NURS 211 - NCLEX Style Questions (Pain)
Exam With Correct Answers
Which of the following is a priority for a nurse to include in a teaching plan for a
pt who desires self-management and alternative strategies?
a. body alignment and superficial heat and cooling
b. patient controlled analgesia (PCA) pump
c. neurostimulation
d. peripheral nerve blocks - ANSWER a. body alignment and superficial heat and
cooling
Body alignment and thermal management are examples of nonpharmacologic
measures to manage pain. They can be used individually or in combination with
other nondrug therapies. Proper body alignment achieved through proper
positioning can help prevent or relieve pain. Thermal measures such as the
application of localized, superficial heat and cooling may relieve pain and
provide comfort. PCA, neurostimulation, and peripheral nerve blocks are not
totally self-managed or alternate therapies, because they are used under the
direction of medical professionals.
Stephanie is a 70-year-old retired schoolteacher who is interested in nondrug,
mind-body therapies, self-management, and alternative strategies to deal with
joint discomfort from rheumatoid arthritis. Which of the following options should
you suggest for her plan of care, considering her expressed wishes?
A. Using a stationary exercise bicycle and free weights and attending a spinning
class.
B. Using mind-body therapies such as music therapy, distraction techniques,
meditation, prayer, hypnosis, guided imagery, relaxation techniques, and pet
therapy.
C. Drinking chamomile tea and applying icy/hot gel.
D. Receiving acupuncture and attending church services. - ANSWER b. Using
mind body therapies
Mind-body therapies are designed to enhance the mind's capacity to affect
bodily functions and symptoms and include music therapy, distraction
techniques, and pet therapy, among many others. Although getting exercise,
drinking chamomile tea and applying gels, and receiving acupuncture and
attending church services may be beneficial, they are not classified as mind-
body therapies in combination as specified in these answer choices.
A 65-year-old woman has fallen while sweeping her driveway, sustaining a
tissue injury. She describes her condition as an aching, throbbing back. Which
type of pain are these complaints most indicative of?
,a. neuropathic pain
b. nociceptive pain
c. chronic pain
d. mixed pain syndrom - ANSWER b. nociceptive pain
Nociceptive pain refers to the normal functioning of physiological systems that
leads to the perception of noxious stimuli (tissue injury) as being painful. Pt's
describe this type of pain as dull or aching, and is poorly localized. Neuropathic
pain is described as shooting, tingling, burning, or numbness that is constant in
the extremities, as in diabetic neuropathy. Chronic pain lasts longer than 30
days and is characterized by a disease affecting brain structure and function,
such as chronic headaches or open wounds. Mixed pain syndromes are caused
by different pathophysiological mechanisms such as a combination of
neuropathic and nociceptive pain; this occurs in syndromes such as sciatica,
spinal cord injuries, and cervical or lumbar spinal stenosis.
Postoperative surgical patients should be given alternating doses of
acetaminophen and which medication throughout the postoperative course,
unless contraindicated?
a. antihistamine
b. local anasthetic
c. opioids
d. nonsteroidal anti-inflammatory drug (NSAID) - ANSWER d. nonsteroidal anti-
inflammatory drug (NSAID)
Unless contraindicated, all surgical pt's should routinely be given
acetaminophen and an NSAID in scheduled doses throughout the postoperative
course. Opioid analgesics are added to the treatment plan to manage moderate-
to-severe postoperative pain. A local anasthetic is sometimes administered
epidurally or by continuous peripheral nerve block
Following the initiation of a pain management plan, pain should be reassessed
and documented on a regular basis as a way to evaluate the effectiveness of
treatments. Pain should be reassessed at which minimum interval?
a. with each new report of pain
b. Before and after administration of narcotic analgesics
c. every 10 minutes
d. every shift - ANSWER a. with each new report of pain
Following the initiation of a pain management plan, pain should be reassessed
and documented on a regular basis as a way to evaluate the effectiveness of
treatments. At a minimum, pain should be reassessed with each new report of
pain and before and after administration of analgesics.
When assessing the pt for pain, which factors should the nurse consider?
