NSG 3130/ NSG 3130 Exam 3 V2 | 2026/2027 Update | Fundamentals of Nursing Practice II | Verified Q&A Pack | Grade A

NSG 3130/ NSG 3130 Exam 3 V2 | 2026/2027 Update | Fundamentals of Nursing Practice II | Verified Q&A Pack | Grade A Which of the following nursing interventions for a patient in pain is based on the gate control theory? a. Giving the patient a back massage b. Changing the patient's position in bed c. Giving the patient a pain medication d. Limiting the number of visitors a. Giving the patient a back massage The patient tells the nurse about a burning sensation in the epigastric area. The nurse should describe this type of pain as: a. referred b. radiating c. visceral d. superficial c. Visceral The nurse must frequently assess a patient experiencing pain. When assessing the intensity of the pain, the nurse should: a. ask about what precipitates the pain b. question the patient about the location of the pain c. offer the patient a pain scale to validate the information d. use open-ended questions to find out about the sensation c. Offer the patient a pain scale to validate the information The patient will be going home on a medication administered through a PCA pump. To assist the family members with an understanding of how this therapy works, the nurse explains that the patient: a. has control over the frequency of the IV analgesic b. can choose the dosage of the drug received c. may request the type of medication received d. controls the route for administering the medication a. has control over the frequency of the IV analgesic An older patient with mild musculoskeletal pain is being seen by the primary care provider (PCP). The nurse anticipates that treatment of this patient's level of discomfort will include: a. fentanyl b. diazepam c. acetaminophen d. oxycodone c. acetaminophen Nurses working with patients 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? a. Chronic pain is mostly psychological in nature b. Regular use of analgesics leads to drug addiction c. The patient is the best authority on the pain experience d. The amount of tissue damage is accurately reflected in the degree of pain perceived c. The patient is the best authority on the pain experience A nonpharmacological approach that the nurse may implement for patients experiencing pain that focuses on creating a calm state with controlled breathing and relaxation is: a. acupressure b. meditation c. biofeedback d. hypnosis b. meditation The nurse consults with the primary care provider (PCP) of a patient who is experiencing continuous, severe pain. In planning for the patient's treatment, the nurse is aware of the principles of pain management and that it is appropriate to expect treatment to include: a. focusing on intramuscular administration of analgesics b. waiting for pain to become more intense before administering opioids c. administering opioid with nonopioid analgesics for severe pain experiences d. administering large doses of opioids initially to patients who have not taken the medications before. c. administering opioid with nonopioid analgesics for severe pain experiences Upon entering the room, the nurse discovers that the patient is experiencing acute pain. An expected assessment finding for this patient is: a. bradycardia b. diaphoresis C. bradypnea d. decreased muscle tension b. diaphoresis Which of the following is an example of multimodal analgesia? a. Ginseng b. Massage c. IV morphine d. Tylenol with codeine d. Tylenol with codeine The nurse expects to administer which of the following medications for a narcotic overdose? a. Naloxone b. Meperidine c. Butorphanol d. Dezocine a. Naloxone The nurse recognizes that anticipatory grieving can be most beneficial to a patient or family because it can: a. be done in private b. be discussed with others c. promote separation of the ill patient from the family d. help a person or family start to develop coping skills d. help a person or family start to develop coping skills An identified outcome for the family of a patient with a terminal illness is that they will be able to provide psychological support to the dying patient. To assist the family to meet this outcome, the nurse plans to include in the teaching plan: a. application of oxygen devices b. demonstration of bathing techniques c. recognition of patient needs and fears d. information on when to contact the hospice nurse c. recognition of patient needs and fears A patient has been diagnosed with terminal cancer of the liver and is receiving chemotherapy on a medical unit. In an in-depth conversation with the nurse, the patient states, "I don't think that the test results could be right." According