Adult Care 1 Exam 2 questions with
complete solutions
Family members are encouraging your client to "tough it out" rather than run the
risk of becoming addicted to narcotics. The client is stoically abiding by the
family's wishes. Priority nursing interventions for this client should target which
dimension of pain?
A)Sensory
B)Affective
C)Sociocultural
D)Behavioral
E)Cognitive - correct answer ✔✔D) Sociocultural
Explanation:
The family is part of the sociocultural dimension of pain. They are influencing the
client and should be included in the teaching sessions about the appropriate use
of narcotics and about the adverse effects of pain on the healing process. The
other dimensions should be included to help the client/family understand overall
treatment plan and pain mechanism
Which client is most likely to receive opioids for extended periods of time?
A) A client with fibromyalgia
B) A client with phantom limb pain
C) A client with progressive pancreatic cancer
,D) A client with trigeminal neuralgia - correct answer ✔✔C) A client with
progressive pancreatic cancer
Explanation:
Cancer pain generally worsens with disease progression and the use of opioids is
more generous. Fibromyalgia is more likely to be treated with non-opioid and
adjuvant medications. Trigeminal neuralgia is treated with anti-seizure
medications such as carbamazepine (Tegretol). Phantom limb pain usually
subsides after ambulation begins.
In applying the principles of pain treatment, what is the first consideration?
A) Treatment is based on client goals.
B) A multidisciplinary approach is needed.
C) The client must be believed about perceptions of his own pain.
D) Drug side effects must be prevented and managed. - correct answer ✔✔C) The
client must be believed about perceptions of his own pain.
Explanation:
The client must be believed and his or her experience of pain must be
acknowledged as valid. The data gathered via client reports can then be applied to
other options in developing the treatment plan.
Which route of administration is preferred if immediate analgesia and rapid
titration are necessary?
A) Intraspinal
,B) Patient-controlled analgesia (PCA)
C) Intravenous (IV)
D) Sublingual - correct answer ✔✔C) Intravenous
Explanation:
The IV route is preferred as the fastest and most amenable to titration. A PCA
bolus can be delivered; however, the pump will limit the dosage that can be
delivered unless the parameters are changed. Intraspinal administration requires
special catheter placement and there are more potential complications with this
route. Sublingual is reasonably fast, but not a good route for titration, medication
variety in this form is limited.
A client appears upset and tearful, but denies pain and refuses pain medication,
because "my sibling is a drug addict and has ruined out lives." What is the priority
intervention for this client?
A) Encourage expression of fears on past experiences
B) Provide accurate information about use of pain medication
C) Explain that addiction is unlikely among acute care clients
D) Seek family assistance in resolving this problem - correct answer ✔✔A)
Encourage expression of fears on past experiences
Explanation:
This client has strong beliefs and emotions related to the issue of sibling addiction.
First, encourage expression. This indicates to the client that their feelings are real
and valid. It is also an opportunity to assess beliefs and fears. Giving facts and
information is appropriate at the right time. Family involvement is important,
, bearing in mind that their beliefs about drug addiction may be similar to those of
the client.
A client is being tapered off opioids and the nurse is watchful for signs of
withdrawal. What is one of the first signs of withdrawal?
A) Fever
B) Nausea
C) Diaphoresis
D) Abdominal cramps - correct answer ✔✔C) Diaphoresis
Explanation:
Diaphoresis is one of the early signs that occur between 6 and 12 hours. Fever,
nausea, and abdominal cramps are late signs that occur between 48 and 72 hours.
For a cognitively impaired client who cannot accurately report pain, what is the
first action that you should take?
A) Closely assess for nonverbal signs such as grimacing or rocking.
B) Obtain baseline behavioral indicators from family members
C) Look at MAR and chart, to note the time of the last dose and response.
D) Give the maximum PRS dose within the minimum time frame for relief. -
correct answer ✔✔B) Obtain baseline behavioral indicators from family members.
