Question 1

The nurse is reviewing the admission orders for an older adult client who is being admitted for a hysterectomy.The client,who has been diagnosed as having uterine cancer,has chronic pain caused by arthritis.The healthcare provider has prescribed long-acting oral narcotic medication to be administered every 4 hours.What should the nurse do when providing the medication to the client?
A)Administer the medication if the client requests it.
B)Administer the medication every 4 hours around the clock.
C)Consult the provider to order intravenous pain medication.
D)Administer the medication sparingly to avoid narcotic addiction.

Accepted Answer

The healthcare provider has prescribed long-acting oral narcotic medication to be administered every 4 hours. Therefore, the nurse should administer the medication every 4 hours around the clock, regardless of whether the client requests it or not. This will ensure that the client's pain is effectively managed, which is important for their recovery after the surgery. The nurse should also monitor the client closely for any signs of adverse effects or medication side effects. Consulting the provider to order intravenous pain medication may not be necessary at this point, as the oral medication may be sufficient. Administering the medication sparingly could lead to inadequate pain relief, which may delay the client's recovery or lead to further complications.

Question 2

Which of the following statements best describes the therapeutic approach to acute and chronic pain,fatigue,fibromyalgia,and sleep disorders?
A)Therapy is primarily psychosocial in nature.
B)Therapy involves both pharmacologic and nonpharmacologic approaches.
C)Therapy is essentially physiologically focused.
D)Therapy mostly involves the client avoiding risk behaviors.

Accepted Answer

The therapeutic approach to acute and chronic pain, fatigue, fibromyalgia, and sleep disorders typically involves both pharmacologic (medications) and nonpharmacologic (therapy, exercise, lifestyle changes) approaches. Psychosocial factors may also be addressed in therapy, but it is not the primary focus. The approach is physiologically focused to address the underlying causes of the symptoms. Avoiding risk behaviors may be a component, but it is not the main focus of therapy.

Question 3

The nurse is creating a pain management plan using the three-step approach for a client with intractable pain.Which interventions should the nurse include in this plan? Select all that apply.
A)Administer a nonopioid analgesic first.
B)Administer an opioid analgesic first.
C)Administer a nonopioid with an opioid second.
D)Administer an opioid analgesic last.
E)Administer analgesics upon client request.

Accepted Answer

A)The first step in the three-step approach to pain management involves administering a nonopioid drug first. If pain is not adequately controlled with this mild intervention, clients should advance to step 2 and receive a mild opioid in combination with the same or a new nonopioid drug. If the client is still experiencing pain, the mild opioid should be replaced with a stronger opioid in step 3. Pain-relieving drugs should be given "by the clock" (every 3-6 hours)rather than on demand to maintain freedom from pain.
B)The first step in the three-step approach to pain management involves administering a nonopioid drug first. If pain is not adequately controlled with this mild intervention, clients should advance to step 2 and receive a mild opioid in combination with the same or a new nonopioid drug. If the client is still experiencing pain, the mild opioid should be replaced with a stronger opioid in step 3. Pain-relieving drugs should be given "by the clock" (every 3-6 hours)rather than on demand to maintain freedom from pain.
C)The first step in the three-step approach to pain management involves administering a nonopioid drug first. If pain is not adequately controlled with this mild intervention, clients should advance to step 2 and receive a mild opioid in combination with the same or a new nonopioid drug. If the client is still experiencing pain, the mild opioid should be replaced with a stronger opioid in step 3. Pain-relieving drugs should be given "by the clock" (every 3-6 hours)rather than on demand to maintain freedom from pain.
D)The first step in the three-step approach to pain management involves administering a nonopioid drug first. If pain is not adequately controlled with this mild intervention, clients should advance to step 2 and receive a mild opioid in combination with the same or a new nonopioid drug. If the client is still experiencing pain, the mild opioid should be replaced with a stronger opioid in step 3. Pain-relieving drugs should be given "by the clock" (every 3-6 hours)rather than on demand to maintain freedom from pain.
E)The first step in the three-step approach to pain management involves administering a nonopioid drug first. If pain is not adequately controlled with this mild intervention, clients should advance to step 2 and receive a mild opioid in combination with the same or a new nonopioid drug. If the client is still experiencing pain, the mild opioid should be replaced with a stronger opioid in step 3. Pain-relieving drugs should be given "by the clock" (every 3-6 hours)rather than on demand to maintain freedom from pain.

Question 4

An 18-month-old toddler scheduled for routine vaccinations begins to cry when placed on the examination table.The parent attempts to comfort the toddler,but nothing is effective.Which action by the nurse is the most appropriate?
A)Allow the toddler to sit on the parent's lap and begin the assessment.
B)Allow the toddler to stand on the floor until the crying stops.
C)Ask another nurse in the office to hold the toddler because the parent is not able to control the toddler's behavior.
D)Instruct the parent to hold the toddler down tightly to complete the examination.