to Kubler-Ross, the nurse identifies that this stage is associate with: a. anxiety b. denial c. bargaining d. depression b. denial Which of the following is the primary concern of the nurse for providing care to a dying patient? The nurse should: a. encourage optimism in the patient b. promote dignity and self-esteem c. intervene in the patient's activities of daily living d. allow the patient to be alone most of the time b. Promote dignity and self-esteem Hospice nursing care has a different focus for the patient. The nurse is aware that patient care provided through hospice is: a designed to meet the patient's individual's wishes, as much as possible b. usually aimed at offering curative treatment for the patient c. involved in teaching families to provide postmortem care d. offered primarily for hospitalized patient a. designed to meet the patient's individual's wishes as much as possible A nursing intervention to assist the patient with a nursing diagnosis of Sleep pattern alteration associated with the loss of spouse and fear of nightmares should be to: a. administer sleeping medication per order b. refer the patient to a psychologist or psychotherapist c. have the patient complete a detailed sleep pattern assessment d. sit with the patient and encourage verbalization of feelings d. sit with the patient and encourage verbalization of feelings The nurse prepares for which of the following after the family's home is totally lost in a tornado? a. Chronic loss b. Unresolved loss c. Complicated loss d. Perceived loss c. Complicated loss The patient who is in Kubler-Ross's bargaining stage is likely to state: a. "I just want to be able to see my son graduate from school." b. "This just can't be the only treatment that is available?" C. "I don't believe that the MRI results were actually mine." d. "It's going to be okay." a. "I just want to be able to see my son graduate from school." The client asks the nurse about different herbal therapies that may promote phsical endurance and reduce stress. Information may be provided on: a. Ginseng b. Ginger c. Echinacea d. Chamomile Ginseng When assessing a client's use of alternative therapies, the nurse should ask: a. "What herbal supplements have you taken?" b. "Have you ever used relaxation therapy?" c. "What types of activities or remedies do you use when you do not feel well?" d. "Do you use holistic treatments?" c. "What types of activities or remedies do you use when you do not feel well?" A client is experiencing chronic back pain and receiving analgesics. The nurse suggests which nonpharmacologic measure to help relieve this pain? a. Hypnosis b. Herbal therapy c. Guided imagery / distraction d. Epidural analgesia c. Guided imagery / distraction A client expresses an interest in taking St. John's wort. The nurse explains that one of the warnings to taking the medication is that it: a. may increase the anticoagulant effects of aspirin and anticoagulants b. may decrease the effectiveness of glaucoma medications c. may increase the sedative effects of antianxiety medication d. may potentiate antidepressant medications d. may potentiate antidepressan Stress: -An automatic psychologic or emotional response to an internal or external environmental challenge, which is automatic and typically beyond a person's resources or ability to response (physiologic, psychological, sociocultural). Stressor: -An event of stimulus that disrupts the person's sense of equilibrium. People react to stress in different ways, which are determined by their appraisal of the stressful event and their self perceived ability to respond to the stressor. -Stressors may be exhibited as physical or psychosocial symptoms or through denial. Nonverbal stress: -Irritability, agitation, anxiety, and poor eye contact. Stress can be caused by: -Loss of job, the death of a family member or friend, the diagnosis of an illness, finances, being a caregiver, relationships, and caring for children. -The nurse should observe caregivers for symptoms of stress to determine the strength of patient support systems. Sense of coherence (SOC): -Characteristics of personality that references one's perception of the world as comprehensible, manageable, and meaningful. Strong SOC: Low SOC: -Likely to be overwhelmed. Coping: -Dynamic cognitive and behavioral efforts to manage demands (internal or external). Defence mechanisms: -Unconscious, protective methods. Coping strategies: -Problem-focused techniques aimed at altering or removing the stressor. -Emotion-focused coping strategies work to ease emotional distress. Coping skills: -Denial, projection, rationalization. -Successful coping is both problem and emotion