Question 1

The patient is admitted with persistent pain.She states that nothing takes the pain away totally,but that "Dilaudid works best." The fact that the patient calls the medication by name should alert the nurse to

Accepted Answer

The patient identifying a specific medication that provides relief suggests that the nurse should assess the patient's acceptable level of comfort and manage pain accordingly, rather than assuming drug-seeking behavior or other conclusions.

Question 2

The patient had knee-replacement surgery and has a local infusion pump to provide a local anaesthetic to the surgical site.The patient puts on the call light and complains that pain at the site is more intense than it has ever been and is getting worse.The nurse checks the site and finds that the dressing is damp but intact.The infusion pump is pumping,and there is medication in the bag.The most probable cause of the problem might be the

Accepted Answer

The catheter may be displaced, leading to ineffective delivery of the anesthetic to the surgical site, which would explain the increasing pain despite the pump functioning and medication being present.

Question 3

The nurse who is caring for a patient postoperatively notes that he is expressing discomfort and is diaphoretic.Which of the following interventions is most appropriate?

Accepted Answer

The patient is expressing discomfort and is diaphoretic, which could indicate pain. Administering prescribed pain medications would be the most appropriate intervention in this situation. Straightening bed linens or checking for displaced equipment would not address the patient's discomfort and diaphoresis. Changing the surgical dressing may be necessary, but addressing the pain should be the priority intervention.

Question 4

Before administering an epidural medication,the nurse aspirates and suspects that the catheter has migrated into the subarachnoid space when

Accepted Answer

Aspiration of more than 1 mL of clear fluid or bloody return means that the catheter may have migrated into the subarachnoid space or into a vessel.Do not inject the drug.Notify the physician.Purulent drainage is a sign of infection,indicating that local inflammation and superficial skin infection at the insertion site have occurred.Redness,warmth,and edema are signs of inflammation,indicating that local inflammation at the insertion site has occurred.

Question 5

When assessing a local infusion pump site,the nurse notes that which of the following requires an intervention?

Accepted Answer

Loose catheter connections can lead to leakage or dislodgement, which can compromise the infusion and patient safety, requiring immediate intervention.

Question 6

A nonpharmacological approach that the nurse may implement for patients who are experiencing pain that focuses on diverting the patient's attention away from the pain sensation by promoting pleasurable and meaningful stimuli is

Accepted Answer

Distraction techniques can involve activities or topics that interest the patient and take their mind off the pain. Examples include listening to music, watching a movie or TV show, playing a game, or engaging in conversation about a topic of interest. These pleasurable and meaningful stimuli can help to reduce the focus on the pain sensation, making it feel less intense. While massage, heat/cold, and guided imagery can also be helpful for pain management, they are not specifically focused on distraction.

Question 7

The nurse knows that an advantage of intraspinal analgesia is the

Accepted Answer

The advantage of intraspinal analgesia is the ability to achieve appropriate analgesia with smaller dosages. This is because the medication is placed directly into the spinal fluid, allowing for a more targeted effect on pain receptors. This can result in a lower risk of side effects compared to systemic medications, as well as a decreased risk of toxicity. While epidural and intrathecal medications may have different dosages, overall the advantage is in the smaller amount required for effective pain control.

Question 8

Offering the patient a backrub before preparing for sleep can promote relaxation and comfort.An effective backrub takes

Accepted Answer

Massage hastens the elimination of wastes stored in the muscles,improves oxygenation of tissues,and stimulates the relaxation response in the nervous system.An effective backrub takes 3 to 6 minutes.

Question 9

The patient is scheduled for surgery late in the afternoon.His postoperative prescriptions include patient-controlled analgesia (PCA)therapy.Which of the following nursing interventions is appropriate to perform?

Accepted Answer

Teaching the patient about PCA before surgery and before preoperative medication administration ensures that the patient is alert and able to understand how to use the PCA effectively.

Question 10

The patient is admitted for persistent pain.He states that morphine sulphate has been used to relieve his pain,but recently he has needed to use more of the medication to relieve pain.This patient's plan of care will have to incorporate interventions to deal with which of the following?

Accepted Answer

The patient is experiencing tolerance, which is when the body becomes accustomed to a drug over time, requiring higher doses to achieve the same effect.