Accepted Answer

Allowing the toddler to sit on the parent's lap can provide comfort and reassurance to the child, making the examination less stressful for both the child and parent. This also allows the nurse to complete the examination while the child is in a familiar and comforting position. Holding down or restraining the child may increase their anxiety and make future visits more challenging. Allowing the child to stand on the floor may not be feasible or safe during the examination. Asking another nurse to hold the child may not be necessary if the parent is present and capable of calming the child.

Question 5

The nurse is caring for a client who is experiencing acute chest pain that is rated as a 9 on a 0 to 10 pain scale.Based on this data,which medication does the nurse expect to administer?
A)Acetaminophen
B)Morphine
C)Ibuprofen
D)Naproxen

Accepted Answer

Acute chest pain rated as a 9 on the pain scale is severe and requires potent pain medication such as morphine. Acetaminophen, ibuprofen, and naproxen are not typically used for severe pain.

Question 6

The nurse is preparing to assess a 1-year-old client for signs of discomfort.When conducting the assessment,which action by the nurse is the most appropriate?
A)Asking the client to rate the pain on a scale of 0-10 during the assessment process
B)Asking the parent to hold the client in the lap during the assessment process
C)Reading a book to the client during the assessment process
D)Recommending that the parent leave the room during the assessment process

Accepted Answer

Asking the parent to hold the client in the lap during the assessment process is the most appropriate action. This will provide comfort and security to the child, making the assessment process less stressful for both the child and the nurse. Asking the child to rate the pain on a scale or reading a book to the child may not be effective in eliciting signs of discomfort in a 1-year-old. Recommending that the parent leaves the room could increase the child's anxiety and disrupt the therapeutic relationship between the nurse and the child.

Question 7

What is the relationship between a full opioid agonist and the ceiling effect?
A)A full opioid agonist produces few withdrawal symptoms when the drug's effects plateau and the client begins easing off the drug.
B)A client may use a full opioid agonist as much or as little as necessary to control chronic pain with no ill effects.
C)Side effects may limit a full opioid agonist's use but not a plateau in the beneficial effects it produces.
D)At some point,a full opioid agonist's side effects cease to increase in potency,but the pain-relieving effect continues to increase.

Accepted Answer

A)Full opioid agonists do not have a ceiling effect. Therefore, full opioid agonists can be given in increasing doses until pain is relieved or side effects become intolerable.
B)Full opioid agonists do not have a ceiling effect. Therefore, full opioid agonists can be given in increasing doses until pain is relieved or side effects become intolerable.
C)Full opioid agonists do not have a ceiling effect. Therefore, full opioid agonists can be given in increasing doses until pain is relieved or side effects become intolerable.
D)Full opioid agonists do not have a ceiling effect. Therefore, full opioid agonists can be given in increasing doses until pain is relieved or side effects become intolerable.

Question 8

The nurse is caring for a pediatric client with a surgical wound.The wound is red with purulent drainage and is causing discomfort for the client.Which diagnostic test will determine if the discomfort of the wound is caused by an infection?
A)White blood cell count
B)Hematocrit measurement
C)Urine analysis
D)X-rays of the site

Accepted Answer

White blood cell count is a diagnostic test that measures the number of white blood cells in the blood. An increase in the number of white blood cells is typically indicative of an infection, which could be causing the redness and purulent drainage in the pediatric client's surgical wound. Hematocrit measurement, urine analysis, and X-rays of the site are not typically used to diagnose wound infections.

Question 9

A toddler being prepared for a lumbar puncture begins to cry when carried into the treatment room by the mother.Which nursing diagnosis is most appropriate for the client at this time?
A)Knowledge Deficient of the procedure
B)Anxiety related to anticipated painful procedure
C)Fear related to the unfamiliar environment
D)Ineffective Coping related to an invasive procedure

Accepted Answer

The toddler is crying, indicating anxiety related to the anticipated painful procedure. While the other options may also be applicable, the immediate concern at this time is the anxiety and distress the child is experiencing. The nurse should first address this by providing age-appropriate explanation and distraction techniques to help relieve the child's anxiety.

Question 10

A client who has been undergoing treatment for chronic back pain has been considering various over-the-counter nonopioids to manage the pain.The nurse has assessed the client's needs and discussed the use of available methods with the client.Which client statement indicates the need for further instruction?
A)"Nonopioid pain medications can have serious side effects I need to consider and watch for carefully."
B)"I should not take a higher than recommended dose because the beneficial effect isn't likely to be higher with a higher dose."
C)"I may use these medications for as long as I think they are necessary."
D)"I may use both opioid and nonopioid medications together,especially to relieve severe pain."

