43 pain management review questions – Flashcards
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1. Giving the client a back massage
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Which one of the following nursing interventions for a client in pain is based on the gate-control theory? 1. Giving the client a back massage 2. Changing the client's position in bed 3. Giving the client a pain medication 4. Limiting the number of visitors
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3. Monitor vital signs every 15 minutes
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A priority nursing intervention when caring for a client who is receiving an epidural infusion for pain relief is to: 1. Use aseptic technique 2. Label the port as an epidural catheter 3. Monitor vital signs every 15 minutes 4. Avoid supplemental doses of sedatives
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3. Deep or visceral
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The nurse should describe pain that is causing the client a "burning sensation in the epigastric region" as: 1. Referred 2. Radiating 3. Deep or visceral 4. Superficial or cutaneous
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3. Offer the client a pain scale to objectify the information
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Which of the following is most appropriate when the nurse assesses the intensity of the client's pain? 1. Ask about what precipitates the pain. 2. Question the client about the location of the pain. 3. Offer the client a pain scale to objectify the information. 4. Use open-ended questions to find out about the sensation.
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1. "What does your discomfort feel like?"
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The nurse on a postoperative care unit is assessing the quality of the client's pain. In order to obtain this specific information about the pain experience from the client, the nurse should ask: 1. "What does your discomfort feel like?" 2. "What activities make the pain worse?" 3. "How much does it hurt on a scale of 0 to 10?" 4. "How much discomfort are you able to tolerate?"
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1. Has control over the frequency of the intravenous (IV) analgesia
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When a client's husband questions how a patient-controlled analgesia (PCA) pump works, the nurse explains that the client: 1. Has control over the frequency of the intravenous (IV) analgesia 2. Can choose the dosage of the drug received 3. May request the type of medication received 4. Controls the route for administering the medication
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3. Acetaminophen
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An older client with mild musculoskeletal pain is being seen by the primary care provider. The nurse anticipates that treatment of this client's level of discomfort will include: 1. Fentanyl 2. Diazepam 3. Acetaminophen 4. Meperidine hydrochloride
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3. Anticipatory response
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Before inserting a Foley catheter, the nurse explains that the client may feel some discomfort. This is an example of: 1. Distraction 2. Reducing pain perception 3. Anticipatory response 4. Self-care maintenance
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2. Is recovering after a total hip replacement
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The nurse knows that a PCA pump would be most appropriate for the client who: 1. Has psychogenic discomfort 2. Is recovering after a total hip replacement 3. Experiences renal dysfunction 4. Recently experienced a cerebrovascular accident (stroke)
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2. Use the unit when pain is perceived
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A client with chronic back pain has an order for a transcutaneous electrical nerve stimulation (TENS) unit for pain control. The nurse should instruct the client to: 1. Keep the unit on high 2. Use the unit when pain is perceived 3. Remove the electrodes at bedtime 4. Use the therapy without medications
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3. Adapt the analgesics as the nursing assessment reveals the need for specific medications.
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The nurse caring for a terminally ill client with liver cancer understands which of the following goals would be most appropriate? 1. Increasingly administer narcotics to oversedate the client and thereby decrease the pain. 2. Continue to change the analgesics until the right narcotic is found that completely alleviates the pain. 3. Adapt the analgesics as the nursing assessment reveals the need for specific medications. 4. Withhold analgesics because they are not being effective in relieving discomfort.
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4. Nausea and vomiting
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A client is having severe, continuous discomfort from kidney stones. Based on the client's experience, the nurse anticipates which of the following findings in the client's assessment? 1. Tachycardia 2. Diaphoresis 3. Pupil dilation 4. Nausea and vomiting
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1. The client is the best authority on the pain experience
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Nurses working with clients in pain need to recognize and avoid common misconceptions and myths about pain. In regard to the pain experience, which of the following is correct? 1. The client is the best authority on the pain experience. 2. Chronic pain is mostly psychological in nature. 3. Regular use of analgesics leads to drug addiction. 4. The amount of tissue damage is accurately reflected in the degree of pain perceived.
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2. Distraction
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A nonpharmacological approach that the nurse may implement for clients experiencing pain that focuses on promoting pleasurable and meaningful stimuli is: 1. Acupressure 2. Distraction 3. Biofeedback 4. Hypnosis
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3. Secure the catheter to the outside skin
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Which of the following is the most appropriate nursing intervention for a client who is receiving epidural analgesia? 1. Change the tubing every 48 to 72 hours. 2. Change the dressing every shift. 3. Secure the catheter to the outside skin. 4. Use a bulky occlusive dressing over the site.