Question 11

The nurse is caring for a patient who is a devout Orthodox Jew.The patient is on a patient-controlled analgesia (PCA)pump.What accommodations might the nurse have to make to conform to the patient's cultural needs?

Accepted Answer

It is important to ask the patient whether they will need alternative forms of medication for the Sabbath as Orthodox Jews follow specific dietary laws during this time that may affect their use of the PCA pump.

Question 12

While reviewing a patient's medication history,the nurse determines that intraspinal analgesia is contraindicated as a result of

Accepted Answer

Intraspinal analgesia is contraindicated with recent administration of anticoagulants due to the increased risk of bleeding and potential for spinal hematoma.

Question 13

The nurse frequently must assess a patient who is experiencing pain.When assessing the intensity of the pain,the nurse should

Accepted Answer

Offering the patient a pain scale allows for more accurate and standardized measurement of pain intensity. Asking about precipitating factors, location, and sensation are also important components of pain assessment, but using a pain scale helps to objectify the information.

Question 14

A nurse is evaluating the epidural catheter insertion site and suspects that the intraspinal catheter has punctured the dura when _____ noted.

Accepted Answer

Clear drainage may indicate puncture of the dura.Bloody drainage may indicate that the catheter has entered the blood vessel.Purulent drainage is a sign of infection.Redness,warmth,and swelling are signs of inflammation.Local inflammation and superficial skin infection can occur at the insertion site.

Question 15

The patient's family is concerned that the patient may get too much pain medication after surgery and become addicted to the medication if he is placed on a patient-controlled analgesia (PCA)pump.They also voice concern about the effectiveness of the PCA.The nurse should instruct the family and the patient that

Accepted Answer

The nurse should educate the family and patient that the PCA pump delivers medication as soon as the patient needs it, possibly resulting in less medication being required overall. It is important to address their concerns about addiction and effectiveness, but providing accurate information about the benefits and potential risks of the PCA pump can help ease their fears. Option A is incorrect because pain relief with the PCA pump can be just as effective as medication administered by the nurse. Option B is not accurate because pain relief should be consistent with the use of the PCA pump, and the patient should not experience a drop in pain relief. Option D is unrelated to the concerns expressed by the patient's family.

Question 16

Which of the following patient conditions is categorized as a neurobiological disease?

Accepted Answer

Addiction is a neurobiological disease that is characterized by compulsive drug seeking and use, despite negative consequences.

Question 17

The nurse caring for a patient who has a patient-controlled analgesia (PCA)knows that it

Accepted Answer

PCA provides a more constant level of medication by allowing the patient to self-administer small doses of medication as needed. It may not be appropriate for all hospitalized patients and should only be used for patients who are cognitively and physically able to use the device. It is not intended for family use to manage a patient's pain. While PCA can help prevent mistakes in medication administration, it still requires careful monitoring by the nurse.

Question 18

When evaluating the effects of patient-controlled analgesia (PCA),the nurse notes that the patient is sedated and is difficult to arouse.What step should the nurse take next?

Accepted Answer

Sedation and difficulty arousing are signs of overmedication with PCA. The PCA should be stopped, and the healthcare provider should be notified immediately. Inserting an airway or turning the patient to the side may be necessary interventions, but stopping the PCA is the priority action. Sedation and difficulty arousing are not expected outcomes of PCA therapy and should not be ignored.

Question 19

A nurse checks the continuous intravenous (IV)infusion for the intraspinal analgesia.The IV setup should be changed if

Accepted Answer

The presence of a tubing with a Y-port attached can put the patient at risk of accidental intravenous administration of the intraspinal analgesia, which can cause serious harm. It is recommended to use a separate IV line for intravenous access if needed. An infusion pump, taped tubing connections, or the use of a diluted, preservative-free medication are not contraindications for the IV setup for intraspinal analgesia.

Question 20

The patient is in the hospital undergoing major abdominal surgery.When the patient returns from the recovery room,the nurse expects that he most likely will be receiving pain medication

Accepted Answer

Research shows the epidural route to be most effective in managing postoperative pain from thoracic and abdominal surgeries.

Quiz 16: Pain Assessment and Management