Chapter 10 PAIN
1. When doing a pain assessment for a client who has been admitted with metastatic breast
cancer, which question asked by the nurse will give the most information about the client’s
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 medicate for pain?”
ANS: B
1. When doing a pain assessment for a client who has been admitted with metastatic breast cancer, which question
asked by the nurse will give the most information about the client’s 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 medicate for pain?”
ANS: B
2. A client who uses a fentanyl patch for chronic cancer pain complains to the nurse of the rapid
onset of pain at a level 9 (0–10 scale) and requests “something for pain that will work
quickly.” Which of the following types of pain is the most appropriate for the nurse to
document for this client?
2. A client who uses a fentanyl patch for chronic cancer pain complains to the nurse of the rapid onset of pain at a
level 9 (0–10 scale) and requests “something for pain that will work quickly.” Which of the following types of pain
is the most appropriate for the nurse to document for this client?
1. a.
2. Somatic pain
3. b.
4. Referred pain
5. c.
6. Neuropathic pain
7. d.
8. Breakthrough pain
9.
10.
11. ANS: D
a. Somatic pain b. Referred pain
b. c. Neuropathic pain d. Breakthrough pain
ANS: D
3. A postoperative client asks the nurse how the prescribed ibuprofen will control the incisional pain. The nurse will
teach the client that ibuprofen interferes with the pain process by decreasing which of the following physiological
responses?
a. Modulating effect of descending nerves
,b. Sensitivity of the brain to painful stimuli
c. Production of pain-sensitizing chemicals
d. Spinal cord transmission of pain impulses
ANS: C
4. The nurse is caring for a client who is taking an opioid for postoperative pain. Which of the following
interventions should the nurse include in the clients plan of care to manage possible adverse effects of opioids?
a. Ensure the medication is given PRN only.
b. Administer the prescribed stool softener OD.
c. Ensure the administration route maximizes drug concentration at the site of the adverse effect.
d. Request a prescription for a different classification of medication.
ANS: B
5. A client with chronic abdominal pain has learned to control the pain with the use of imagery and hypnosis. A
family member asks the nurse how these techniques work. Which of the following reasons provide the basis for the
nurse’s response in relation to the effectiveness of these strategies?
a. Impact the cognitive and affective components of pain.
b. Increase the modulating effect of the efferent pathways.
c. Prevent transmission of nociceptive stimuli to the cortex.
d. Slow the release of transmitter chemicals in the dorsal horn.
ANS: A
6. A client who is receiving sustained-release morphine sulphate every 12 hours for chronic pain experiences level 9
(0–10 scale) breakthrough pain and anxiety. Which of these prescribed medications should the nurse anticipate
administering?
a. Lorazepam 1 mg orally b. Amitriptyline 10 mg orally
c. Ibuprofen 400–800 mg orally d. Immediate-release morphine 30 mg orally
ANS: D
7. The nurse is caring for a client with chronic back pain who has arrived at the pain clinic for a
follow-up appointment. In order to evaluate whether the pain management is effective, which
of the following questions is most appropriate for the nurse to ask?
a.
“Can you describe the quality of your pain?”
b.
“Has there been a change in the pain location?”
c.
“How would you rate your pain on a 0–10 scale?”
d.
“Does the pain keep you from doing things you enjoy?”
ANS: D
, The goal for the treatment of chronic pain usually is to enhance function and quality of life.
The other questions also are appropriate to ask, but information about client function is more
useful in evaluating effectiveness.
DIF: Cognitive Level: Application TOP: Nursing Process: Evaluation
MSC: NCLEX: Physiological Integrity
8. A client with second-degree burns has been receiving morphine through patient-controlled
analgesia (PCA) for a week. The client wakes up frequently during the night complaining of
pain. Which of the following actions should the nurse implement?
a.
Administer a dose of morphine every 1–2 hours from the PCA machine while the
client is sleeping.
b.
Consult with the health care provider about using a different treatment protocol to
control the client’s pain.
c.
Request that the health care provider order a bolus dose of morphine to be given
when the client awakens with pain.
d.
Teach the client to push the button every 10 minutes for an hour before going to
sleep, even if the pain is minimal.
ANS: B
7. The nurse is caring for a client with chronic back pain who has arrived at the pain clinic for a follow-up
appointment. In order to evaluate whether the pain management is effective, which of the following questions is
most appropriate for the nurse to ask?
a. “Can you describe the quality of your pain?”
b. “Has there been a change in the pain location?”
c. “How would you rate your pain on a 0–10 scale?”
d. “Does the pain keep you from doing things you enjoy?”
ANS: D
8. A client with second-degree burns has been receiving morphine through patient-controlled analgesia (PCA) for a
week. The client wakes up frequently during the night complaining of pain. Which of the following actions should
the nurse implement?
a. Administer a dose of morphine every 1–2 hours from the PCA machine while the client is sleeping.
b. Consult with the health care provider about using a different treatment protocol to control the client’s pain.
c. Request that the health care provider order a bolus dose of morphine to be given when the client awakens with
pain.
d. Teach the client to push the button every 10 minutes for an hour before going to sleep, even if the pain is minimal.
ANS: B
9. The nurse is caring for a client who is receiving epidural morphine. Which of the following
information obtained by the nurse indicates that the client may be experiencing an adverse
effect of the medication?
