Question 1

The nurse is questioning if a patient is experiencing pain.Which myth should the nurse recall when determining this patient's pain level?

Accepted Answer

Patients can laugh and talk while in pain-it is an effective coping mechanism.A.C.D.These statements are all true and are not myths.

Question 2

A patient admitted with liver disease complains of pain in his right shoulder.What should the nurse use as explanation for this patient's site of pain?

Accepted Answer

Nociceptive pain in the visceral organs may be referred to other parts of the body.A.C.D.These explanations are possible but not most likely.

Question 3

A patient is given a prescription for oxycodone/acetaminophen (Vicodin),two tablets to be taken every 4 to 6 hours as needed for pain.What should the nurse include when teaching about this medication?

Accepted Answer

Acetaminophen has a ceiling effect,so there is a dose beyond which there is no improvement in the analgesic effect,and there may be an increase in adverse effects.When used in combination with opioids,care must be taken to ensure that the dose of the nonopioid drug does not exceed the maximum safe dose for a 24-hour period.A.Respiratory depression occurs when doses of opioids are raised too quickly,not at specific doses or time intervals.C.Oxycodone does not form a dangerous metabolite when given with acetaminophen.B.No analgesic always relieves pain.

Question 4

A patient is experiencing phantom limb pain.For which type of pain should the nurse plan care for this patient?

Accepted Answer

Chronic nonmalignant pain persists beyond the time when healing usually takes place.Examples include low back pain,the pain accompanying arthritis,and phantom limb pain.A.B.C.Acute or cancer pain is not present after healing takes place.

Question 5

A patient is determined to be physically dependent on prescribed pain medication.How should the nurse interpret this patient's dependency?

Accepted Answer

Patients who are physically dependent on a drug will have symptoms of withdrawal if the drug is taken away suddenly.A.Addiction includes a psychological component.C.Requesting pain medication more often than it is ordered describes a patient whose pain is not adequately treated.D.Tolerance is taking more medication that previously needed to relieve the patient.

Question 6

The mother of an adolescent recovering from surgery for a fractured leg asks if all pain medication can be non-narcotic,because she does not want her child to become addicted.What should the nurse respond to the mother?

Accepted Answer

One myth about pain medication is that teenagers are more likely to become addicted than older patients.The fact is addiction to opioids is very uncommon in all age groups when taken for pain by patients without a prior drug abuse history.A.All pain medication is not addicting.C.The nurse needs to provide the patient with pain medication based upon the findings of a pain assessment.D.The patient is not more likely to become addicted to pain medication than other patients."

Question 7

The nurse notes that a patient experiencing a pain level of 9 on a scale from 0 to 10 has a change in vital signs.What type of pain should the nurse realize this patient is experiencing?

Accepted Answer

Acute pain is associated with elevated heart rate and blood pressure.A.B.D.These types of pain are more chronic,and adaptive mechanisms allow vital signs to remain more normal.

Question 8

A patient taking hydromorphone for cancer pain is experiencing constipation.What should the nurse teach to help this patient?

Accepted Answer

A high-fiber diet and fluids are the first line of defense because they help prevent constipation.A.B.Laxatives and enemas treat constipation after it becomes a problem.C.It is inappropriate to encourage a patient with cancer pain to decrease analgesia,because pain will recur.

Question 9

A patient receiving opioid medication for cancer pain is experiencing increasing pain when being repositioned and changing bed linen.What should the nurse consider is occurring with this patient?

Accepted Answer

Hyperalgesia is increased sensitivity to pain.Patients with hyperalgesia have pain at the slightest touch,such as the moving of sheets,and require further medical intervention.A.Tolerance is a normal biological adaptation and means that it takes a larger dose to provide the same level of pain relief.B,Addiction or psychological dependence is a disease of the brain that causes the compulsive pursuance of a substance,or behavior,in order to obtain reward or relief.D.Breakthrough pain is transient pain that arises during generally effective pain control and is seen most often in patients receiving timed-controlled pain medication.

Question 10

A patient of Asian American descent recovering from abdominal surgery refuses all pain medication.What can the nurse do to ensure for this patient's comfort?

Accepted Answer

The nurse needs to take the patient's culture into consideration.For the patient of Asian-American descent,the nurse should offer the pain medication as a method to promote healing.A.Offering tea might be helpful for the patient of Hispanic-American descent.B.Praying with the patient might be helpful for the patient of African-American descent.D.The nurse needs to do more than document that the patient is refusing pain medication.