focused. -Focused on successful strategies that have been helpful with past stressors. Crisis intervention: -Short-term, problem-solving oriented assistance provided at a time of physical or emotional upheaval with the goal of helping the person is distress to regain equilibrium. This reduces the risk of long-term ineffective coping and negative outcomes. and mental well-being. -Example: Encouraging a person to drive as soon as possible after involvement in a fatal accident that took the life of a friend. Anxiety: -Intensity: mild, severe, and panic. -Disorders: Generalized anxiety disorder (GAD), Social anxiety, Obsessive-compulsive disorder, and post-traumatic stress disorders (PTSD). -Anxiety is a response to stress that causes uncertainty and apprehension. IMPENDING DANGER! Anger: -Antagonism toward another person or situation. Depression: Feelings of worthlessness, guilt, or hopelessness. Mild anxiety: -Motivational, foster creativity, increase a person's ability to think clearly/remember things. Moderate anxiety: Narrows focus, dulls perceptions and may challenge a person to pay attention or use problem solving skills. Moderate and mild anxiety are considered normal- these are experienced on a regular basis! Severe anxiety: -Inability to make decisions, solve problems. Panic: -Highest level of anxiety: associated with a multitude of physiologic changes and feelings of extreme terror or dread. Can immobilize a person- they cannot communicate, concentrate or think in any rational manner. -S/S: sweating, chest pain, SOB and palpations. Nurse burnout: -It is important for nurses to maintain a work-life balance. Fostering healthy, meaningful relationships both in and out of the workplace are critical component to address compassion fatigue and burnout. -Burnout: a mental or physical exhaustion due to constant stress or anxiety. -Decreased job satisfaction. -To care more effectively for others, nurses must first take time to care for themselves. -Healthy coping strategies: exercise, balanced nutrition, and mindfulness therapy. Alarm: -Hypothalamic and pituitary excitation. -Adrenal cortex. -Adrenal medula stimulation. Review what chemicals are responsible for what assessment findings you see! -Hypothalamic and Pituitary Excitation: -High ADH. -High ACTH. Adrenal Cortex: -High cortisol. -Gbuconeogensis. -Fat and protein catabolism. -High aldosterone. -High water and sodium retention. -High potassium excretion. Adrenal medulla stimulation: -High epinephrine. -High heart rate. -High oxygen intake. -High blood glucose. -High mental activity. -High norepinephrine. -High arterial BP. -High blood flow to skeletal muscles. Resistance: -Attempts to stabilize. -High parasympathetic activity. Resolution/Recovery: -Return to pre-demand state. Exhaustion: -Decreasing energy as resources are depleted. -Inability to adapt. -Death. Loss: -The absence of something to which the affected person has formed an attachment. -Reminders of the loss, even years late, can elicit the grief response. -Loss can involve people, places, and things. -Ex.: Loss of a friend/family member to death; loss of a limb or organ to disease or injury; loss of health or independence. Can include loss of financial stability, loss of choices, etc. Grief: -The emotional response to a loss. -Produces feelings including anger, frustration, loneliness, sadness, guilt, regret, a sense of resolution, and peace. -Grief is determined by the value placed on the items lost. This is a deeply person experience. Can be physical, emotional, behavioral and cognitive. It includes feelings, behaviors and reactions to loss. Can take months to years- variable progression. Models and stages of death and dying/loss of grief: -Kubler-Ross -Bowlby -Sheldon -Models to help explain certain patterns and similarities in the grieving process. Indicates probable course towards resolution of grief. Initially developed 5 stages of grief when working with patients diagnosed with terminal illness and the dying. This later was translated to all types of loss.It is important to note that there are no "timetables" that determine the course of grief or how long it should last. Grief is not linear! Mourning: -The outward, social expression of loss. -Mourning is demonstrated in an individual basis and often is related to a person's cultural norms, cultural norms, rituals, traditions, and religious/spiritual beliefs. Tasks of mourning: -Worden. -The nurse should assess each family's beliefs of death and the dying process to consider for intervention development. -Tasks of mourning are described by Worden as a series of events: accept the reality or shock, working through the grief/pain