Question 1

The nurse is caring for James,a 19-year-old college student,in the emergency department.He has a medical diagnosis of a sprained ankle.What type of pain is James most likely experiencing?

Accepted Answer

A sprained ankle is a type of musculoskeletal injury that causes somatic pain, which is caused by damage to tissues such as bones, ligaments, and muscles. Mild pain may occur with a sprained ankle, but the severity can vary. Referred pain and visceral pain are not associated with a sprained ankle.

Question 2

The health care team agrees that Marie's injury has resulted in changes to her central nervous system (CNS)causing an abnormal interpretation of normal stimuli and the chronic pain that she now feels.What kind of nervous system plasticity does this explanation describe?

Accepted Answer

The explanation describes central sensitization, which is a type of nervous system plasticity where the CNS becomes abnormally sensitized to pain stimuli, causing chronic pain. Gate control theory relates to the interaction between pain signals and non-pain signals, but does not specifically address changes in the CNS. Perception refers to the process of interpreting sensory information, but does not specifically address changes in the CNS. Peripheral sensitization is a type of nervous system plasticity where the peripheral nerves become sensitized to pain stimuli, but this does not fully explain Marie's chronic pain.

Question 3

The nurse is caring for Mrs.Henri,who has been placed on a Patient Controlled Analgesic (PCA)pump to control pain following an appendectomy.What are the advantages for Mrs.Henri of this type of pain control?

Accepted Answer

The advantage of a Patient Controlled Analgesic (PCA) pump is that the client can manage when the next dose of analgesia is given, allowing for more personalized pain control. This can lead to better pain management and increased patient satisfaction. Additionally, with a PCA pump, the patient is less likely to receive an overdose of the opioid as the pump is programmed to a specific dosage range. While it may require more medication, the benefits of better pain control outweigh the costs. The nurse's time spent with the patient may not necessarily increase or decrease with the use of a PCA pump.

Question 4

Marie,a 25-year-old nurse,injured her back at work a year ago.She is now feeling angry,frustrated,and depressed because of persistent back pain.What type of pain is Marie experiencing?

Accepted Answer

Marie is experiencing chronic pain, which is defined as pain that lasts for more than 3 months. Chronic pain can lead to emotional distress such as anger, frustration, and depression. Acute pain is sudden and temporary, visceral pain is internal pain from organs, and nociceptive pain is caused by tissue damage or inflammation.

Question 5

Mrs.Cheema has just returned to the surgical unit following a bowel resection.While repositioning her,the nurse notices her grimacing.She states she is having pain.What type of pain is Mrs.Cheema most likely experiencing?

Accepted Answer

Mrs.Cheema has just undergone surgery and is experiencing pain while being repositioned. This type of pain is most likely acute pain which is a sudden and sharp pain that is usually caused by a specific injury or illness. Chronic pain is characterized by pain that lasts for more than three months and is often associated with a chronic condition such as arthritis or fibromyalgia. Neuropathic pain is caused by damage to the nerves and can cause a burning or numb sensation. Phantom pain is a type of neuropathic pain experienced by amputees who feel pain in the amputated limb. None of these types of pain are the most likely explanation for Mrs.Cheema's pain at this time.

Question 6

Which of the following pain syndromes is characterized by widespread musculoskeletal pain and fatigue?

Accepted Answer

Fibromyalgia is a chronic pain syndrome characterized by widespread musculoskeletal pain, fatigue, and tenderness in localized areas called tender points. Trigeminal neuralgia is a condition that causes sudden, severe facial pain, often triggered by touching specific areas of the face. Post-herpetic neuralgia is a complication of shingles that causes pain in the area where the shingles rash occurred. Phantom pain is pain that feels like it is coming from a body part that has been amputated.

Question 7

While the nurse is checking the orders for analgesia,which of the following nursing interventions is most appropriate in response to Simon's perception of pain?

Accepted Answer

Having Simon's mother hold him provides physical and emotional comfort, which can reduce his perception of pain. The other options do not address his pain directly or can even exacerbate it.

Question 8

The nurse is providing discharge instructions to Mr.Charles,who was started on a fentanyl citrate skin patch.Which of the following measures can be used to decrease the risk of constipation?

Accepted Answer

Increasing fluid intake can help prevent constipation, which is a common side effect of opioids such as fentanyl. Antihistamines have no effect on constipation, and assessing respiratory rate and dietary intake are important, but not specifically related to preventing constipation.

Question 9

Mrs.Franco has brought her 13-month-old daughter Ella into the emergency room with nausea and vomiting.Ella is crying.Which of the following behavioural pain assessment scales would be appropriate for the nurse to use to determine the intensity of Ella's pain?

Accepted Answer

The Face, Legs, Activity, Cry, Consolability (FLACC) scale is the most appropriate choice for assessing pain in infants who are unable to verbally communicate their pain. It takes into consideration behaviors such as facial expressions, crying, and body movements to determine the level of pain that the infant is experiencing. The other options, such as the Behavioral Pain Scale (BPS), are better suited for assessing pain in older patients who can communicate their pain levels. The Faces Pain Scale and Visual Analog Scale are also not appropriate for infants who are unable to understand or respond to the visual cues presented.

Question 10

Mrs.Beamish describes her pain at an 8 out of 10,with 0 being no pain.She receives a dose of morphine sulphate subcutaneously (SC).After 30 minutes,which of the following evaluative data is the most accurate indicator that Mrs.Beamish's pain has decreased?