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2. Do not chew the unit after administration
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The client is experiencing breakthrough pain while receiving opioids. An order is written for the client to receive a transmucosal fentanyl "unit." In teaching about this medication, the nurse should instruct the client to: 1. Swab the unit over the cheeks 2. Do not chew the unit after administration 3. Take no more than two units per episode of discomfort 4. Allow the unit to dissolve slowly in the mouth over 15 minutes or more
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3. Administering opioids with nonopioid analgesics for severe pain experiences
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When caring for a client who is experiencing continuous severe pain, the nurse should expect that the pain management plan would include: 1. Focusing on intramuscular administration of analgesics 2. Waiting for pain to become more intense before administering opioids 3. Administering opioids with nonopioid analgesics for severe pain experiences 4. Administering large doses of opioids initially to clients who have not taken the medications before
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3. Diaphoresis
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Which of the following symptoms would the nurse expect with a client who is experiencing acute pain? 1. Bradycardia 2. Bradypnea 3. Diaphoresis 4. Decreased muscle tension
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4. " I can only accept what the client reports concerning the pain being felt and attempt to intervene successfully in its management."
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Which of the following statements made by a nurse shows the greatest understanding of the personal nature of the pain experience? 1. "I have experienced pain before, and so I have great compassion for anyone dealing with pain." 2. "People handle pain differently, but everyone in pain is only interested in having the pain stop." 3. "Managing a client's pain is the single most important thing a nurse can do for a client experiencing pain." 4. "I can only accept what the client reports concerning the pain being felt and attempt to intervene successfully in its management."
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2. "My postsurgical clients get the prescribed pain medications on schedule with no diversion from the schedule."
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Which of the following statements made by a nurse requires follow-up with additional instruction regarding the personal nature of pain? 1. "I have experienced pain before, and so I have great compassion for anyone dealing with pain." 2. "My postsurgical clients get the prescribed pain medications on schedule with no diversion from that schedule." 3. "If I were experiencing severe pain, I certainly would want someone to devote their time to managing for me." 4. "Clients don't always request pain medication, and so I always ask them if they want it according to the schedule."
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3. "I'm exhausted physically and emotionally trying to live with this pain."
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Which of the following statements made by a client reporting severe pain expresses the most insight into how pain impacts a client's energy reserves? 1. "I can't sleep if I don't get something for this pain." 2. "If only I could get an hour when I was free of this pain." 3. "I'm exhausted physically and emotionally trying to live with this pain." 4. "I don't see how I can continue to cope with this pain; I need some relief."
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4. " Trying to cope with pain is using up the energy so he can get some rest."
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Which of the following statements made by a nurse caring for a client reporting severe pain expresses the most insight into how pain impacts a client's energy reserves? 1. "If I can't get his pain under control, his recovery will take a lot longer." 2. "Pain certainly interferes with the client's ability to rest and recuperate." 3. "I'm going to call for another pain prescription so he can get some rest." 4. "Trying to cope with pain is using up the energy that his recovery requires."
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4. "She says she's in pain, but she doesn't act like she is in pain."
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Which of the following statements made by the nurse regarding the client's self-assessment of pain requires immediate follow-up regarding the personal nature of pain? 1. "The medication should be providing enough relief; try to ambulate her." 2. "I've never known anyone to have such pain after that procedure." 3. "He should be able to ambulate with only minimal pain by now." 4. "She says she's in pain, but she doesn't act like she is in pain."
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2. His endorphin levels were high as a result of the physical stressors of the race
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The nurse recognizes that the most likely reason a runner who has injured his ankle during a race is not aware of it until after he crosses the finish line is that: 1. The emotional exhilaration of running the race masked the pain of the injury 2. His endorphin levels were high as a result of the physical stressors of the race 3. He was mentally distracted by the need to concentrate on the ever-changing nature of the race 4. The physical effects of the injury slowly increased during the race and reached pain-producing capacity only after the race
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1. "His pulse and blood pressure are within his normal baseline limits, so i'm sure the pain medication is working"
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Which of the following statements by the nurse reflects a need for immediate follow-up regarding the physical effects of chronic pain on body function? 1. "His pulse and blood pressure are within his normal baseline limits, so I'm sure the pain medication is working." 2. "Please take his pulse and blood pressure, and let me know if they are elevated above his normal baselines." 3. "If his pulse and blood pressure are above his normal baseline, let me know, and I will medicate him for pain." 4. "Unmanaged pain usually manifests itself in both an elevated pulse and blood pressure."
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3."Taking the medication as prescribed will help you to be more active; your family will be happy you can do things with them again."
