents in long-term care facilities have a minimal level of pain.
C) The older client has decreased sensitivity to pain.
D) A heightened pain tolerance occurs in the older adult.

Question 21

The nurse is caring for a client who is receiving morphine via a patient-controlled analgesia (PCA) pump. The nurse notes that the client's respiratory rate is 10 breaths per minute. The client is somnolent, with minimal response to physical stimulation. The nurse should prepare to administer which of the following medications?

A) Intravenous naloxone (Narcan)
B) Intravenous flumazenil (Romazicon)
C) Oral modafinil (Provigil)
D) Nebulized albuterol (Proventil)

Question 22

A client having acute pain tells the nurse that her pain has gradually reduced, but that she fears it could recur and become chronic. What is a characteristic of chronic pain?

A) Chronic pain will lead to psychological imbalance.
B) Chronic pain has far-reaching effects on the client.
C) Chronic pain can be severe in its initial stages.
D) Chronic pain eases with healing and eventually disappears.

Question 23

A client has an order for a narcotic analgesic every three to four hours and he received his last dose three hours earlier. Which of the following actions is most appropriate for the nurse to take in response to the client's request for pain medication on his first postoperative day?

A) Provide the client with pain medication
B) Tell the client that the pain cannot be severe
C) Document and ask the client to wait one hour
D) Contact the physician for a change in medication

Question 24

The nurse is caring for a client with terminal bone cancer. The client states, My pain is getting worse and worse, and the morphine doesn't help anymore. The nurse determines the client's pain is which of the following?

A) Acute
B) Chronic malignant
C) Diffuse
D) Intractable

Question 25

A nurse is assessing a mentally challenged, adult client who is in pain after a fall. Which of the following scales should the nurse use to assess the client's pain?

A) Pain Assessment in Advanced Dementia (PAINAD)
B) Wong-Baker Faces scale
C) Linear Scale
D) Numeric Scale

Question 26

The nurse has just completed programming of a patient-controlled analgesia (PCA) pump using prescribed parameters. Which of the following actions should you take next?

A) Verify the settings with another nurse.
B) Document implementation of the PCA on the client's chart.
C) Attach the PCA pump tubing to the client's intravenous access device.
D) Check the pump's electrical cords for cracks, splits, or fraying.

Question 27

A nurse is caring for a client with acute back pain. When should the nurse assess the client's pain?

A) Six hours after administering a prescribed analgesic
B) After the client is discharged from the health care facility
C) Once per day when the pain is a potential problem
D) Whenever the vital signs are measured and documented

Question 28

A nurse asks a client to rate his pain on a scale of 0 to 10, with 0 being no pain and 10 being worst pain. What characteristic of pain is the nurse assessing?

A) Duration
B) Location
C) Chronology
D) Intensity

Question 29

A nurse is assessing the vital signs of a client who is moaning due to the acute onset of pain. What would be the expected objective findings?

A) Decreased pulse and respirations
B) Increased pulse and blood pressure
C) Increased temperature
D) No change from client's norms

Question 30

A mother calls the nurse practitioner to say, "I don't know what is wrong with my baby. He cried all night and kept pulling at his ear." How would the nurse respond?

A) "Oh, he probably was just hungry and wet. Did you feed him?"
B) "Babies at that age cry at night. Think nothing of it."
C) "That means his ear hurt. Bring him in to be checked."
D) "That probably means he had a tummy ache. How is he now?"

Question 31

A nurse is assessing a client with arthritis. Which of the following should the nurse consider in the initial assessment of the client?

A) Blood group
B) Anxiety level
C) Pain level
D) Glucose level

Question 32

Besides controlling pain of the post-abdominal surgery client with narcotics, the nurse suggests to the client that he ...

A) focus on pain relief
B) use distraction
C) describe the pain
D) think about the next dose

Question 33

The Joint Commission supports the client's right to pain management, and published standards for assessment and management of pain in hospitals, ambulatory care settings, and home care settings (Joint Commission, 2008b). Which of the following are recommended guidelines for pain management? Select all that apply.

A) Teach all clients to use a pain rating scale.
B) Determine a pain-rating goal with each client.
C) Use pharmacologic pain relief measures first.
D) Manipulate factors that affect the pain experience.
E) Keep the primary care provider in charge of all pain relief measures.

Question 34

A nurse is ordered to apply a transcutaneous electrical nerve stimulation (TENS) unit to a client recovering from abdominal surgery. Which of the following is a consideration when using this device?

A) TENS is an invasive technique for providing pain relief.
B) TENS involves the electrical stimulation of large-diameter fibers to inhibit the transmission of painful impulses carried over small-diameter fibers.
C) TENS is most beneficial when used to treat pain that is generalized.
D) A TENS unit is applied intermittently throughout the day and should not be worn for extended periods of time.

Question 35

The nurse talks with a client who states, "My primary care provider wants me to try a TENS unit for my pain. How can electricity decrease my pain?" Which of the following responses is most appropriate?

A) "The mild electrical impulses block the pain signal before it can reach the brain."
B) "The electrode patches generate heat and decrease muscle tension."
C) "The machine tricks the mind into believing the pain does not exist."
D) "The electricity produces numbness and alters tissue sensitivity."