Accepted Answer

The statement "I may use these medications for as long as I think they are necessary" indicates a lack of understanding about the potential risks and limitations of nonopioid pain medications. The nurse should clarify that these medications should only be used for a limited period of time and in conjunction with other pain management strategies, such as physical therapy and lifestyle changes. The other statements indicate appropriate understanding and knowledge about nonopioid pain medication use.

Question 11

What is an example of chronic pain?
A)Pain that precedes injury
B)Pain that follows injury and ends when healing is complete
C)Pain that is felt during injury and immediately after
D)Pain that outlasts the healing process

Accepted Answer

Chronic pain is ongoing pain that outlasts the healing process and may last for months or even years. Examples of chronic pain include arthritis pain, back pain, and migraines.

Question 12

The nurse is designing a teaching plan for community members on ways to prevent chronic pain.Which information should the nurse include in this teaching plan? Select all that apply.
A)Eating a healthy diet
B)Obtaining adequate sleep
C)Avoiding illicit drug use
D)Limiting smoking to only before bedtime
E)Avoiding repetitive movements

Accepted Answer

Eating a healthy diet, obtaining adequate sleep, avoiding illicit drug use, and avoiding repetitive movements are all effective ways to prevent chronic pain. Smoking, even limited to before bedtime, is not a recommended practice and can actually contribute to chronic pain.

Question 13

The nurse is preparing to assess comfort for several clients.If the nurse,in addition to assessing the client's physical experience of pain,assesses whether the client has a present and reliable personal support network,then the nurse is assessing which context of holistic human experience during this process?
A)Transcendence
B)Environmental
C)Psychospiritual
D)Sociocultural

Accepted Answer

By assessing the client's personal support network, the nurse is assessing the Sociocultural context, which involves the client's social and cultural factors that influence their health and well-being. This includes their support network, beliefs, and values. The other options are not relevant to this specific assessment.

Question 14

Which client is most likely to reject attempts at comfort?
A)An infant crying
B)A school-age child with abdominal pain who is anxious about a procedure
C)An adolescent with a sleep disorder who doesn't want his parents to be near him
D)An older adult with end-stage renal disease

Accepted Answer

Adolescents often value their independence and may reject attempts at comfort from parents or other authority figures. They may want to cope with their problems on their own or with the help of peers. Infants often respond positively to attempts at comfort, as they rely on caregivers for safety and security. The school-age child with abdominal pain may benefit from comfort measures such as distraction, reassurance, and pain relief. The older adult with end-stage renal disease may appreciate comfort measures such as pain management, emotional support, and spiritual care.

Question 15

Which of the following best characterizes the sociocultural context of holistic human experience?
A)Balance of physical processes
B)Connection to a higher power
C)Connection to others
D)Equilibrium with external circumstances

Accepted Answer

A)The sociocultural context of holistic human experience involves connection with others in society. Connection to a higher power is involved in the psychospiritual context. Homeostatic balance is involved in the physical context. Equilibrium with external circumstances is involved in the environmental context.
B)The sociocultural context of holistic human experience involves connection with others in society. Connection to a higher power is involved in the psychospiritual context. Homeostatic balance is involved in the physical context. Equilibrium with external circumstances is involved in the environmental context.
C)The sociocultural context of holistic human experience involves connection with others in society. Connection to a higher power is involved in the psychospiritual context. Homeostatic balance is involved in the physical context. Equilibrium with external circumstances is involved in the environmental context.
D)The sociocultural context of holistic human experience involves connection with others in society. Connection to a higher power is involved in the psychospiritual context. Homeostatic balance is involved in the physical context. Equilibrium with external circumstances is involved in the environmental context.

Question 16

Which of the following statements best characterizes risk for injury as it relates to pain?
A)Risk for injury is an external risk factor for pain.
B)It is difficult to predict what might pose a risk for injury.
C)Risk for injury can be decreased by living a healthy lifestyle.
D)Precautions against risk for injury are rarely successful in preventing injury.

Accepted Answer

A)External risk factors for pain, such as the risk for injury, can be decreased by safety precautions such as wearing a seat belt or helmet. Similarly, internal risk factors for pain, such as the risk for developing a chronic disease, can be decreased by living a healthy lifestyle. It is not difficult to anticipate what might pose a risk for injury.
B)External risk factors for pain, such as the risk for injury, can be decreased by safety precautions such as wearing a seat belt or helmet. Similarly, internal risk factors for pain, such as the risk for developing a chronic disease, can be decreased by living a healthy lifestyle. It is not difficult to anticipate what might pose a risk for injury.
C)External risk factors for pain, such as the risk for injury, can be decreased by safety precautions such as wearing a seat belt or helmet. Similarly, internal risk factors for pain, such as the risk for developing a chronic disease, can be decreased by living a healthy lifestyle. It is not difficult to anticipate what might pose a risk for injury.
D)External risk factors for pain, such as the risk for injury, can be decreased by safety precautions such as wearing a seat belt or helmet. Similarly, internal risk factors for pain, such as the risk for developing a chronic disease, can be decreased by living a healthy lifestyle. It is not difficult to anticipate what might pose a risk for injury.