and experiencing the loss, and rearranging and redefining the life roles. The final tasks is to move on with life through acceptance of the loss. Anticipatory grief: -The cognitive, affective, cultural, and social reactions to an expected death, felt by the patient as well as family members and friends. May include looking at photos, sharing memories, looking at pictures or videos. -Nursing response: Emotional support with positive presence, active listening, and reassurance; encouraging verbalization of the anticipated loss. Complicated grief: -Distressing symptoms lasting at least 6 months after the death of a significant person. Types of complicated grief: -Chronic grief reactions that do not diminish over time. -Delayed: suppression of the grief reaction. -Exaggerated: the survivor is overwhelmed by grief. -Masked: behaviors of the survivor interfere with normal functioning and conceal the actual grieving process. -Dementia patients-- they still display pain. Disenfranchised grief: -Any loss that is not validated or recognized. Bereavement: -Includes grief and mourning: the inner feelings and outwards expressions of people experiencing loss. -Is the period of time a person experiencing the loss is feeling the pain of the loss, are experiencing the grieving process and begin to adjust to life without what was lost. As the nurse, you are going to assist patients and families in this experience. Understanding the cultural context of his/her life experience. Active and compassionate listening is crucial for the nurse. S/S of impending death: -Decrease in urine output. -Cold and mottled extremities. -Changes in vital signs. Pain: -Pain has physical and emotional aspects. -Pain is whatever the person with the pain says it is and that it exists whenever the person says it does. -Pain may prevent injury or results from injury. -Pain is the most subjective of all symptoms that patients experience. It can only be experienced or described by the patient. A patient does not need to "prove" pain is present. VS are NOT an accurate measure of pain being present (especially with chronic pain). With chronic pain, BP, and HR may even be decreased. -Cognitive, affective, behavioral, and sensory factors can influence pain. -VS such as HR may be elevated initially with acute pain- but this alone is not a reliable indicator of pain level. S/S of death: -Absence of heartbeat and respirations. -Involuntary release of stool and or urine. -Lack of any response to verbal or tactile stimuli. -Drop in body temperature as the body begins to cool. Care of the patient and family at the time of death/dying patient: -Provide education about the stages of grief. -Encourage healthy behaviors. -Listen while patients or families tell the story of their loss and the deceased. -Include the entire family or significant others in the assessment and planning. -Use community resources and make appropriate referrals. Referred pain: -Pain in an area other than the area causing the pain. -Source of pain: Jaw and left arm pain with a myocardial infraction. Radiating pain: -Pain that extends to other areas. -Source of pain: Gastroesophageal reflux, extending to the thorax. PQRST: -P: Precipitating or palliative. -Q: Quality or quantity. -R: Region or radiation. -S: Severity scale. -T: Timing. COLDSPA: -Character: Describe the sign or symptom (burning, stabbing). -Onset: When did it begin? -Location: Where is it? Does it radiate? -Duration: How long does it last? Does it recur? -Severity: How bad is it? -Pattern: What makes it better? What makes it worse? -Associated Factors: What other symptoms occur with it? When would you use the numeric pain scale vs the Wong-Baker Scale? -If a patient is able to articulate a pain level (and comprehend what information is being requested), a numeric pain rating or other self-reported pain scale is appropriate. Gate control therapy: -Pain signal is either stopped at the GATE or id the signal goes to the brain to register pain. If there are competing signals (such as rubbing [activating different fibers] or opioid medications that bind the gate sites, or meditation , etc.) they can block the gate and inhibit pain. Neuromatrix theory: -Pain is multidimensional experience and is distinctive (perception and regulation of pain is an individual experience). The experience of pain is affected by a person's physical, psychological, cognitive and life experiences. Nociceptive pain: -Trauma. -Inflammation. -Tissue damage. -Visceral pain: rises from organs. -Somatic pain: Injuries from skin, muscles, bones, and joints. Neuropathic pain: -Nerve injury. -Stems from injuries to the nerve; continues after injury has