(Select all that apply)
, a. previous medical history
b. physical appearance
c. age, gender, and culture
d. lifestyle and loss of appetite
e. hair color and style - ANSWER a, b. c. d
Medical history, physical appearance, age, gender, culture, lifestyle, and loss of
appetite should be considered when conducting a pain assessment. Hair color
and style are not necessary components of pain assessment.
Which statement best describes the dosage of pain medication that a nurse
should administer given pharmacologic treatment considerations?
a. The smallest dose possible to avoid opioid addiction.
b. the smallest dose possible to decrease adverse effects
c. a dose that best manages pain with fewest side effects
d. a large dose initially to decrease the initial level of pain. - ANSWER c
Based on the pt's report of pain, the nurse administers the dose of medication
that is effective in relieving pain without causing adverse side effects.
administering too small of a dose does not relieve pain. Administering a large
dose may result in unwanted side effects. Addiction to narcotics is rare
Which method is the most accurate way to determine the pain level of a pt who is
alert and oriented?
a. evaluate whether the pt is crying and grimacing
b. assess the pt heat rate and BP
c. consider the seriousness of the pt's condition
d. use a pain assessment tool and ask the pt to rate the pain level - ANSWER d.
Because pain is defined as what a patient says it is, a pt's report based on the
pain scale is currently the most accurate way to determine the pain level of a
cognitively alert pt. Crying or grimacing may be considered on a noncognitive
scale for a nonverbal pt. Vital signs as the pt's condition contribute to a pain
assessment, but they may not be the most accurate determinants.
A pt who has a serious back injury received IV medication for pain approx 1 hour
earlier. The pt practices relaxation techniques but still is reporting pain at a level
of 9 of 10. What intervention should the nurse implement next?
a. report the lack of pain relief to the PCP
b. tell the pt to give the medication more time
c. reposition the pt, and try diversion activities
d. document in the nurse's notes that the pt has a low pain tolerance - ANSWER
a
If the pt with a serious injury is not obtaining pain relief from pharmacologic and
nonpharmacologic interventions, the PCP should be notified. Waiting longer and
Exam With Correct Answers
Which of the following is a priority for a nurse to include in a teaching plan for a
pt who desires self-management and alternative strategies?
a. body alignment and superficial heat and cooling
b. patient controlled analgesia (PCA) pump
c. neurostimulation
d. peripheral nerve blocks - ANSWER a. body alignment and superficial heat and
cooling
Body alignment and thermal management are examples of nonpharmacologic
measures to manage pain. They can be used individually or in combination with
other nondrug therapies. Proper body alignment achieved through proper
positioning can help prevent or relieve pain. Thermal measures such as the
application of localized, superficial heat and cooling may relieve pain and
provide comfort. PCA, neurostimulation, and peripheral nerve blocks are not
totally self-managed or alternate therapies, because they are used under the
direction of medical professionals.
Stephanie is a 70-year-old retired schoolteacher who is interested in nondrug,
mind-body therapies, self-management, and alternative strategies to deal with
joint discomfort from rheumatoid arthritis. Which of the following options should
you suggest for her plan of care, considering her expressed wishes?
A. Using a stationary exercise bicycle and free weights and attending a spinning
class.
B. Using mind-body therapies such as music therapy, distraction techniques,
meditation, prayer, hypnosis, guided imagery, relaxation techniques, and pet
therapy.
C. Drinking chamomile tea and applying icy/hot gel.
D. Receiving acupuncture and attending church services. - ANSWER b. Using
mind body therapies
Mind-body therapies are designed to enhance the mind's capacity to affect
bodily functions and symptoms and include music therapy, distraction
techniques, and pet therapy, among many others. Although getting exercise,
drinking chamomile tea and applying gels, and receiving acupuncture and
attending church services may be beneficial, they are not classified as mind-
body therapies in combination as specified in these answer choices.
A 65-year-old woman has fallen while sweeping her driveway, sustaining a
tissue injury. She describes her condition as an aching, throbbing back. Which
type of pain are these complaints most indicative of?
