Critical Care: Exam #1: Quiz Question
Practice
Which of the following statements about pain is NOT true?
a. pain is a uniquely subjective experience and therefore it is whatever the patient says it is
and exists whenever the patient says it does.
b. pain is a global experience, meaning it has sensory, affective, cognitive, behavioral, and
physiologic components.
c. physiologic data is the best way to assess patients' pain.
d. the experience of pain is associated with potential or actual threats to physiologic integrity.
e. unmanaged pain is associated with adverse patient outcomes in all domains of human
experience. - correct answer-c
Nurses understand that managing pain in critically ill patients while crucial can be
challenging for the following reasons:
a. Patients often have diminished ability to communicate.
b. Patients are often coping with multiple stressors which may heighten their perception of
pain.
c. Patients in ICU settings are often drug-seeking making it difficult to distinguish actual pain
from reported pain.
d. a and b only
e. All of the above - correct answer-d
The nurse understands that neuropathic pain is believed to be driven by peripheral or central
nervous system dysfunction and can occur in the absence of actual tissue inflammation or
damage. Which of the following patients is most at risk for experiencing neuropathic pain?
a. A 62 year old patient with poorly controlled diabetes.
b. A 36 year old patient with a chest tube for a tension pneumothorax
c. A 68 year old patient with urinary retention and a history of BPH, with bladder scan
demonstrating approximately 850 cc urine
d. A 42 year old patient who is post-op day 1 from a cholecystectomy
e. An 18 year old patient with a post-op wound infection - correct answer-a
The nurse understands that patient report is the best way to assess pain. However, Mr.
Jones has significant cognitive impairment that prevents him from participating in the
process. The nurse knows that the following may be non-verbal indicators that Mr. Jones is
experiencing pain:
a. He has become increasingly agitated over the past hour
b. He ate all of his breakfast and lunch but is refusing dinner
c. He stiffened and grabbed the side rails when the nurse and PCT attempted to assist him
out of bed
, d. He grimaces when he changes positions in bed
e. All of the above - correct answer-e
The nurse understands that opioids are associated with many side effects. The most
concerning side effect in patients with complex illness conditions is respiratory depression.
Which of the following are the most reliable indicators of respiratory depression?
a. A new onset of extreme agitation and hypertension in a previously quiet normo-tensive
(BP within normal limits) patient
b. Respiratory rate of 8/minute, elevated C02, decreased O2 saturation
c. A rise in oxygen saturation, fall in C02 levels and tachycardia
d. Somnolence, lack of appetite, and difficulty ambulating
e. History of opioid addiction, change in level of consciousness, respiratory rate 12/minute -
correct answer-b
he nurse has just completed inter-shift handover of care. Which of the following patients on
the nurse's assignment is at risk for altered levels of consciousness (sedation/agitation)?
a. A 74 year old woman with a history of COPD, CHF, and diabetes transferred to the unit
following hip replacement surgery
b. A 55 year old man with a history of ETOH admitted with pneumonia
c. An 18 year old man status post appendectomy readmitted with high fever, hypotension,
and intractable nausea and vomiting
d. A 46 year old woman with metastatic breast cancer who was just started on
hydromorphone via patient-controlled analgesia pump
e. All of the above - correct answer-e
The nurse understands that in order to enhance patient safety, the most important step
before administering a sedative is:
a. To assess and treat modifiable factors (such as electrolyte imbalances, pain, hypoxia) that
may be contributing to agitation
b. To apply soft restraints
c. To create a soothing environment by turning off the lights and playing classical music in
the patient's room
d. To teach the patient deep breathing to promote relaxation
e. To send all family visitors home as they are likely increasing the patient's agitation -
correct answer-a
Which of the following statements regarding management of agitation/sedation is true?
a. All sedating meds have analgesic properties. Therefore, administering both pain
medications and sedatives to a patient is always contraindicated.
b. Spontaneous breathing trials (SBT) or awakening trials (SAT) are considered best practice
for deeply sedated patients in an ICU setting
c. Benzodiazepines are considered the best choice for sedation in critically ill patients
because of the low risk of delirium.