Question 11

A patient with a gastrostomy tube is prescribed a sustained-released opioid medication.What should the nurse do when preparing to provide this medication to the patient?

Accepted Answer

The nurse should ask the physician to prescribe the medication as an elixir for tube administration,because a time-release tablet should never be crushed.B.A controlled- or time-release tablet should never be crushed.Because the tablet is designed to deliver a dose of medication over time,crushing it could deliver the entire dose at once,resulting in overdose.C.Dissolving the medication in water and administering it through the tube could also cause an overdose.A.The patient has a gastrostomy tube for a reason.Oral intake is probably compromised.This patient is unable to take oral medications.

Question 12

A patient has been requesting hydrocodone/acetaminophen (Vicodin)for pain every 4 hours for several days.Now the patient calls the nurse after only 3 hours and says,"I need more Vicodin.The pain is worse." On which initial assumption should the nurse base a decision about what to do next?

Accepted Answer

The majority of patients ask for analgesics because they are in pain.B.C.D.If there are signs that the patient is becoming addicted or is drug-seeking,the nurse should consult with the physician,not assume that the patient is not in pain.

Question 13

A patient requesting pain medication asks that the medication be provided in the form of an injection because it works better.The patient is prescribed oral pain medication.What should the nurse respond to this patient?

Accepted Answer

Intramuscular (IM)injections are not recommended because they are painful,have unreliable absorption from the muscle,and have a lag time to peak effect and rapid falloff compared with oral administration.A.Oral administration is the first choice if possible,or whenever the IV route is not an option.B.The IV route has the most rapid onset of action and is the preferred route for postoperative administration.D.The physician does not need to be contacted for an order change.

Question 14

A patient recovering from surgery for a ruptured appendix yesterday has an order for morphine 4 mg q 6 hours prn.Every 5 hours and 55 minutes,the patient puts on the call light and asks for the morphine.A staff member comments that the patient is drug-seeking.Which action by the nurse is most appropriate first?

Accepted Answer

The patient has acute postsurgical pain that is not being controlled effectively with a q 6 hour schedule.The nurse should consult with the RN or physician for a change in orders.D.The patient just had surgery yesterday,so it is not reasonable to wean off the opioid yet.A.The morphine cannot be given every 4 hours without an order.B.Educating the staff member may be appropriate,but treating the patient's pain is the first priority.

Question 15

A patient is prescribed acetaminophen to help with pain control.How many grams of acetaminophen can the nurse safely administer to the patient each day?

Accepted Answer

The maximum daily dose of acetaminophen is 4 g.B.C.D.Over 4 grams of acetaminophen can lead to liver damage.

Question 16

The nurse is determining a pain management plan for a patient with chronic pain.What should the nurse identify as the best analgesic schedule for this patient?

Accepted Answer

Around-the-clock pain management prevents pain.A.B.D.Any other schedule allows pain to recur between doses,and pain can get out of control and more difficult to manage.

Question 17

A patient receiving morphine sulfate 5 mg IV every 4 hours around the clock and acetaminophen PO every 4 hours reports intense itching.Assuming all are ordered,which prn medication should the nurse administer?

Accepted Answer

Nalbuphine (Nubain)is an agonist-antagonist that can be used to treat itching and nausea that may accompany the administration of opioids.A smaller dose can be given so that the analgesia is not reversed completely along with the reversal of the adverse effect.B.D.Fentanyl and methadone are opioids that may worsen itching.A.Motrin is an NSAID and will not be helpful.

Question 18

A nursing home resident complains of joint pain.Which medication should the nurse choose first to relieve the patient's pain?

Accepted Answer

NSAIDs are effective anti-inflammatory agents and are the best choice for joint pain.B.C.D.These medications do not reduce inflammation.

Question 19

A large family of a patient with terminal cancer pain is constantly calling to report that the patient is in pain or needs to be moved or needs a drink.The nurse is having difficulty caring for other patients because this family is so demanding.What is the best way to deal with this situation?

Accepted Answer

It is difficult for family members to see loved ones in pain.Including them in the planning helps them feel that they can help make the patient more comfortable.A.C.D.Asking them to leave or limit their visits will make them even more anxious as would limiting nursing care.

Question 20

A patient comes into the emergency department after vomiting blood.The nurse should be most concerned if the patient reports taking which medication?

Accepted Answer

Gastrointestinal bleeding is a side effect of aspirin and NSAIDs.B.C.D.These medications do not cause bleeding.

Quiz 10: Nursing Care of Patients in Pain