1. When doing a pain assessment for a client who has been admitted with metastatic breast
cancer, which question asked by the nurse will give the most information about the client’s
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 medicate for pain?”
ANS: B
1. When doing a pain assessment for a client who has been admitted with metastatic breast cancer, which question
asked by the nurse will give the most information about the client’s 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 medicate for pain?”
ANS: B
2. A client who uses a fentanyl patch for chronic cancer pain complains to the nurse of the rapid
onset of pain at a level 9 (0–10 scale) and requests “something for pain that will work
quickly.” Which of the following types of pain is the most appropriate for the nurse to
document for this client?
2. A client who uses a fentanyl patch for chronic cancer pain complains to the nurse of the rapid onset of pain at a
level 9 (0–10 scale) and requests “something for pain that will work quickly.” Which of the following types of pain
is the most appropriate for the nurse to document for this client?
1. a.
2. Somatic pain
3. b.
4. Referred pain
5. c.
6. Neuropathic pain
7. d.
8. Breakthrough pain
9.
10.
11. ANS: D
a. Somatic pain b. Referred pain
b. c. Neuropathic pain d. Breakthrough pain
ANS: D
3. A postoperative client asks the nurse how the prescribed ibuprofen will control the incisional pain. The nurse will
teach the client that ibuprofen interferes with the pain process by decreasing which of the following physiological
responses?
a. Modulating effect of descending nerves
,b. Sensitivity of the brain to painful stimuli
c. Production of pain-sensitizing chemicals
d. Spinal cord transmission of pain impulses
ANS: C
4. The nurse is caring for a client who is taking an opioid for postoperative pain. Which of the following
interventions should the nurse include in the clients plan of care to manage possible adverse effects of opioids?
a. Ensure the medication is given PRN only.
b. Administer the prescribed stool softener OD.
c. Ensure the administration route maximizes drug concentration at the site of the adverse effect.
d. Request a prescription for a different classification of medication.
ANS: B
5. A client with chronic abdominal pain has learned to control the pain with the use of imagery and hypnosis. A
family member asks the nurse how these techniques work. Which of the following reasons provide the basis for the
nurse’s response in relation to the effectiveness of these strategies?
a. Impact the cognitive and affective components of pain.
b. Increase the modulating effect of the efferent pathways.
c. Prevent transmission of nociceptive stimuli to the cortex.
d. Slow the release of transmitter chemicals in the dorsal horn.
ANS: A
6. A client who is receiving sustained-release morphine sulphate every 12 hours for chronic pain experiences level 9
(0–10 scale) breakthrough pain and anxiety. Which of these prescribed medications should the nurse anticipate
administering?
a. Lorazepam 1 mg orally b. Amitriptyline 10 mg orally
c. Ibuprofen 400–800 mg orally d. Immediate-release morphine 30 mg orally
ANS: D
7. The nurse is caring for a client with chronic back pain who has arrived at the pain clinic for a
follow-up appointment. In order to evaluate whether the pain management is effective, which
of the following questions is most appropriate for the nurse to ask?
a.
“Can you describe the quality of your pain?”
b.
“Has there been a change in the pain location?”
c.
“How would you rate your pain on a 0–10 scale?”
d.
“Does the pain keep you from doing things you enjoy?”
ANS: D
, The goal for the treatment of chronic pain usually is to enhance function and quality of life.
The other questions also are appropriate to ask, but information about client function is more
useful in evaluating effectiveness.
DIF: Cognitive Level: Application TOP: Nursing Process: Evaluation
MSC: NCLEX: Physiological Integrity
8. A client with second-degree burns has been receiving morphine through patient-controlled
analgesia (PCA) for a week. The client wakes up frequently during the night complaining of
pain. Which of the following actions should the nurse implement?
a.
Administer a dose of morphine every 1–2 hours from the PCA machine while the
client is sleeping.
b.
Consult with the health care provider about using a different treatment protocol to
control the client’s pain.
c.
Request that the health care provider order a bolus dose of morphine to be given
when the client awakens with pain.
d.
Teach the client to push the button every 10 minutes for an hour before going to
sleep, even if the pain is minimal.
ANS: B
7. The nurse is caring for a client with chronic back pain who has arrived at the pain clinic for a follow-up
appointment. In order to evaluate whether the pain management is effective, which of the following questions is
most appropriate for the nurse to ask?
a. “Can you describe the quality of your pain?”
b. “Has there been a change in the pain location?”
c. “How would you rate your pain on a 0–10 scale?”
d. “Does the pain keep you from doing things you enjoy?”
ANS: D
8. A client with second-degree burns has been receiving morphine through patient-controlled analgesia (PCA) for a
week. The client wakes up frequently during the night complaining of pain. Which of the following actions should
the nurse implement?
a. Administer a dose of morphine every 1–2 hours from the PCA machine while the client is sleeping.
b. Consult with the health care provider about using a different treatment protocol to control the client’s pain.
c. Request that the health care provider order a bolus dose of morphine to be given when the client awakens with
pain.
d. Teach the client to push the button every 10 minutes for an hour before going to sleep, even if the pain is minimal.
ANS: B
9. The nurse is caring for a client who is receiving epidural morphine. Which of the following
information obtained by the nurse indicates that the client may be experiencing an adverse
effect of the medication?