Practice
Which of the following statements about pain is NOT true?
a. pain is a uniquely subjective experience and therefore it is whatever the patient says it is
and exists whenever the patient says it does.
b. pain is a global experience, meaning it has sensory, affective, cognitive, behavioral, and
physiologic components.
c. physiologic data is the best way to assess patients' pain.
d. the experience of pain is associated with potential or actual threats to physiologic integrity.
e. unmanaged pain is associated with adverse patient outcomes in all domains of human
experience. - correct answer-c
Nurses understand that managing pain in critically ill patients while crucial can be
challenging for the following reasons:
a. Patients often have diminished ability to communicate.
b. Patients are often coping with multiple stressors which may heighten their perception of
pain.
c. Patients in ICU settings are often drug-seeking making it difficult to distinguish actual pain
from reported pain.
d. a and b only
e. All of the above - correct answer-d
The nurse understands that neuropathic pain is believed to be driven by peripheral or central
nervous system dysfunction and can occur in the absence of actual tissue inflammation or
damage. Which of the following patients is most at risk for experiencing neuropathic pain?
a. A 62 year old patient with poorly controlled diabetes.
b. A 36 year old patient with a chest tube for a tension pneumothorax
c. A 68 year old patient with urinary retention and a history of BPH, with bladder scan
demonstrating approximately 850 cc urine
d. A 42 year old patient who is post-op day 1 from a cholecystectomy
e. An 18 year old patient with a post-op wound infection - correct answer-a
The nurse understands that patient report is the best way to assess pain. However, Mr.
Jones has significant cognitive impairment that prevents him from participating in the
process. The nurse knows that the following may be non-verbal indicators that Mr. Jones is
experiencing pain:
a. He has become increasingly agitated over the past hour
b. He ate all of his breakfast and lunch but is refusing dinner
c. He stiffened and grabbed the side rails when the nurse and PCT attempted to assist him
out of bed
, d. He grimaces when he changes positions in bed
e. All of the above - correct answer-e
The nurse understands that opioids are associated with many side effects. The most
concerning side effect in patients with complex illness conditions is respiratory depression.
Which of the following are the most reliable indicators of respiratory depression?
a. A new onset of extreme agitation and hypertension in a previously quiet normo-tensive
(BP within normal limits) patient
b. Respiratory rate of 8/minute, elevated C02, decreased O2 saturation
c. A rise in oxygen saturation, fall in C02 levels and tachycardia
d. Somnolence, lack of appetite, and difficulty ambulating
e. History of opioid addiction, change in level of consciousness, respiratory rate 12/minute -
correct answer-b
he nurse has just completed inter-shift handover of care. Which of the following patients on
the nurse's assignment is at risk for altered levels of consciousness (sedation/agitation)?
a. A 74 year old woman with a history of COPD, CHF, and diabetes transferred to the unit
following hip replacement surgery
b. A 55 year old man with a history of ETOH admitted with pneumonia
c. An 18 year old man status post appendectomy readmitted with high fever, hypotension,
and intractable nausea and vomiting
d. A 46 year old woman with metastatic breast cancer who was just started on
hydromorphone via patient-controlled analgesia pump
e. All of the above - correct answer-e
The nurse understands that in order to enhance patient safety, the most important step
before administering a sedative is:
a. To assess and treat modifiable factors (such as electrolyte imbalances, pain, hypoxia) that
may be contributing to agitation
b. To apply soft restraints
c. To create a soothing environment by turning off the lights and playing classical music in
the patient's room
d. To teach the patient deep breathing to promote relaxation
e. To send all family visitors home as they are likely increasing the patient's agitation -
correct answer-a
Which of the following statements regarding management of agitation/sedation is true?
a. All sedating meds have analgesic properties. Therefore, administering both pain
medications and sedatives to a patient is always contraindicated.
b. Spontaneous breathing trials (SBT) or awakening trials (SAT) are considered best practice
for deeply sedated patients in an ICU setting
c. Benzodiazepines are considered the best choice for sedation in critically ill patients
because of the low risk of delirium.
