NSG 4067: CARING FOR OLDER ADULTS EXPERIENCING PAIN
1. A nurse assesses an older adult following the repair of an abdominal hernia. The older adult
client states, "I really hate to take pain medication." Which response by the nurse is best?
A) "Early treatment of pain helps now and can reduce the incidence of chronic pain."
B) "Pain medication today doesn't really have any side effects."
C) "Tell me about your fears regarding pain medication."
D) "This pain you are having is normal, and as you heal, the pain level will decrease."
Ans: A
Feedback:
Recent studies have focused on the complex mechanisms involved with the development of
persistent postsurgical pain, finding that its incidence can be reduced with the use of aggressive
and early analgesic therapy. The client does not express that they have "fear." Medications have
side effects. The pain level may decrease with time. But if not treated, it is unlikely to and more
likely to develop into persistent pain.
2. An 80-year-old black woman minimizes her pain in the joints and back as "normal aging."
Which of the following actions by the nurse is most appropriate?
A) Address the client's concerns regarding addiction.
B) Allow the client to choose to minimize the pain.
C) Encourage opioid use for pain relief.
D) Offer warm packs for joints.
Ans: D
Feedback:
Racial and ethnic minorities and women are at high risk for receiving inadequate pain relief. The
nurse must discuss nonpharmacologic interventions as well as dispelling myths regarding the
functional consequences of aging and pain treatment. This client does not express concerns
regarding addiction. Older adults commonly fear negative consequences of analgesics.
3. A nurse assesses the pain of an older adult. Which of the following findings indicates the
presence of persistent pain?
A) The client's vital signs are unchanged.
B) The client is asleep in the chair.
C) The client has not reported pain to the nurse.
D) The client rubs hands together.
Ans: D
, Feedback:
Essential assessment information is also obtained by observing for nonverbal indicators of pain,
such as grimacing, muscle tension, rubbing, and protecting body parts. Relying on vital signs,
presuming that sleeping clients are not experiencing pain, and relying on the absence of reporting
of pain are all flawed pain assessment techniques.
4. A nurse assesses an older adult client with confusion related to hyponatremia who reports
pain. Which of the following data should the nurse use as a guide for choosing interventions?
A) Symptoms of hyponatremia do not include pain.
B) The client does not manifest any outward signs of pain.
C) The client is confused from the pain.
D) The client rates the pain at 8 out of 10.
Ans: D
Feedback:
The client's subjective self-report of pain is the priority assessment finding and reflects the adage
that pain is what the client says it is. The nurse should not discount the reports of clients based on
medical diagnoses and expected findings, because the client has a history of cognitive deficits, or
because the client does not appear to be in pain.
5. A nurse is teaching an older adult about some of the risks associated with using opioid
analgesics. Which of the following statements best demonstrates the individual has gained a
sound knowledge base?
A) "I know that if I become dependent on the drug, my doctor and I will come up with a plan
to discontinue it."
B) "I'll need to be careful that I don't become addicted to the drug over time."
C) "If I do develop a tolerance to the drug, I can expect some withdrawal symptoms."
D) "It sounds like I might have my dosages increased over time because of tolerance."
Ans: D
Feedback:
Tolerance denotes a decreased response to a drug over time, a fact that may necessitate an
increase in drug dosage. Dependence on a drug's effects is not an indication that the drug
necessarily needs to be discontinued, but rather that the drug is needed for living and that
withdrawal symptoms would accompany cessation. Addiction is not a common result of opioid
use, and clients should be made aware of that fact. Withdrawal symptoms are associated with
dependence, not drug tolerance.
1. A nurse assesses an older adult following the repair of an abdominal hernia. The older adult
client states, "I really hate to take pain medication." Which response by the nurse is best?
A) "Early treatment of pain helps now and can reduce the incidence of chronic pain."
B) "Pain medication today doesn't really have any side effects."
C) "Tell me about your fears regarding pain medication."
D) "This pain you are having is normal, and as you heal, the pain level will decrease."
Ans: A
Feedback:
Recent studies have focused on the complex mechanisms involved with the development of
persistent postsurgical pain, finding that its incidence can be reduced with the use of aggressive
and early analgesic therapy. The client does not express that they have "fear." Medications have
side effects. The pain level may decrease with time. But if not treated, it is unlikely to and more
likely to develop into persistent pain.
2. An 80-year-old black woman minimizes her pain in the joints and back as "normal aging."
Which of the following actions by the nurse is most appropriate?
A) Address the client's concerns regarding addiction.
B) Allow the client to choose to minimize the pain.
C) Encourage opioid use for pain relief.
D) Offer warm packs for joints.
Ans: D
Feedback:
Racial and ethnic minorities and women are at high risk for receiving inadequate pain relief. The
nurse must discuss nonpharmacologic interventions as well as dispelling myths regarding the
functional consequences of aging and pain treatment. This client does not express concerns
regarding addiction. Older adults commonly fear negative consequences of analgesics.
3. A nurse assesses the pain of an older adult. Which of the following findings indicates the
presence of persistent pain?
A) The client's vital signs are unchanged.
B) The client is asleep in the chair.
C) The client has not reported pain to the nurse.
D) The client rubs hands together.
Ans: D
, Feedback:
Essential assessment information is also obtained by observing for nonverbal indicators of pain,
such as grimacing, muscle tension, rubbing, and protecting body parts. Relying on vital signs,
presuming that sleeping clients are not experiencing pain, and relying on the absence of reporting
of pain are all flawed pain assessment techniques.
4. A nurse assesses an older adult client with confusion related to hyponatremia who reports
pain. Which of the following data should the nurse use as a guide for choosing interventions?
A) Symptoms of hyponatremia do not include pain.
B) The client does not manifest any outward signs of pain.
C) The client is confused from the pain.
D) The client rates the pain at 8 out of 10.
Ans: D
Feedback:
The client's subjective self-report of pain is the priority assessment finding and reflects the adage
that pain is what the client says it is. The nurse should not discount the reports of clients based on
medical diagnoses and expected findings, because the client has a history of cognitive deficits, or
because the client does not appear to be in pain.
5. A nurse is teaching an older adult about some of the risks associated with using opioid
analgesics. Which of the following statements best demonstrates the individual has gained a
sound knowledge base?
A) "I know that if I become dependent on the drug, my doctor and I will come up with a plan
to discontinue it."
B) "I'll need to be careful that I don't become addicted to the drug over time."
C) "If I do develop a tolerance to the drug, I can expect some withdrawal symptoms."
D) "It sounds like I might have my dosages increased over time because of tolerance."
Ans: D
Feedback:
Tolerance denotes a decreased response to a drug over time, a fact that may necessitate an
increase in drug dosage. Dependence on a drug's effects is not an indication that the drug
necessarily needs to be discontinued, but rather that the drug is needed for living and that
withdrawal symptoms would accompany cessation. Addiction is not a common result of opioid
use, and clients should be made aware of that fact. Withdrawal symptoms are associated with
dependence, not drug tolerance.
