Chapter 08: Pain
Test Bank for Lewis Medical Surgical Nursing 11th Edition by
Harding
MULTIPLE CHOICE
1. Which question asked by the nurse will give the most information about the
patients metastatic bone cancer pain?
a. How long have you had this pain?
b. How would you describe your pain?
c. How much medication do you take for the pain?
d. How many times a day do you take medication for the pain?
ANS: B
Because pain is a multidimensional experience, asking a question that addresses
the patients experience with the pain will elicit more information than the more
specific information asked in the other three responses. All of these questions are
appropriate, but the response beginning How would you describe your pain? is
the best initial question.
DIF: Cognitive Level: Apply (application)
TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity
2. A patient who uses a fentanyl (Duragesic) patch for chronic cancer pain suddenly
complains of rapid onset pain at a level 9 (0 to 10 scale) and requests something for
pain that will work now. How will the nurse document the type of pain reported by
this patient?
a. Somatic pain
b. Referred pain
c. Neuropathic pain
d. Breakthrough pain
ANS: D
Pain that occurs beyond the chronic pain already being treated by appropriate
analgesics is termed breakthrough pain. Neuropathic pain is caused by damage to
peripheral nerves or the central nervous system (CNS). Somatic pain is localized
and arises from bone, joint, muscle, skin, or connective tissue. Referred pain is
pain that is localized in uninjured tissue.
DIF: Cognitive Level: Apply (application)
TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity
3. The nurse teaches a student nurse about the action of ibuprofen. Which statement, if
made by the student, indicates that teaching was effective?
, a. The drug decreases pain impulses in the spinal cord.
b. The drug decreases sensitivity of the brain to painful stimuli.
c. The drug decreases production of pain-sensitizing chemicals.
d. The drug decreases the modulating effect of descending nerves.
ANS: C
Nonsteroidal antiinflammatory drugs (NSAIDs) provide analgesic effects by
decreasing the production of pain sensitizing chemicals such as prostaglandins at
the site of injury. Transmission of impulses through the spinal cord, brain
sensitivity to pain, and the descending nerve pathways are not affected by
NSAIDs.
DIF: Cognitive Level: Understand (comprehension)
TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity
4. A nurse assesses a patient with chronic cancer pain who is receiving imipramine
(Tofranil) in addition to long-acting morphine. Which statement, if made by the
patient, indicates to the nurse that the patient is receiving adequate pain control?
a. Im not anxious at all.
b. I sleep 8 hours every night.
c. I feel much less depressed since Ive been taking the Tofranil.
d. The pain is manageable and I can accomplish my desired activities.
ANS: D
Imipramine is being used in this patient to manage chronic pain and improve
functional ability. Although the medication is also prescribed for patients with
depression, insomnia, and anxiety, the evaluation for this patient is based on
improved pain control and activity level.
DIF: Cognitive Level: Apply (application)
TOP: Nursing Process: Evaluation MSC: NCLEX: Physiological Integrity
5. A patient with chronic back pain has learned to control the pain with the use of
imagery and hypnosis. The patients spouse asks the nurse how these techniques work.
Which response by the nurse is best?
a. The strategies work by affecting the perception of pain.
b. These techniques block the pain pathways of the nerves.
c. Both strategies prevent transmission of painful stimuli to the brain.
d. The therapies slow the release of chemicals in the spinal cord that cause pain.
ANS: A
Cognitive therapies affect the perception of pain by the brain rather than affecting
efferent or afferent pathways or influencing the release of chemical transmitters in
the dorsal horn.
DIF: Cognitive Level: Apply (application)
TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity
Test Bank for Lewis Medical Surgical Nursing 11th Edition by
Harding
MULTIPLE CHOICE
1. Which question asked by the nurse will give the most information about the
patients metastatic bone cancer pain?
a. How long have you had this pain?
b. How would you describe your pain?
c. How much medication do you take for the pain?
d. How many times a day do you take medication for the pain?
ANS: B
Because pain is a multidimensional experience, asking a question that addresses
the patients experience with the pain will elicit more information than the more
specific information asked in the other three responses. All of these questions are
appropriate, but the response beginning How would you describe your pain? is
the best initial question.
DIF: Cognitive Level: Apply (application)
TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity
2. A patient who uses a fentanyl (Duragesic) patch for chronic cancer pain suddenly
complains of rapid onset pain at a level 9 (0 to 10 scale) and requests something for
pain that will work now. How will the nurse document the type of pain reported by
this patient?
a. Somatic pain
b. Referred pain
c. Neuropathic pain
d. Breakthrough pain
ANS: D
Pain that occurs beyond the chronic pain already being treated by appropriate
analgesics is termed breakthrough pain. Neuropathic pain is caused by damage to
peripheral nerves or the central nervous system (CNS). Somatic pain is localized
and arises from bone, joint, muscle, skin, or connective tissue. Referred pain is
pain that is localized in uninjured tissue.
DIF: Cognitive Level: Apply (application)
TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity
3. The nurse teaches a student nurse about the action of ibuprofen. Which statement, if
made by the student, indicates that teaching was effective?
, a. The drug decreases pain impulses in the spinal cord.
b. The drug decreases sensitivity of the brain to painful stimuli.
c. The drug decreases production of pain-sensitizing chemicals.
d. The drug decreases the modulating effect of descending nerves.
ANS: C
Nonsteroidal antiinflammatory drugs (NSAIDs) provide analgesic effects by
decreasing the production of pain sensitizing chemicals such as prostaglandins at
the site of injury. Transmission of impulses through the spinal cord, brain
sensitivity to pain, and the descending nerve pathways are not affected by
NSAIDs.
DIF: Cognitive Level: Understand (comprehension)
TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity
4. A nurse assesses a patient with chronic cancer pain who is receiving imipramine
(Tofranil) in addition to long-acting morphine. Which statement, if made by the
patient, indicates to the nurse that the patient is receiving adequate pain control?
a. Im not anxious at all.
b. I sleep 8 hours every night.
c. I feel much less depressed since Ive been taking the Tofranil.
d. The pain is manageable and I can accomplish my desired activities.
ANS: D
Imipramine is being used in this patient to manage chronic pain and improve
functional ability. Although the medication is also prescribed for patients with
depression, insomnia, and anxiety, the evaluation for this patient is based on
improved pain control and activity level.
DIF: Cognitive Level: Apply (application)
TOP: Nursing Process: Evaluation MSC: NCLEX: Physiological Integrity
5. A patient with chronic back pain has learned to control the pain with the use of
imagery and hypnosis. The patients spouse asks the nurse how these techniques work.
Which response by the nurse is best?
a. The strategies work by affecting the perception of pain.
b. These techniques block the pain pathways of the nerves.
c. Both strategies prevent transmission of painful stimuli to the brain.
d. The therapies slow the release of chemicals in the spinal cord that cause pain.
ANS: A
Cognitive therapies affect the perception of pain by the brain rather than affecting
efferent or afferent pathways or influencing the release of chemical transmitters in
the dorsal horn.
DIF: Cognitive Level: Apply (application)
TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity
