Question 1

The nurse is determining the effective of pain medication provided to a patient.What is the best way for the nurse to measure effectiveness of pain medication?

Accepted Answer

Pain is subjective,and the best measure is the patient's self-report.A.Patients can sleep while in pain.B/ D/ Groaning and elevated vital signs are not always present with pain.

Question 2

A patient has been on opioids for 3 months to control pain caused by injuries from a motor vehicle crash.The patient asks about the risk of withdrawal symptoms when the drugs are no longer needed.How should the nurse respond to the patient?

Accepted Answer

After 3 months of use,some withdrawal symptoms are likely; these can be minimized or eliminated by slowly tapering the dose.A.Sedatives are not usually necessary and may be addictive.C.The nurse has no way of knowing the patient's potential response to withdrawing from the medication.D.The reason for the medication is not important.

Question 3

A patient has abdominal pain after gallbladder surgery.For which type of pain should the nurse provide care?

Accepted Answer

Nociception refers to the body's normal or physiological reaction to noxious stimuli,such as tissue damage (e.g.,surgery),with the release of pain-producing substances.C.Neuropathic pain is associated with injury to either the peripheral or central nervous system.A.Surgery is associated with acute,not chronic,pain.D.Surgical pain has a physiological cause.

Question 4

The nurse is preparing to provide an opioid medication for a patient's postoperative pain.Which action should the nurse take first?

Accepted Answer

Opioids are respiratory depressants,and respiratory function is a priority.B.C.D.Skin color,temperature,and oral intake may be helpful,but they are not the most important when providing this medication.

Question 5

A patient with peripheral neuropathy states,"I don't know why the doctor put me on an antidepressant.I am not depressed!" Which response by the nurse is best?

Accepted Answer

Certain antidepressants have been shown to relieve pain related to neuropathy.A.B.Depression is not necessarily a factor in neuropathy.D.Antidepressants may take several weeks to be effective,so they should not be stopped prematurely.

Question 6

A physician writes an order to give a saline injection to a patient who has been requesting frequent meperidine (Demerol)shots.Which initial response by the LPN is best?

Accepted Answer

If a placebo is ordered for a patient,discuss concerns with the physician and nurse supervisor.A.Use of placebos is unethical and inappropriate unless the patient has given written consent.B.C.The use of placebos is a denial of the patient's report of pain.

Question 7

A nursing assistant,observing the licensed practical nurse (LPN)prepare medication for a patient asks why so much morphine is being provided since patients have quit breathing after receiving such a high dose.The patient has been receiving the same dose of medication for several days without respiratory compromise.Which response by the LPN is best?

Accepted Answer

Morphine is an opioid agonist.Opioid doses can be escalated (titrated upward)indefinitely as needed as the patient's pain increases.B.As long as it is titrated slowly,tolerance to respiratory depression will develop.C.Monitoring may identify respiratory depression,but it will not prevent it.A.This statement blocks communication and does not take advantage of a teaching opportunity.

Question 8

The nurse is preparing to assess a patient's pain level.Which definition of pain should the nurse use to guide practice?

Accepted Answer

All the definitions can be true,but however pain is whatever the experiencing person says it is because pain is subjective,and nurses must trust the patient's report of pain as true in order to treat it appropriately.

Question 9

A patient with chronic back pain has a new order for a fentanyl (Duragesic)patch.As the nurse applies the patch,the patient states,"I'm really glad to get that patch on.I am really hurting bad." Which response by the nurse is correct?

Accepted Answer

It may take up to 3 days for a patch to provide an effective level of pain relief,and the patient may require an immediate-release form of pain medication until that time.It is appropriate to administer a short-acting agent while waiting for the patch to take effect.A.D.Pain will not be relieved with a minute or half of an hour.C.Other pain medications can be provided while the patch is in place.

Question 10

The nurse enters a room just as a patient's daughter pushes the button of his intravenous (IV)patient-controlled analgesia (PCA)pump.Which response by the nurse is appropriate?

Accepted Answer

No one should push the button except the patient.PCA is safe if it is controlled by the patient and appropriately monitored.Family members can help by reminding their loved one to use the PCA if they think the person is in pain.A.B.The safety of IV PCA is affected if someone other than the patient administers the dose.D.Admonishing the daughter is unnecessary-she needs to be educated,not scolded.

Question 11

A patient who has just returned from abdominal surgery states,"I learned relaxation exercises,so I won't need any drugs." Which statement about relaxation therapy should the nurse use to guide care for this patient?

Accepted Answer

Relaxation is an adjunct treatment for any type of pain but should not be expected to replace pain medication.B.It can help the patient feel more in control.A.Relaxation therapy does not work the same as a placebo.D.The use of relaxation cannot eliminate the need for analgesics after surgery.

Question 12

The nurse is having difficulty assessing the pain of a mentally impaired patient who has an approximate functional level of a 4-year-old child.Which method should the nurse use to determine the patient's pain level?

Accepted Answer

The faces scale was developed for use in children and would be appropriate for someone functioning at a 4-year-old level.D.The 0-to-10 scale is too complex for a 4-year-old.B.C.Facial expression and the response to "Are you hurting?" may be helpful,but they are not as objective as using a research-validated scale.

Question 13

A patient with chronic pain is on a sustained-release opioid that is ordered every 12 hours.After 6 hours,the patient complains of increasing pain.Which intervention by the nurse is appropriate?

Accepted Answer

Breakthrough pain is treated with immediate-release agents.D.It is unethical to not treat the patient's pain.B.A relaxation exercise might help for a short period of time but not for 6 hours.C.Giving the next dose early does not follow physician's orders and will only help one time.The patient needs an order for future use also.

Question 14

The nurse enters the room of a patient who is moaning loudly and thrashing around in bed.What action should the nurse take first?

Accepted Answer

Assessment is always the first step in the problem-solving process.A.C.D.Asking the patient to quiet down or administering a medication first both skips the assessment stage.

Question 15

A patient receiving large doses of opioids is lethargic and difficult to arouse,with a respiratory rate of 6 per minute and constricted pupils.Which medication should the nurse anticipate being prescribed?

Accepted Answer

The patient is exhibiting signs of opioid overdose.Narcan is an opioid antagonist.C.Valium is a benzodiazepine that could further depress the patient's level of consciousness.B.Lasix is a diuretic.D.Romazicon is the antidote to benzodiazepine overdose.

Question 16

A 91-year-old nursing home resident has been receiving meperidine (Demerol)injections for right shoulder pain.During the morning assessment,the nurse finds the resident irritable and jumpy.Which nursing actions and rationales is appropriate?

Accepted Answer

The RN or physician should be notified and a different analgesic ordered.Meperidine (Demerol),when broken down in the body,produces a toxic metabolite called normeperidine.Normeperidine is a cerebral irritant that can cause adverse effects ranging from dysphoria and irritable mood to seizures in the older adult.A.B.C.Administering a dose of Demerol will worsen the symptoms.

Question 17

A patient describes abdominal pain as "my belly feels as if a watermelon is stuck in it." What is the best way for the nurse to document this information?

Accepted Answer

A patient's description of pain is subjective data and should be recorded as the patient stated it.A.B.C.Documenting distention,bloating,or acute pain is making assumptions that may or may not be true.

Question 18

A nurse provides an opioid antidote to a patient experiencing opioid toxicity.Which outcome should the nurse expect after providing this medication?

Accepted Answer

An opioid antagonist removes the effect of the opioid,including the pain relief.B.C.D.Tachypnea,confusion,and sedation would not be expected.

Question 19

The nurse answers a patient's call for pain medication,only to find the patient laughing and joking with visitors.Which response by the nurse is appropriate?

Accepted Answer

Distraction (by the patient's visitors)is an effective adjuvant treatment but does not replace analgesics for pain.The nurse should administer the analgesic.A.B.C.These actions withhold the pain medication and the patient may be in increased pain after the visitors leave,which will be more difficult to control.

Question 20

A patient with terminal cancer describes a pain rating of 7 on a 0-to-10 scale.The nurse notes that the patient's vital signs are unchanged and recalls that vital signs may be elevated with pain.What is the best explanation for this?

Accepted Answer

Because of the body's ability to adapt,patients with chronic nonmalignant pain or chronic cancer pain may not appear to be in pain.C.D.The physiological responses that accompany acute pain,such as elevated heart rate and blood pressure,cannot be sustained without harm to the body,so the body adapts,and the vital signs return to normal.A.If the patient says he or she is in pain,the patient must be believed.

Quiz 10: Nursing Care of Patients in Pain