Explanation:
complete solutions
Family members are encouraging your client to "tough it out" rather than run the
risk of becoming addicted to narcotics. The client is stoically abiding by the
family's wishes. Priority nursing interventions for this client should target which
dimension of pain?
A)Sensory
B)Affective
C)Sociocultural
D)Behavioral
E)Cognitive - correct answer ✔✔D) Sociocultural
Explanation:
The family is part of the sociocultural dimension of pain. They are influencing the
client and should be included in the teaching sessions about the appropriate use
of narcotics and about the adverse effects of pain on the healing process. The
other dimensions should be included to help the client/family understand overall
treatment plan and pain mechanism
Which client is most likely to receive opioids for extended periods of time?
A) A client with fibromyalgia
B) A client with phantom limb pain
C) A client with progressive pancreatic cancer
,D) A client with trigeminal neuralgia - correct answer ✔✔C) A client with
progressive pancreatic cancer
Explanation:
Cancer pain generally worsens with disease progression and the use of opioids is
more generous. Fibromyalgia is more likely to be treated with non-opioid and
adjuvant medications. Trigeminal neuralgia is treated with anti-seizure
medications such as carbamazepine (Tegretol). Phantom limb pain usually
subsides after ambulation begins.
In applying the principles of pain treatment, what is the first consideration?
A) Treatment is based on client goals.
B) A multidisciplinary approach is needed.
C) The client must be believed about perceptions of his own pain.
D) Drug side effects must be prevented and managed. - correct answer ✔✔C) The
client must be believed about perceptions of his own pain.
Explanation:
The client must be believed and his or her experience of pain must be
acknowledged as valid. The data gathered via client reports can then be applied to
other options in developing the treatment plan.
Which route of administration is preferred if immediate analgesia and rapid
titration are necessary?
A) Intraspinal
,B) Patient-controlled analgesia (PCA)
C) Intravenous (IV)
D) Sublingual - correct answer ✔✔C) Intravenous
Explanation:
The IV route is preferred as the fastest and most amenable to titration. A PCA
bolus can be delivered; however, the pump will limit the dosage that can be
delivered unless the parameters are changed. Intraspinal administration requires
special catheter placement and there are more potential complications with this
route. Sublingual is reasonably fast, but not a good route for titration, medication
variety in this form is limited.
A client appears upset and tearful, but denies pain and refuses pain medication,
because "my sibling is a drug addict and has ruined out lives." What is the priority
intervention for this client?
A) Encourage expression of fears on past experiences
B) Provide accurate information about use of pain medication
C) Explain that addiction is unlikely among acute care clients
D) Seek family assistance in resolving this problem - correct answer ✔✔A)
Encourage expression of fears on past experiences
Explanation:
This client has strong beliefs and emotions related to the issue of sibling addiction.
First, encourage expression. This indicates to the client that their feelings are real
and valid. It is also an opportunity to assess beliefs and fears. Giving facts and
information is appropriate at the right time. Family involvement is important,
, bearing in mind that their beliefs about drug addiction may be similar to those of
the client.
A client is being tapered off opioids and the nurse is watchful for signs of
withdrawal. What is one of the first signs of withdrawal?
A) Fever
B) Nausea
C) Diaphoresis
D) Abdominal cramps - correct answer ✔✔C) Diaphoresis
Explanation:
Diaphoresis is one of the early signs that occur between 6 and 12 hours. Fever,
nausea, and abdominal cramps are late signs that occur between 48 and 72 hours.
For a cognitively impaired client who cannot accurately report pain, what is the
first action that you should take?
A) Closely assess for nonverbal signs such as grimacing or rocking.
B) Obtain baseline behavioral indicators from family members
C) Look at MAR and chart, to note the time of the last dose and response.
D) Give the maximum PRS dose within the minimum time frame for relief. -
correct answer ✔✔B) Obtain baseline behavioral indicators from family members.
Explanation:
