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A patient complains of abdominal pain that is difficult to localize. the nurse categorically interprets this as which type of pain?
(causalgia is pain that occurs in area of injured peripheral nerves, cutaneous pain is superficial and psychogenic pain is pain whose source cannot be identified)
A patient complains of pain in a site that is different from where it originates. the nurse documents this as what type of pain
4. referred pain
(transient pain is brief and passes quickly)
A patient who has fallen and injured his wrist carefully cradles it with the other hand. The patient is demonstrating which of the following responses to pain?
(affective responses are psychological, physiological or involuntary response would be increased blood pressure or dilation of pupils)
to help relieve pain, ann concentrates on a favorite vacation setting. the nurse interprets this technique as:
(relaxation reduces skeletal muscle tension and lessens anxiety, recall is a noninvasive relief measure)
applying gate control theory of pain, which of the following would be an effective nursing intervention for a patient with lower back pain?
1. encouraging regular use of analgesics
2. applying a moist heating pad to the area at prescribed intervals
3. reviewing the pain experience with the patient
4. ambulating the patient after administering medication
applying moist heating pad to area at prescribed intervals
(the other choices do not involve attempts to stimulate large nerve fibers that interfere with pain transmission)
which of the following would the nurse expect to assess as a physiologic response to moderate pain?
1. pupil dilation
3. decreased pulse rate
4. protection of the painful area
(decreased pulse is severe pain)
A patient is receiving ATC medication for treatment of terminal cancer. She has recently reported several episodes of breakthrough pain. What treatment is most effective to manage these sudden flare ups of pain?
1. increasing the dose of ATC meds
2. restricting physical activity
3. doing nothing since her pain is terminal
4. supplementing w/ doses of short acting opioid
supplementing w doses of short acting opioid
(breakthrough pain is best addressed by administering short acting opioid. increasing her ATC meds would just increase her risk for developing side effects and limiting physical activity will not affect her pain)
When assessing pain in a child, the nurse needs to be aware of which of the following
1. immature neurologic development results in reduced sensation of pain
2. inadequate or inconsistent relief of pain is widespread
3. reliable assessment tools are unavailable
4. narcotic analgesics should be avoided
inadequate or inconsistent relief of pain is widespread
When planning strategies for pain control in older patients, the nurse should be aware of which of the following?
1. pain is a natural outcome of the aging process
2. sensitivity to pain increases with age
3. narcotic use should be avoided
4. denial of pain may occur
when developing plan of care for patients with chronic pain, the nurse plans interventions based on the knowledge that chronic pain is most effectively relieved when analgesics are administered in what manner?
1. p.r.n. (as needed)
3. around the clock (ATC)
(ATC) around the clock
the nurse provides vigilant monitoring of a patient receiving analgesia to prevent the occurrence of which of the following?
2. urinary retention
4. respiratory depression
(too much of an opioid drug given by way of an epidural catheter or a displaced catheter may result in the occurrence of respiratory depression. pruritus, urinary retention, and vomiting may occur but are not life threatening)
which of the following is a powerful vasodilator that increases capillary permeability and constricts smooth muscles, playing a role in the chemistry of pain at the injury site?
3. substance P
pain receptors consisting of free nerve endings that are involved in fast-conducting acute, well localized pain include which of the following
1. c fibers
2. gamma fibers
3. b fibers
4. A-delta fibers
The highest level of integration of sensory impulses of pain occurs in which of the following regions?
4. spinal cord
A patient who recently underwent amputation of a leg complains of pain in the amputated part. the nurse should explain to the patient which of the following?
1. the pain cannot exist because the leg as been amputated
2. the pain is a phenomenon known as "ghost pain"
3. the pain is a real experience for the patient
4. the patient is experiencing central pain syndrome
which of the following means of pain control can be generally explained on the basis of the gate control theory?
A patient suddenly develops right lower quadrant pain, nausea, vomiting and rebound tenderness. how should the nurse classify this patients pain?
acute pain typically has short duration and rebound tenderness. chronic pain lasts longer than 6 months and interferes with ADL's. intractable pain is chronic and highly re one or resistant to relief. neuropathic pain is a type of chronic pain that occurs from injury to one ore more nerves.
How should the nurse classify pain that a patient with lung cancer is experiencing
2. deep somatic
visceral pain is commonly experienced in the abdominal cavity, cranium or thorax. Lung cancer produces visceral pain. deep somatic pain is typically caused by fracture, sprain, arthritis, and bone cancer.