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A client with a history of chronic back pain is questioning the need to "keep asking for pain medication," fearing that he will be viewed as being weak by his family. The most therapeutic nursing response to this client would be: 1. "Chronic back pain is very difficult to deal with; utilize the pain medication because that's what it's there for." 2. "Your family won't think you're weak; they want you to be comfortable, and the medication will help." 3. "Taking the medication as prescribed will help you to be more active; your family will be happy you can do things with them again." 4. "It's important that you manage your pain as effectively as possible; it really doesn't matter what other people think about you."
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3. An understanding that it is easier to prevent the pain than to stop the pain
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A client who is scheduled for the second in a series of painful dressing changes asks for "my pain medication now so it's working when the dressing is changed" is most likely expressing: 1. A great fear of the expected pain 2. A need to be in control of his pain 3. An understanding that it is easier to prevent the pain than to stop the pain 4. An acceptance of the pain that the dressing change will obviously cause him
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4. His pain will be more effectively managed if he reports a need for pain medication while the pain is still tolerable
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The nurse inquires of a postoperative client as to the need for pain medication. The client denies the need then but 30 minutes later reports, "I am really in a lot of pain. Can you bring me my pain pill now?" The nurse recognizes that the most immediate need for client education is related to explaining that: 1. His oral medication will take approximately 30 minutes to affect his pain 2. There may be a need to administer his pain medication via the intravenous route 3. Pain medication is more effective if blood levels are maintained at a constant level 4. His pain will be more effectively managed if he reports a need for pain medication while the pain is still tolerable
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4. observing the client's body movements and facial expressions for typical pain behavior
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The nurse is caring for a cognitively impaired client who has experienced a painful procedure. The nurse is most effective in determining the client's pain medication needs when using which of the following assessment methods? 1. Medicating the client with the as-needed (prn) analgesic as often as ordered 2. Utilizing the pain face scale to assess the client's pain experience 3. Asking the client to rate his or her pain on a scale of 1 to 10, with 10 being the most severe pain 4. Observing the client's body movements and facial expressions for typical pain behaviors
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4. He is not ready to participate in the activities needed to recover quickly
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The nurse is attempting to ambulate a postoperative client who continues to rate his pain as a 7 on a scale of 0 to 10, with 10 being the most severe. The client is reluctant to walk and consents to move only to the chair, reporting that "it hurts too much to walk." The nurse's primary concern regarding the client's recovery related to his pain experience is that: 1. His pain medications are not effectively managing his pain 2. He does not fully understand the importance of ambulation 3. He is expending too much of his energy dealing with the pain 4. He is not ready to participate in the activities needed to recover quickly
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4. Assess the client for other factors that may be affecting his ability and motivation to ambulate
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The nurse is attempting to ambulate an older adult client who recently experienced a fall at the assisted living facility where he resides. The client is reluctant to walk and consents to move only to the chair, reporting that "it hurts too much to walk." Which of the following nursing interventions is most therapeutic regarding this client? 1. Allow the client to remain in bed in order to conserve his energy. 2. Transfer him to the chair, realizing some activity is preferable to none. 3. Call his health care provider to discuss the apparent ineffectiveness of his pain medications. 4. Assess the client for other factors that may be affecting his ability and motivation to ambulate.
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1. "Together we will all work at making your pain tolerable."
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A client with chronic pain states, "I just want to be pain-free. Do something to make that happen." The most therapeutic response is: 1. "Together we will all work at making your pain tolerable." 2. "I will do everything I can to manage your pain; I promise." 3. "Are you feeling depressed or anxious because of your pain?" 4. "You sound anxious. Would you like something for your nerves?"
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1.A limited vocabulary
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The greatest barrier to a 3-year-old client's ability to self-assess her pain is: 1. A limited vocabulary 2. Increased separation anxiety 3. Reluctance to talk to strangers 4. Inability to grasp the concept of pain
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4. " I think a nap is a good idea because we seem to feel pain more when we are tired."
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The nurse is discussing the effects of pain with an older adult client diagnosed with osteoarthritis. The most therapeutic response to the client's comment of, "I wonder whether it would hurt if I took a nap in the afternoon?" would be: 1. "As long as it did not interfere with your getting a good night's sleep." 2. "I'd suggest taking your nap right after you take your pain medication." 3. "If it helps you cope better with the pain, I don't see any harm in taking a nap." 4. "I think a nap is a good idea because we seem to feel pain more when we are tired."
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4. " I will make a point of asking you to rate your pain at least every 2 hours, so this miscommunication won't happen again."
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Which of the following statements is the most appropriate response to a client's statement, "I thought you could tell I was in pain"? 1. "How do you express a need for pain medication if not by asking?" 2. "I'm so very sorry; may I get you your pain medication right now? 3. "I don't think it's wise to assume I can effectively read your mind regarding the need for pain medication." 4. "I will make a point of asking you to rate your pain at least every 2 hours, so this miscommunication won't happen again."
