Chapter 3: Assessment and Care of Patients with Pain
Ignatavicius: Medical-Surgical Nursing, 8th Edition
MULTIPLE CHOICE
1. A student asks the nurse what is the best way to assess a client’s pain. Which response by the nurse is
best?
a. Numeric pain scale
b. Behavioral assessment
c. Objective observation
d. Client’s self-report
ANS: D
Many ways to measure pain are in use, including numeric pain scales, behavioral assessments, and
other objective observations. However, the most accurate way to assess pain is to get a self-report
from the client.
DIF: Remembering/Knowledge REF: 25
KEY: Pain| pain assessment
MSC: Integrated Process: Nursing Process: Assessment
NOT: Client Needs Category: Health Promotion and Maintenance
2. A new nurse reports to the precepting nurse that a client requested pain medication, and when the
nurse brought it, the client was sound asleep. The nurse states the client cannot possibly sleep with
the severe pain the client described. What response by the experienced nurse is best?
a. “Being able to sleep doesn’t mean pain
doesn’t exist.”
b. “Have you ever experienced any type of
pain?”
c. “The client should be assessed for drug
addiction.”
d. “You’re right; I would put the medication
back.”
ANS: A
A client’s description is the most accurate assessment of pain. The nurse should believe the client and
provide pain relief. Physiologic changes due to pain vary from client to client, and assessments of
them should not supersede the client’s descriptions, especially if the pain is chronic in nature. Asking if
the new nurse has had pain is judgmental and flippant, and does not provide useful information. This
amount of information does not warrant an assessment for drug addiction. Putting the medication
back and ignoring the client’s report of pain serves no useful purpose.
DIF: Understanding/Comprehension REF: 28
KEY: Pain| pain assessment
MSC: Integrated Process: Communication and Documentation
NOT: Client Needs Category: Health Promotion and
Maintenance
3. The nurse in the surgery clinic is discussing an upcoming surgical procedure with a client. What
information provided by the nurse is most appropriate for the client’s long-term outcome?
a. “At least you know that the pain after
surgery will diminish quickly.”
b. “Discuss acceptable pain control
after your operation with the
surgeon.”
1
,c. “Opioids often cause nausea but you won’t
have to take them for long.”
d. “The nursing staff will give you pain
medication when you ask them for it.”
2
, ANS: B
The best outcome after a surgical procedure is timely and satisfactory pain control, which diminishes
the likelihood of chronic pain afterward. The nurse suggests that the client advocate for himself and
discuss acceptable pain control with the surgeon. Stating that pain after surgery is usually short lived
does not provide the client with options to have personalized pain control. To prevent or reduce
nausea and other side effects from opioids, a multimodal pain approach is desired. For acute pain after
surgery, giving pain medications around the clock instead of waiting until the client requests it is a
better approach.
DIF: Applying/Application REF: 26 KEY: Pain| acute pain
MSC: Integrated Process: Teaching/Learning
NOT: Client Needs Category: Health Promotion and Maintenance
4. A nurse is assessing pain on a confused older client who has difficulty with verbal expression. What
pain assessment tool would the nurse choose for this assessment?
a. Numeric rating scale
b. Verbal Descriptor Scale
c. FACES Pain Scale-Revised
d. Wong-Baker FACES Pain Scale
ANS: C
All are valid pain rating scales; however, some research has shown that the FACES Pain Scale-Revised
is preferred by both cognitively intact and cognitively impaired adults.
DIF: Applying/Application REF: 30
KEY: Pain assessment| FACES
MSC: Integrated Process: Nursing Process: Assessment
NOT: Client Needs Category: Health Promotion and Maintenance
5. The nurse is assessing a client’s pain and has elicited information on the location, quality, intensity,
effect on functioning, aggravating and relieving factors, and onset and duration. What question by
the nurse would be best to ask the client for completing a comprehensive pain assessment?
a. “Are you worried about addiction to pain
pills?”
b. “Do you attach any spiritual meaning to
pain?”
c. “How high would you say your pain tolerance
is?”
d. “What pain rating would be acceptable to
you?”
ANS: D
A comprehensive pain assessment includes the items listed in the question plus the client’s opinion on
a functional goal, such as what pain rating would be acceptable to him or her. Asking about addiction is
not warranted in an initial pain assessment. Asking about spiritual meanings for pain may give the
nurse important information, but getting the basics first is more important. Asking about pain tolerance
may give the client the idea that pain tolerance is being judged.
DIF: Applying/Application REF: 29 KEY: Pain assessment
MSC: Integrated Process: Nursing Process: Assessment
NOT: Client Needs Category: Physiological Integrity: Reduction of Risk Potential
6. A nurse is assessing pain in an older adult. What action by the nurse is best?
a. Ask only “yes-or-no” questions so the client
doesn’t get too tired.
