Fundamentals of Nursing, 2nd Edition – Active Learning for
Collaborative Practice by Yoost & Crawford
Chapter 36: Pain Management
Multiple Choice Questions
1. The nurse is caring for a patient recovering from knee replacement surgery who
complains of severe pain in the knee after receiving hydrocodone with acetaminophen
(Vicodin) 2 hours previously. What is the nurse's best action to manage this pain
effectively?
A. Administer another dose of the medication without consulting the provider.
B. Apply ice packs to the knee to reduce swelling and pain.
C. Apply heat packs to the knee to increase blood flow.
D. Perform gentle range of motion exercises to improve mobility.
Answer: B
Explanation: Applying ice packs reduces swelling and pain by slowing nerve conduction and
providing local analgesia, which is appropriate for postoperative pain management. Heat packs
would increase blood flow and exacerbate swelling, and administering another dose without an
order or performing range of motion could worsen the pain.
Why Other Options Are Wrong: A is incorrect because administering another dose without a
provider's order is unsafe. C is incorrect because heat increases blood flow and swelling. D is
incorrect because range of motion exercises would increase pain at this stage.
2. The nurse is assessing a patient 30 minutes after administering pain medication. Which
finding best indicates that the pain medication was effective?
A. The patient is sleeping quietly.
B. The patient states a reduction in pain intensity.
C. The patient's respirations are slow and regular.
D. The patient's blood pressure has returned to baseline.
Answer: B
Explanation: The most reliable indicator of pain relief is the patient's self-report of reduced pain.
Other findings like sleep or vital signs may suggest comfort but are not definitive.
Why Other Options Are Wrong: A is incorrect because sleep does not confirm pain relief. C and
D are incorrect because respirations and blood pressure are indirect measures and can be
influenced by other factors.
, 3. The nurse is caring for a patient with severe abdominal pain caused by acute
cholecystitis. Which type of pain is this patient most likely experiencing?
A. Visceral pain.
B. Somatic pain.
C. Radiating pain.
D. Referred pain.
Answer: A
Explanation: Visceral pain arises from internal organs like the gallbladder, which is inflamed in
cholecystitis. It is often described as deep, dull, or cramping.
Why Other Options Are Wrong: B is incorrect because somatic pain originates from skin,
muscles, or joints. C and D are incorrect because radiating and referred pain involve discomfort
felt away from the source.
4. The nurse is evaluating the best pain medication option for a patient with severe long-
term cancer pain at home. Which choice is most appropriate?
A. Fentanyl (Duragesic) 50 mcg transdermal patch every 72 hours.
B. Meperidine (Demerol) 50 mg IM every 6 hours.
C. Hydromorphone (Dilaudid) 0.2 mg IV via PCA pump every 10 minutes.
D. Hydromorphone (Dilaudid) 0.08 mg/hour infusion through an epidural catheter.
Answer: A
Explanation: Transdermal fentanyl provides continuous pain relief over 72 hours and is ideal for
home use due to its non-invasive administration.
Why Other Options Are Wrong: B is incorrect because frequent IM injections are impractical for
long-term use. C and D are incorrect because PCA pumps and epidurals are typically used in
hospital settings.
5. The nurse applied the first 50 mcg fentanyl (Duragesic) patch 2 hours ago for a patient
with severe chronic pain, but the patient rates pain at 9/10. What is the nurse's priority
action?
A. Reassure the patient that the patch will start working soon.
B. Check the provider's orders for a short-acting narcotic for breakthrough pain.
C. Provide non-pharmacological interventions like guided imagery.
D. Apply a second 25 mcg patch immediately.
Collaborative Practice by Yoost & Crawford
Chapter 36: Pain Management
Multiple Choice Questions
1. The nurse is caring for a patient recovering from knee replacement surgery who
complains of severe pain in the knee after receiving hydrocodone with acetaminophen
(Vicodin) 2 hours previously. What is the nurse's best action to manage this pain
effectively?
A. Administer another dose of the medication without consulting the provider.
B. Apply ice packs to the knee to reduce swelling and pain.
C. Apply heat packs to the knee to increase blood flow.
D. Perform gentle range of motion exercises to improve mobility.
Answer: B
Explanation: Applying ice packs reduces swelling and pain by slowing nerve conduction and
providing local analgesia, which is appropriate for postoperative pain management. Heat packs
would increase blood flow and exacerbate swelling, and administering another dose without an
order or performing range of motion could worsen the pain.
Why Other Options Are Wrong: A is incorrect because administering another dose without a
provider's order is unsafe. C is incorrect because heat increases blood flow and swelling. D is
incorrect because range of motion exercises would increase pain at this stage.
2. The nurse is assessing a patient 30 minutes after administering pain medication. Which
finding best indicates that the pain medication was effective?
A. The patient is sleeping quietly.
B. The patient states a reduction in pain intensity.
C. The patient's respirations are slow and regular.
D. The patient's blood pressure has returned to baseline.
Answer: B
Explanation: The most reliable indicator of pain relief is the patient's self-report of reduced pain.
Other findings like sleep or vital signs may suggest comfort but are not definitive.
Why Other Options Are Wrong: A is incorrect because sleep does not confirm pain relief. C and
D are incorrect because respirations and blood pressure are indirect measures and can be
influenced by other factors.
, 3. The nurse is caring for a patient with severe abdominal pain caused by acute
cholecystitis. Which type of pain is this patient most likely experiencing?
A. Visceral pain.
B. Somatic pain.
C. Radiating pain.
D. Referred pain.
Answer: A
Explanation: Visceral pain arises from internal organs like the gallbladder, which is inflamed in
cholecystitis. It is often described as deep, dull, or cramping.
Why Other Options Are Wrong: B is incorrect because somatic pain originates from skin,
muscles, or joints. C and D are incorrect because radiating and referred pain involve discomfort
felt away from the source.
4. The nurse is evaluating the best pain medication option for a patient with severe long-
term cancer pain at home. Which choice is most appropriate?
A. Fentanyl (Duragesic) 50 mcg transdermal patch every 72 hours.
B. Meperidine (Demerol) 50 mg IM every 6 hours.
C. Hydromorphone (Dilaudid) 0.2 mg IV via PCA pump every 10 minutes.
D. Hydromorphone (Dilaudid) 0.08 mg/hour infusion through an epidural catheter.
Answer: A
Explanation: Transdermal fentanyl provides continuous pain relief over 72 hours and is ideal for
home use due to its non-invasive administration.
Why Other Options Are Wrong: B is incorrect because frequent IM injections are impractical for
long-term use. C and D are incorrect because PCA pumps and epidurals are typically used in
hospital settings.
5. The nurse applied the first 50 mcg fentanyl (Duragesic) patch 2 hours ago for a patient
with severe chronic pain, but the patient rates pain at 9/10. What is the nurse's priority
action?
A. Reassure the patient that the patch will start working soon.
B. Check the provider's orders for a short-acting narcotic for breakthrough pain.
C. Provide non-pharmacological interventions like guided imagery.
D. Apply a second 25 mcg patch immediately.