,a. neuropathic pain
b. nociceptive pain
c. chronic pain
d. mixed pain syndrom - ANSWER b. nociceptive pain
Nociceptive pain refers to the normal functioning of physiological systems that
leads to the perception of noxious stimuli (tissue injury) as being painful. Pt's
describe this type of pain as dull or aching, and is poorly localized. Neuropathic
pain is described as shooting, tingling, burning, or numbness that is constant in
the extremities, as in diabetic neuropathy. Chronic pain lasts longer than 30
days and is characterized by a disease affecting brain structure and function,
such as chronic headaches or open wounds. Mixed pain syndromes are caused
by different pathophysiological mechanisms such as a combination of
neuropathic and nociceptive pain; this occurs in syndromes such as sciatica,
spinal cord injuries, and cervical or lumbar spinal stenosis.
Postoperative surgical patients should be given alternating doses of
acetaminophen and which medication throughout the postoperative course,
unless contraindicated?
a. antihistamine
b. local anasthetic
c. opioids
d. nonsteroidal anti-inflammatory drug (NSAID) - ANSWER d. nonsteroidal anti-
inflammatory drug (NSAID)
Unless contraindicated, all surgical pt's should routinely be given
acetaminophen and an NSAID in scheduled doses throughout the postoperative
course. Opioid analgesics are added to the treatment plan to manage moderate-
to-severe postoperative pain. A local anasthetic is sometimes administered
epidurally or by continuous peripheral nerve block
Following the initiation of a pain management plan, pain should be reassessed
and documented on a regular basis as a way to evaluate the effectiveness of
treatments. Pain should be reassessed at which minimum interval?
a. with each new report of pain
b. Before and after administration of narcotic analgesics
c. every 10 minutes
d. every shift - ANSWER a. with each new report of pain
Following the initiation of a pain management plan, pain should be reassessed
and documented on a regular basis as a way to evaluate the effectiveness of
treatments. At a minimum, pain should be reassessed with each new report of
pain and before and after administration of analgesics.
When assessing the pt for pain, which factors should the nurse consider?
(Select all that apply)
, a. previous medical history
b. physical appearance
c. age, gender, and culture
d. lifestyle and loss of appetite
e. hair color and style - ANSWER a, b. c. d
Medical history, physical appearance, age, gender, culture, lifestyle, and loss of
appetite should be considered when conducting a pain assessment. Hair color
and style are not necessary components of pain assessment.
Which statement best describes the dosage of pain medication that a nurse
should administer given pharmacologic treatment considerations?
a. The smallest dose possible to avoid opioid addiction.
b. the smallest dose possible to decrease adverse effects
c. a dose that best manages pain with fewest side effects
d. a large dose initially to decrease the initial level of pain. - ANSWER c
Based on the pt's report of pain, the nurse administers the dose of medication
that is effective in relieving pain without causing adverse side effects.
administering too small of a dose does not relieve pain. Administering a large
dose may result in unwanted side effects. Addiction to narcotics is rare
Which method is the most accurate way to determine the pain level of a pt who is
alert and oriented?
a. evaluate whether the pt is crying and grimacing
b. assess the pt heat rate and BP
c. consider the seriousness of the pt's condition
d. use a pain assessment tool and ask the pt to rate the pain level - ANSWER d.
Because pain is defined as what a patient says it is, a pt's report based on the
pain scale is currently the most accurate way to determine the pain level of a
cognitively alert pt. Crying or grimacing may be considered on a noncognitive
scale for a nonverbal pt. Vital signs as the pt's condition contribute to a pain
assessment, but they may not be the most accurate determinants.
A pt who has a serious back injury received IV medication for pain approx 1 hour
earlier. The pt practices relaxation techniques but still is reporting pain at a level
of 9 of 10. What intervention should the nurse implement next?
a. report the lack of pain relief to the PCP
b. tell the pt to give the medication more time
c. reposition the pt, and try diversion activities
d. document in the nurse's notes that the pt has a low pain tolerance - ANSWER
a
If the pt with a serious injury is not obtaining pain relief from pharmacologic and
nonpharmacologic interventions, the PCP should be notified. Waiting longer and