3
, b. Give the client a picture of the pain scale and
come back later.
c. Question the client about new pain only, not
normal
4
Ignatavicius: Medical-Surgical Nursing, 8th Edition
MULTIPLE CHOICE
1. A student asks the nurse what is the best way to assess a client’s pain. Which response by the nurse is
best?
a. Numeric pain scale
b. Behavioral assessment
c. Objective observation
d. Client’s self-report
ANS: D
Many ways to measure pain are in use, including numeric pain scales, behavioral assessments, and
other objective observations. However, the most accurate way to assess pain is to get a self-report
from the client.
DIF: Remembering/Knowledge REF: 25
KEY: Pain| pain assessment
MSC: Integrated Process: Nursing Process: Assessment
NOT: Client Needs Category: Health Promotion and Maintenance
2. A new nurse reports to the precepting nurse that a client requested pain medication, and when the
nurse brought it, the client was sound asleep. The nurse states the client cannot possibly sleep with
the severe pain the client described. What response by the experienced nurse is best?
a. “Being able to sleep doesn’t mean pain
doesn’t exist.”
b. “Have you ever experienced any type of
pain?”
c. “The client should be assessed for drug
addiction.”
d. “You’re right; I would put the medication
back.”
ANS: A
A client’s description is the most accurate assessment of pain. The nurse should believe the client and
provide pain relief. Physiologic changes due to pain vary from client to client, and assessments of
them should not supersede the client’s descriptions, especially if the pain is chronic in nature. Asking if
the new nurse has had pain is judgmental and flippant, and does not provide useful information. This
amount of information does not warrant an assessment for drug addiction. Putting the medication
back and ignoring the client’s report of pain serves no useful purpose.
DIF: Understanding/Comprehension REF: 28
KEY: Pain| pain assessment
MSC: Integrated Process: Communication and Documentation
NOT: Client Needs Category: Health Promotion and
Maintenance
3. The nurse in the surgery clinic is discussing an upcoming surgical procedure with a client. What
information provided by the nurse is most appropriate for the client’s long-term outcome?
a. “At least you know that the pain after
surgery will diminish quickly.”
b. “Discuss acceptable pain control
after your operation with the
surgeon.”
1
,c. “Opioids often cause nausea but you won’t
have to take them for long.”
d. “The nursing staff will give you pain
medication when you ask them for it.”
2
, ANS: B
The best outcome after a surgical procedure is timely and satisfactory pain control, which diminishes
the likelihood of chronic pain afterward. The nurse suggests that the client advocate for himself and
discuss acceptable pain control with the surgeon. Stating that pain after surgery is usually short lived
does not provide the client with options to have personalized pain control. To prevent or reduce
nausea and other side effects from opioids, a multimodal pain approach is desired. For acute pain after
surgery, giving pain medications around the clock instead of waiting until the client requests it is a
better approach.
DIF: Applying/Application REF: 26 KEY: Pain| acute pain
MSC: Integrated Process: Teaching/Learning
NOT: Client Needs Category: Health Promotion and Maintenance
4. A nurse is assessing pain on a confused older client who has difficulty with verbal expression. What
pain assessment tool would the nurse choose for this assessment?
a. Numeric rating scale
b. Verbal Descriptor Scale
c. FACES Pain Scale-Revised
d. Wong-Baker FACES Pain Scale
ANS: C
All are valid pain rating scales; however, some research has shown that the FACES Pain Scale-Revised
is preferred by both cognitively intact and cognitively impaired adults.
DIF: Applying/Application REF: 30
KEY: Pain assessment| FACES
MSC: Integrated Process: Nursing Process: Assessment
NOT: Client Needs Category: Health Promotion and Maintenance
5. The nurse is assessing a client’s pain and has elicited information on the location, quality, intensity,
effect on functioning, aggravating and relieving factors, and onset and duration. What question by
the nurse would be best to ask the client for completing a comprehensive pain assessment?
a. “Are you worried about addiction to pain
pills?”
b. “Do you attach any spiritual meaning to
pain?”
c. “How high would you say your pain tolerance
is?”
d. “What pain rating would be acceptable to
you?”
ANS: D
A comprehensive pain assessment includes the items listed in the question plus the client’s opinion on
a functional goal, such as what pain rating would be acceptable to him or her. Asking about addiction is
not warranted in an initial pain assessment. Asking about spiritual meanings for pain may give the
nurse important information, but getting the basics first is more important. Asking about pain tolerance
may give the client the idea that pain tolerance is being judged.
DIF: Applying/Application REF: 29 KEY: Pain assessment
MSC: Integrated Process: Nursing Process: Assessment
NOT: Client Needs Category: Physiological Integrity: Reduction of Risk Potential
6. A nurse is assessing pain in an older adult. What action by the nurse is best?
a. Ask only “yes-or-no” questions so the client
doesn’t get too tired.
3
, b. Give the client a picture of the pain scale and
come back later.
c. Question the client about new pain only, not
normal
4