Question 17

Which of the following is a pharmacologic therapy for acute pain?
A)Antidepressants
B)Muscle relaxants
C)Opioid analgesics
D)Stimulants

Accepted Answer

Opioid analgesics are a class of drugs specifically used to treat moderate to severe pain, making them a suitable choice for pharmacologic therapy for acute pain. Antidepressants, muscle relaxants, and stimulants are not typically used for this purpose.

Question 18

A preschool-age client's IV has infiltrated and must be restarted immediately for medication administration.There is no time for placing local anesthetic cream on the skin to decrease the pain associated with the procedure.Which complementary therapy would be most helpful when placing the IV for this pediatric client?
A)Moderate sedation
B)Restraint using a "mummy wrap"
C)Anesthesia
D)Distraction using bubbles

Accepted Answer

Distraction using bubbles is a non-invasive complementary therapy that can be used to decrease a child's pain and anxiety during a procedure. It is easy to administer and can be effective in distracting the child from the pain associated with the IV placement. Moderate sedation and anesthesia may be options for more invasive or lengthy procedures, but they carry risks and require trained personnel to administer. Restraint using a "mummy wrap" is not a recommended practice for IV placement and may cause additional distress to the child.

Question 19

The nurse provides an in-service to peers regarding situations that can affect the comfort level of the clients on the unit.Which client statement indicates that the client's sense of well-being is negatively impacted?
A)"I feel like I have no energy today."
B)"I don't feel any physical pain today."
C)"I was able to sleep uninterrupted last night."
D)"I am so glad that playing cards takes my mind off my worries."

Accepted Answer

The client's statement about lacking energy indicates that their sense of well-being is negatively impacted, as it suggests a lack of motivation and potentially negative emotions. The other statements are either neutral or positive in nature.

Question 20

A client is experiencing sudden-onset severe pain in the left lower quadrant of the abdomen that is rated as a 10 on a pain scale of 0-10.The client is also experiencing nausea,vomiting,and restlessness.Based on this data,the nurse concludes that the client is experiencing which phenomenon?
A)Acute pain
B)Chronic pain
C)End-of-life pain
D)Fibromyalgia pain

Accepted Answer

The sudden onset of severe pain with a rating of 10 on the pain scale, along with nausea, vomiting, and restlessness, suggests acute pain. Chronic pain is a long-term, ongoing pain that lasts for months or years, and end-of-life pain is associated with terminal illness. Fibromyalgia pain is a chronic condition characterized by widespread pain and tenderness in the body.

Quiz 3: Comfort

Which of the following statements best describes the therapeutic approach to acute and chronic pain,fatigue,fibromyalgia,and sleep disorders?

The nurse is creating a pain management plan using the three-step approach for a client with intractable pain.Which interventions should the nurse include in this plan? Select all that apply.

An 18-month-old toddler scheduled for routine vaccinations begins to cry when placed on the examination table.The parent attempts to comfort the toddler,but nothing is effective.Which action by the nurse is the most appropriate?

The nurse is caring for a client who is experiencing acute chest pain that is rated as a 9 on a 0 to 10 pain scale.Based on this data,which medication does the nurse expect to administer?

The nurse is preparing to assess a 1-year-old client for signs of discomfort.When conducting the assessment,which action by the nurse is the most appropriate?

What is the relationship between a full opioid agonist and the ceiling effect?

The nurse is caring for a pediatric client with a surgical wound.The wound is red with purulent drainage and is causing discomfort for the client.Which diagnostic test will determine if the discomfort of the wound is caused by an infection?

A toddler being prepared for a lumbar puncture begins to cry when carried into the treatment room by the mother.Which nursing diagnosis is most appropriate for the client at this time?

What is an example of chronic pain?

The nurse is designing a teaching plan for community members on ways to prevent chronic pain.Which information should the nurse include in this teaching plan? Select all that apply.

Which client is most likely to reject attempts at comfort?

Which of the following best characterizes the sociocultural context of holistic human experience?

Which of the following statements best characterizes risk for injury as it relates to pain?

Which of the following is a pharmacologic therapy for acute pain?

The nurse provides an in-service to peers regarding situations that can affect the comfort level of the clients on the unit.Which client statement indicates that the client's sense of well-being is negatively impacted?

A client is experiencing sudden-onset severe pain in the left lower quadrant of the abdomen that is rated as a 10 on a pain scale of 0-10.The client is also experiencing nausea,vomiting,and restlessness.Based on this data,the nurse concludes that the client is experiencing which phenomenon?