resolved. -Abnormal sensations, excessive sensitivity, exaggerated pain response. Cultural factors involving pain: -Believe the client's statement of pain. -Recognize that clients hold different beliefs about pain. -Ask about the client-s beliefs and how they cope with pain. -Recognize that clients have the right to respond to pain in the way they learned is appropriate. -Recognize that expressions vary greatly and no expression is "good" vs "bad", just different. -Avoid stereotyping. Expressions vary between and within cultures. Aging adult and pain: -Be aware of elderly bias where pain is ignored because people simply expect the elderly to have pain. -Decreased renal function= toxicity. -They don't report pain because they become fearful of getting old and disabled. What to remember with pain: -Remember this is the nursing process! Typically when a question is asking what to do first, it means you need to assess! -Keep in mind that not all patients are going to request pain medication or admit they are having severe pain- there are many barriers for patients. Do not expect the patient to provide all the subjective data only- remember your OBJECTIVE data collection! World Health Organization Three-Step Analgesic Ladder: -Mild pain (1-3) use nonopioid analgesics (with or without a co-analgesic). -Moderate pain (4-6) use opioid or combination of opioid and nonopioid. -Severe (7-10) opioids specifically indicated for severe pain indicated and then titrated until pain is relieved. Opioids: -Lower BP. -Slow HR. -Lower respirations. NSAID: -Renal failure -GI bleeds Tylenol: -Liver damage Basic principle of pain medications: -Prevent and control. Multimodal: -Use 2 or more types of drugs. Post operative pain management: -Combination therapy. Pre-medicate (pain): -Before procedures or activity. CAM examples: -Complementary and alternative medicine. -Meditation. -Mindfulness. -Biofeedback. -Energy therapy. -Eastern medicine. -Relaxation therapy. -Exercise. -Sleep. -Guided imagery. -Yoga. CAM: -Complementary therapies frequently are used in conjunction with medical therapies. -Alternative therapies are used in place of medical treatment. -These types of interventions are useful when patients are experiencing physiologic and psychological responses to stress such as increased heart rate, increased respiratory rate, and gastrointestinal symptoms. -Relaxation techniques decrease the physiologic response by decreasing heart rate, respiratory rate, and gastrointestinal motility. Psychological responses to relaxation techniques include an increased sense of well-being and a decrease in depression and anxiety. Meditation: -Meditation involves relaxing the body and quieting the mind by directing one's focus on a specific word, sound or image. -Meditation can be used to decrease stress and anxiety in adults. lowering blood pressure, heart rate, breathing, metabolism, and blood flow to the muscles. Energy: -Energy therapy uses the hands of the practitioner as a conduit to manipulate the negative energy fields of the patient and move the congestion or obstruction of the negative energy away from the energy field. Energy therapy has been shown to decrease stress, anxiety, and acute and chronic pain, and to promote a sense of well-being. -Therapeutic touch and Reiki are types of energy therapy, both of which requiring training. Biofeedback: Biofeedback involves the use of electronic devices to help the patient develop a learned awareness of the body's physiologic responses to unconscious, involuntary stressors. -The learned awareness enables the patient to engage in voluntary actions to decrease the stress in response. -Techniques are taught under the guidance of a biofeedback therapist with specialized training. -It generally requires 8 to 10 sessions to master these skills. Biofeedback is used to treat problems such as stress, addictions, and back pain. Eastern medicine: -Because herbs are grown in many regions with different soil, water, and atmospheric conditions, it is hard to standardize herbal supplements. -The nurse must be vigilant in obtaining an accurate patient medication history that includes the use of herbs, extracts, teas, tinctures, and dietary supplements. -Because many herbs have the same properties as prescription medications, the patient taking an herb and prescription medication for the same effect could experience a toxic reaction. To determine specific side effects and possible drug interactions, each preparation needs to be researched individually. Herbal medicines: -Teas, herbs, extracts, dietary supplements. -Know the patients history because meds and herbs can have a toxic effect on each other.