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1."What would be a satisfactory level of pain control for us to achieve?"
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A 44-year-old client shares with the admitting nurse that the client is having epigastric pain that the client identifies as a 7 on a 0 to 10 scale. In order to plan for the pain management of this client, which is the most appropriate response from the nurse? 1. "What would be a satisfactory level of pain control for us to achieve?" 2. "You don't look like you're in that much pain." 3. "You'll be pain-free following your surgery." 4. "I've cared for a client with a nail in his head who only rated his pain as a 5; are you sure your pain is a 7?"
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2.Parasympathetic stimulation from the body's normal response to pain
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The home care nurse notes that a 67-year-old female diabetic client's blood glucose level has been elevated since she strained her back the previous week. The client states that she cannot understand why her blood glucose level is elevated. The nurse suspects the most likely cause for the elevated blood sugar is: 1. The decreased activity level of the client since the injury 2. Parasympathetic stimulation from the body's normal response to pain 3. The client is consuming more food as a comfort measure 4. The client may not be taking her medication as ordered
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3.Suicide
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A client with chronic pain presents in the emergency department of the local hospital stating "I just can't take this anymore." On questioning the client, the nurse discovers that the client have experienced chronic pain since being involved in an accident 2 years previously. The client states that he has been labeled a "drug seeker" because he is looking for relief for the pain and feels hopeless, angry, and powerless to do anything about the situation. The nurse understands that this client is at risk for: 1. Criminal activity 2. Opioid abuse 3. Suicide 4. Drug addiction
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1.The pain medication will help speed his recovery time
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A client who had knee replacement surgery the previous day refuses to take any pain medication, even though he rates his pain as an 8 on a 0 to 10 scale. Upon questioning the client the nurse learns that the reason for refusing pain medication is because he is concerned about injuring the knee and not feeling it. The best information that the nurse can provide this client is to explain that: 1. The pain medication will help speed his recovery time 2. He need not worry about becoming addicted to the pain medication 3. He will not be perceived as weak for taking the pain medication 4. He is being a difficult client and needs to comply with the health care provider's orders
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4.Deafferentation pain
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A 38-year-old client presents to the pain clinic with complaints of phantom pain. The client was involved in a farming accident 3 years previously that resulted in a below-the-elbow amputation of his right arm. The nurse knows that phantom pain is categorized as: 1. Painful polyneuropathy 2. Somatic pain 3. Sympathetically maintained pain 4. Deafferentation pain
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1. " I would like to speak with your mother to get information."
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The daughter of an 88-year-old female client tells the nurse that her mother has recently quit going on walks in the neighborhood because of pain in her legs. Which of the following is the best response from the nurse? 1. "I would like to speak with your mother to get more information." 2. "Older people frequently suffer from arthritis that can cause leg pain." 3. "Your mother probably has poor circulation in her legs, which is causing the pain." 4. "She is lucky to be as healthy as she is at her age."
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1. "Babies don't experience pain, so i don't need to worry about hurting him when i touch the penis."
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The nursery nurse is explaining postcircumcision care to a new mother. Which of the following statements by the new mother indicates that additional teaching needs to occur? 1. "Babies don't experience pain, so I don't need to worry about hurting him when I touch the penis." 2. "I need to be careful not to put his diaper on too tight to avoid discomfort." 3. "I can comfort my baby following the procedure by holding him." 4. "The health care provider will numb the area before performing the procedure."
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4. An oncology nurse
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Taking into consideration the hospice client's chronic pain from bone cancer, the most appropriate person to collaborate with regarding management of pain is: 1. Occupational therapist to devise a splint for the client's leg 2. Physical therapist to determine exercises to strengthen the leg muscles 3. Art therapist to provide creative therapy as a diversion 4. An oncology nurse
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4. When the client is comfortable
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n creating the plan of care for a newly diagnosed breast cancer client, the nurse is concerned about pain control. The client has expressed an interest in relaxation therapy as a complementary pain therapy. The nurse knows that the best time to teach the client is: 1. Immediately following the client's mastectomy 2. Before giving pain medication to evaluate if the complementary therapy works 3. Immediately preceding surgery 4. When the client is comfortable
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3. "So not massage the client's legs."
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A client who ruptured his spleen in a motor vehicle accident rates his postoperative pain as a level 8 on a 0 to 10 pain scale. After administering pain medication, the nurse discusses the use of complementary therapies with the client to explore ways to reduce the pain. The client would like to try a massage. The nurse delegates this task to the assistive personnel (AP). Which of the following instructions is most important for the nurse to share with the AP? 1. "You need to warm the bottle of lotion before using it." 2. "Report any changes in the client's skin condition to me immediately." 3. "Do not massage the client's legs." 4. "Massage each body part at least 10 minutes."