A patient who sustained a leg laceration in an industrial accident is brought to the emergency department. The area around the laceration is red, swollen, and tender. which substance is responsible for causing this response?
tissue damage causes the release of histamine, bradykinin, ad prostaglandin. bradykinin triggers the release of inframmatory chemicals that cause the injured tissue to become red, swollen, and tender. serotonin is a neurotransmitter and not involved in inflammatory response.
In which process do peripheral nerves carry the pain message to the dorsal horn of the spinal cord?
transduction involves specialized nociceptors that convert mechanical, thermal and chemical stimuli into electrical activity that leads to experience of pain. perception involves recognition of pain by frontal cortex of brain. modulation, pain signal can be facilitated or inhibited, and perception of pain can be changed.
A patient reports that he uses music therapy to help control his chronic pain. Music therapy works by prompting the release of endogenous opioids during which stage of the pain process?
A patient who sustained rib fractures in a motor vehicle accident is complaining that his pain medication is ineffective. Inadequate pain control places this patient at risk for which?
1. metabolic alkalosis
pain associated with rib fractures causes splinting which causes patient to breathe shallowly and avoid deep coughing to expel sputum, which can lead to pneumonia. Rib fractures can lead to complications such as pneumothorax and hemothorax; however, they do not result from inadequate pain control. respiratory acidosis, not metabolic alkalosis, may result from the shallow breaths caused by pain an restricted chest wall movement w splinting.
the nurse administers acetaminophen and codeine orally to a patient complaining of a severe headache. when should the nurse reassess for pain?
1. 15 mins later
2. 60 mins later
3. 90 mins later
4. immediately before next dose is due
60 mins later
should reassess oral pain meds 30 - 60 minutes later. iv meds reassess 10-15 minutes later.
the nurse is teaching a client who sustained an ankle injury about cold application. which instruction should the nurse include in the teaching?
1. place the cold pack directly on the skin
2. apply cold pack to ankle for 30 mins at a time
3. check skin frequently for extreme redness
4. keep cold pack in place for at least 24 hours
check skin frequently for redness.
should be applied intermittently for 24 hours, leaving in place for no longer than 15 minutes.
a patient prescribed a nonsteroidal anti-inflammatory drug (NSAID), naproxen (Aleve, Naprsyn) for treatment of arthritis complains of upset stomach. what should the nurse instruct the patient to do?
1. notify prescriber immediately
2. take the medication with food
3. take the medication with 8 ounces of wter
4. take the medication before bedtime
A client reports taking acetaminophen to control osteoarthritis. Which instructions should the nurse give the patient requiring long-term acetaminophen use?
1. caution combining acetaminophen w alcohol
2. increases the risk for bleeding.
3. take with meals to prevent gastric irritation
4. explain that physical dependence may occur with long term oral use
Which side effects associated with opioid use many improve after taking a few doses of the drug?
3. dry mouth
4. difficulty urinating
which outcome is best for a nursing diagnosis of acute pain related to movement and secondary to surgical resection of a ruptured spleen and possible inadequate analgesia?
1. patient will verbalize reduction in pain after receiving pain meds and repositioning
2. patient will rest quietly when undisturbed
3. on a scale of 0 - 10, patient will rate pain a a 3 while in bed and 4 while ambulating
4. patient will receive pain meds every 2 hrs
A 73 year old patient admitted after a stroke has expressive aphasia. which pain intensity scale would be appropriate to use with this patient?
1. visual analogue
2. numerical rating
3. wong-baker face ratin
4. simple descriptor
a patient diagnosed with lung cancer who is receiving morphine complains of constipation. which instructions by the nurse might help relieve the patients constipation?
1. increase amount of fuits, vegies, and fiber
2. drink 8 eight ounce glasses of water each day
3. avoid stool softeners
4. increase exercise routine to include 1 hour of exercise a day.
A patient will perform intermittent self-catheterization after discharge. which statement by the patient would indicate correct understanding of the procedure?
1. I will need to replace the catheter weekly
2. I can use clean, rather than sterile technique
3. I will inflate the catheter balloon after insertion
4. I will dispose of the catheter after use and get a new one each time
the nurse notes that a patients indwelling urinary catheter tubing contains sediment and crusting at the meatus. which action should the nurse take?
1. notify provider immediately
2. flush catheter tubing with saline
3. replace indwelling urinary catheter
4. encourage fluids that increase urine acidity
the surgeon orders hourly urine output measurement for a patient after abdominal surgery. the patients urine output has been greater than 60 ml/hr for past 2 hrs and suddenly drops to nothing. what should nurse do first?
1. irrigate catheter with 30 ml. sterile solution
2. replace urinary catheter
3. infuse 500 ml normal saline over 1 hr
4. notify surgeon immediately
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