Accepted Answer

The most accurate indicator of pain reduction is the patient's self-report. In this case, Mrs. Beamish's rating of her pain decreasing from 8 to 4 after receiving morphine sulphate SC is the best indicator of pain relief. While the other options may suggest a decrease in pain, they are not definitive and may not accurately reflect Mrs.Beamish's pain level.

Question 11

It has been determined that Simon has gastroenteritis and the appropriate health care provider orders Tylenol for him for abdominal pain.What is the best indicator that the Tylenol is effective for Simon's pain?

Accepted Answer

The answer of It has been determined that Simon has...

Question 12

Sally,18 years old,fractured her tibia and fibula in a ski accident.She has just returned to her room following an open reduction of her tibia and fibula.During the next 24 to 48 hours,what is the most effective timing for the nurse to administer Sally's prn analgesic?

Accepted Answer

Administering the analgesic on a regular schedule is the most effective timing as it helps to control pain and prevent it from getting severe. Waiting for Sally to request it or when she exhibits signs of pain may be too late and not provide adequate pain relief. Also, waiting for a set time like four hours after surgery may not be appropriate as the patient's level of pain can vary. Regular scheduling of pain medication ensures constant pain control and allows for faster healing post-surgery.

Question 13

Which of the following cutaneous stimulation techniques will provide Mr.Murray,who suffers from chronic back pain,with pain relief by closing the pain gate?

Accepted Answer

Massage is a cutaneous stimulation technique that can provide pain relief by closing the pain gate. This is because the physical touch of massage can activate non-painful pressure receptors in the skin and muscles, which can block painful stimuli from getting through to the spinal cord and brain. Distraction, relaxation exercises, and psychoeducation do not involve cutaneous stimulation and are not directly related to closing the pain gate.

Question 14

Which of the four processes involved in nociception uses mediators such as serotonin or histamine to create an action potential from noxious stimuli?

Accepted Answer

Transduction is the process by which noxious stimuli are converted into electrical signals (action potentials) that can be transmitted by nerves to the brain. During transduction, mediators such as serotonin and histamine can bind to receptors on nociceptor fibers and trigger the opening of ion channels, allowing ions to flow into the nerve and create an action potential. The other processes of nociception (transmission, modulation, perception) do not involve the use of mediators to create action potentials.

Question 15

The nurse is caring for Mr.Aaron,a 34-year-old who has an epidural catheter with fentanyl and bupificaine for pain relief following a thoracotomy.The nurse observes that his respiratory rate is eight breaths a minute and shallow.What should the nurse's priority action be?

Accepted Answer

Administering naloxone hydrochloride (Narcan) is the priority action because it is an opioid antagonist that can quickly reverse the effects of opioid-induced respiratory depression, which is indicated by a respiratory rate of eight breaths a minute and shallow breathing.

Question 16

Mr.Williams has been diagnosed with inoperable bowel cancer.Over the past month the nurse has observed his dose of morphine slowly increase as his pain has increased.Which of the following best describes the effect of his response to the opioid analgesic?

Accepted Answer

The gradual increase in morphine dosage suggests drug tolerance, which occurs when the body becomes less responsive to a drug over time, resulting in the need for higher doses to achieve the same pain relief. Equianalgesia refers to the ability to achieve comparable pain relief with different opioids at equivalent doses, addiction is a complex behavioral disorder characterized by compulsive drug seeking, and physical dependence refers to the development of withdrawal symptoms when a drug is discontinued.

Question 17

Mr.Johnson,a regular client in the emergency room,reports that he has severe abdominal pain.Which of the following is an important consideration as the nurse completes her pain assessment?

Accepted Answer

Physiological and behavioral adaptation can occur with severe pain, meaning that a patient might not always show obvious signs of pain despite experiencing it.

Question 18

Simon is a 4-year-old brought to the clinic by his mother,Mrs.Meyers.She states that he has been vomiting all day.He is curled up in his mother's arms,and is moaning and crying.What is the best way of finding out where his pain is located?

Accepted Answer

At 4 years old, children may not be able to verbally articulate their pain accurately, but they can often point to the source of their pain, making this the most effective way to identify the location of discomfort.

Question 19

Mr.Alexander is a nurse working on a surgical floor.He is working with a student nurse who is learning about medication administration.What would his response be when the student asks him what the normal duration of action is for an oral opiate analgesic?

Accepted Answer

The normal duration of action for an oral opiate analgesic is typically around 4 hours. This is a general guideline, as the exact duration can vary based on the specific medication, dosage, and individual patient factors.

Question 20

Mr.Neilson had an epidural catheter placed for pain management following a pneumonectomy.He has a combination of fentanyl and bupivacaine infusing continuously.When his pain is assessed he describes it as 2/10,with 0 being no pain.What considerations would the nurse make when assisting Mr.Neilson up to the chair?

Accepted Answer

Moving slowly to the sitting position is the safest option when assisting a patient with an epidural catheter. This ensures that the catheter is not dislodged, and there are no sudden changes in intrathecal pressure. Disconnecting the tubing or providing pre-emptive opioids is not necessary in this scenario as the patient's pain is well managed at 2/10. Bed rest is not necessary if the patient is able and willing to mobilize.

Quiz 30: Pain Assessment and Management