Question 1

The nurse is caring for an immobile patient with chronic, unrelieved pain that is frequently severe. For which potential complication should the nurse monitor?

Accepted Answer

Urinary retention can occur in patients with chronic, severe pain, especially if they are immobile or if they are taking certain pain medications, such as opioids, which can decrease the urge to urinate and increase the risk of urinary retention.

Question 2

Which characteristic about pain would the nurse most consider when developing a pain management plan for a patient with chronic lower back pain?

Accepted Answer

Pain is a subjective experience that encompasses both sensory and emotional components, as described in option B. It is not solely an objective experience that can be measured through vital signs, nor is it a generalized bodily response or merely an emotional reaction. Understanding pain as both a sensory and emotional experience is crucial for developing effective pain management plans.

Question 3

An older adult receiving hospice care has dementia as a result of metastasis to the brain. The bone cancer has progressed to an advanced stage. Why might the client fail to request pain medication as needed?

Accepted Answer

The client may be unable to effectively communicate the character of the pain due to cognitive impairments caused by dementia.

Question 4

The nurse conducting a pain assessment for a patient would recognize deep somatic pain as having which characteristic?

Accepted Answer

Deep somatic pain is a type of pain that originates from deep structures within the body, such as muscles, bones, and joints. It is often described as achy or dull pain.

Question 5

A nurse using the Richmond Agitation-Sedation Scale documents a patient has a score of +1 before pain medication but after pain medication has a score of -2) Which patient behaviors did the nurse observe?

Accepted Answer

The Richmond Agitation-Sedation Scale (RASS) scores range from +4 (very agitated) to -5 (unarousable). A score of +1 indicates the patient was restless, and a score of -2 indicates the patient was lightly sedated but could be awakened with eye contact to verbal stimulation. This matches the description in option A.

Question 6

The pediatric nurse is caring for a 4-year-old child who is experiencing chronic pain secondary to tissue and joint injury from past sickle cell anemia crises. Which nonpharmacological pain reduction intervention might the nurse have the child try?

Accepted Answer

The answer of The pediatric nurse is caring for a...

Question 7

Which pain management task can be safely delegated to the unlicensed assistive personnel (UAP)?

Accepted Answer

Providing a therapeutic back massage is a task that can be safely delegated to unlicensed assistive personnel (UAP) as it does not require clinical judgment or medication administration, which are responsibilities of licensed healthcare professionals.

Question 8

What is the primary reason the nurse incorporates pain assessment as a part of routine care?

Accepted Answer

Incorporating pain assessment into routine care encourages patients to report pain more readily, ensuring timely and appropriate pain management.

Question 9

A patient develops a respiratory rate of 6 breaths/min after receiving intravenous hydromorphone 2 mg. Which medication should the nurse anticipate administering to this patient after notifying the prescriber of this side effect?

Accepted Answer

Naloxone is an opioid antagonist used to reverse the effects of opioid overdose, including respiratory depression caused by opioids like hydromorphone.

Question 10

After undergoing dural puncture while receiving epidural pain medication, a patient reports a headache. Which action can help alleviate the patient's pain?

Accepted Answer

Offering caffeinated beverages can help alleviate the headache caused by a dural puncture (often referred to as a post-dural puncture headache or spinal headache) by causing vasoconstriction, which can help counteract the headache symptoms.

Question 11

A 70-year-old male with diabetic peripheral neuropathy reports a burning sensation in his feet. He also states, "Those pain pills make me feel funny, and they don't help my pain, so I don't take them." Which medication is likely to be most beneficial in treating this patient's neuropathic pain?

Accepted Answer

Gabapentin is commonly used to treat neuropathic pain, such as that experienced in diabetic peripheral neuropathy, and is generally well-tolerated with fewer side effects compared to opioids.

Question 12

Which expected outcome is best for the patient with a nursing diagnosis of Acute Pain related to movement and secondary to surgical resection of a ruptured spleen and possible inadequate analgesia?

Accepted Answer

The answer of Which expected outcome is best for the...

Question 13

The nurse is caring for several clients with patient controlled analgesia. It would be most important to assess for respiratory depression in the client with:

Accepted Answer

Clients with sleep apnea are at a higher risk for respiratory depression when using patient-controlled analgesia (PCA) due to their pre-existing breathing difficulties. Opioids, commonly used in PCA, can further depress the central nervous system, exacerbating the risk of respiratory depression in these patients.

Question 14

To provide the most analgesic effect, a medication should bind with and block the pain impulse especially at which opioid receptor sites?

Accepted Answer

Mu receptors are primarily responsible for the analgesic effects of opioids, as they are the main sites where opioids bind to block pain impulses.

Question 15

A patient had a bowel resection 5 days ago. Which patient behavior might alert the nurse that the patient has a history of substance abuse?

Accepted Answer

B) Wanting continued use of Patient-controlled analgesia (PCA) can indicate a higher tolerance to opioids, which might suggest a history of substance abuse. Patients with such a history may require more pain medication to achieve the same level of pain control due to tolerance.

Question 16

A patient with Raynaud's disease receives no symptomatic relief with medication. Which surgical intervention might be a treatment option for this patient to help provide pain relief?

Accepted Answer

Sympathectomy is a surgical procedure that can be used to treat Raynaud's disease by interrupting the sympathetic nerve pathways that are responsible for the constriction of blood vessels, thereby helping to relieve symptoms.

Question 17

A patient with a history of mitral valve replacement on long-term anticoagulant therapy, hypertension, and type 2 diabetes mellitus undergoes emergency abdominal surgery. Which factor contraindicates the use of epidural analgesia in this patient?

Accepted Answer

Anticoagulant therapy is a contraindication for epidural analgesia due to the increased risk of developing an epidural hematoma, which can lead to spinal cord compression and permanent neurological damage.

Question 18

The postoperative patient who had arthroscopic right shoulder joint surgery is receiving pain medication through a pump directly into the shoulder joint. Which route for pain medication will the nurse report the patient is receiving?

Accepted Answer

The correct route for pain medication being administered directly into a joint is intra-articular. This method targets the specific area of pain, in this case, the shoulder joint, providing localized relief.

Question 19

What is typically the most reliable indicator of pain?

Accepted Answer

The most reliable indicator of pain is the patient's self-report, as it directly reflects the individual's personal experience of pain.

Question 20

The patient has an epidural catheter for analgesia. Which signs and symptoms would alert the nurse to local anesthesia toxicity?

Accepted Answer

Ringing in the ears (tinnitus) is a sign of local anesthesia toxicity, which can occur if the anesthetic is absorbed systemically. Other symptoms may include metallic taste, numbness around the mouth, and central nervous system effects.

Quiz 31: Pain