Exam 1 Review Questions
Unit 1 (Pain/Periop/Anemia)
Pain
1. What is pain? (Page 25)
Pain is defined as an unpleasant sensory or emotional experience associated with actual
or potential tissue damage
2. What is the difference between acute and chronic pain? (Page 25-26)
Acute pain serves as a biologic purpose in that it acts as a warning signal by activating the sympathetic
nervous system causing various physiologic responses. Responses are similar to “Fight-or-Flight”:
increased vital signs, sweating, & dilated pupils
Has short duration
Usually has a well-defined cause
Decreases with healing
Usually reversible
Initially serves as a biologic purpose (warning sign to withdraw from painful stimuli or seek help)
When prolonged, serves no useful purpose
Ranges from mild to severe intensity
May be accompanied by anxiety & restlessness
When unrelieved, can increase morbidity & mortality & prolong hospital stay
Chronic Pain (Persistent) is pain that last or recurs for an indefinite period, usually more than 3 months.
The onset is gradual & the character & quality of the pain often change over time. The body adapts to
persistent pain so vital signs, such as pulse rate & blood pressure, may actually be lower than normal in
people with chronic pain
Usually last longer than 3 months
May or may not have well-defined cause
Usually begins gradually & persists
Serves no useful purpose
Ranges from mild to severe intensity
, Often accompanied by multiple quality-of-life and functional adverse reactions, including
depression, fatigue, financial burden, and increased dependence on family, friends, & healthcare
system
Can impact the quality of life of family members & friends
3. Describe the placebo effect. Do you see any problems with using placebos? (Page 45-46)
Placebo is defined as any medication or procedure, including surgery, which produces an
effect on in a patient because of its implicit or explicit intent, not because of its specific
physical or chemical properties
Placebos are appropriately used as controls in a research evaluating the effects of new
medication. Patients or volunteers who participate in placebo-controlled research must
be able to give informed consent or have a guardian who can provide consent.
Deceitful administration of a placebo violates informed consent law and jeopardizes the
nurse-patient therapeutic relationship. Never administer a placebo to a patient.
Promptly contact your nurse supervisor if you are given an order to do so.
4. What is the best way to assess pain in a patient? (Page 28)
Subjective descriptions of the experience and measurement of pain intensity are more
accurate than observable qualities of pain.
The nurses primary role in pain management is to advocate for patients by accepting
their reports of pain and acting promptly to relieve it whole respecting patients’
preferences and values
5. As you assess patient’s pain, what question(s) can you ask to gather the information for each
component? (Page 30-32)
a. Location – “Can you state or point to the area(s) of pain on the body?”
b. Intensity – “On a scale from 0-10, can you can rate your pain, 10 being the worse pain
you’ve ever experienced?”
c. Quality – “Can you describe what kind of pain your having?”
d. Onset and duration – “When did the pain begin?” “Is this a constant or intermittent
pain?”
e. Aggravating and relieving factors – “Is there anything that makes the pain better or
worse?”
, f. Effect on quality of life – “How has this pain effected your life?” “What could you do
before the pain that you cannot do now?”
6. Identify the four categories of pain location. (Page 30)
Localized pain is confined to the site of origin
Projected pain is diffuse around the site of origin and is not well localized
Referred pain is felt in an area distant from the site of painful stimuli
Radiating pain is felt along a specific nerve or nerves
7. What options for pain assessment are available if the patient is cognitively impaired or non-
verbal? (page 33)
Key Components of the Hierarchy of Pain Measures requires the nurse to (1) attempt to
obtain self-report (2) consider underlying pathology or conditions & procedures that
might be painful (3) observe behaviors (4) evaluate physiologic indicators (5) conduct an
analgesic trial
Behavioral pain assessment tools are often used to systemically evaluate behaviors to
help determine the presence of pain. Improvement in the behavioral pain score helps
confirm suspicions that pain is present and provides a reference point for assessing the
effectiveness of interventions
Checklist for Nonverbal Pain Indicators (CNPI) - used for varying levels of cognitive
impairment
Pain Assessment in Advanced Dementia (PAINAD) – Used for severe dementia
For mechanically ventilated patient or ones that may not be able to use other tools for
communication: establish yes/no signals, communication boards, picture boards,
computers, alphabet boards, or interpreting lip reading
8. What drug options are available to treat pain? (Page 34-45)
Non Opioid Analgesics- EX: acetaminophen & NSAIDS
Opioid Analgesics- EX: morphine, hydromorphone, fentanyl, & oxycodone
Adjuvant Analgesics (Co-analgesics) - EX: local anesthetics, anticonvulsants, antidepressants
9. What non-pharmacological interventions can nurses use with pain patients? (Page 46-48)
Physical:
, Physical, Occupational, & Aqua therapy
Functional restoration
Acupuncture
Low-impact exercise program
Cutaneous:
Application of heat, cold, or pressure
Therapeutic massage
Vibration
TENS
Imagery
Reading
Tap to a rhythm or singing while listening to music
Follow the logic & participate in sustained conversation
Have an interest in environmental surroundings
Physical Relaxation
Relaxation breathing
Body massage, back rub, or warm bath
Modifying environment to reduce distractions
Moving into comfortable position
Psychological Relaxation
Pleasant conversation
Laughter & humor
Unit 1 (Pain/Periop/Anemia)
Pain
1. What is pain? (Page 25)
Pain is defined as an unpleasant sensory or emotional experience associated with actual
or potential tissue damage
2. What is the difference between acute and chronic pain? (Page 25-26)
Acute pain serves as a biologic purpose in that it acts as a warning signal by activating the sympathetic
nervous system causing various physiologic responses. Responses are similar to “Fight-or-Flight”:
increased vital signs, sweating, & dilated pupils
Has short duration
Usually has a well-defined cause
Decreases with healing
Usually reversible
Initially serves as a biologic purpose (warning sign to withdraw from painful stimuli or seek help)
When prolonged, serves no useful purpose
Ranges from mild to severe intensity
May be accompanied by anxiety & restlessness
When unrelieved, can increase morbidity & mortality & prolong hospital stay
Chronic Pain (Persistent) is pain that last or recurs for an indefinite period, usually more than 3 months.
The onset is gradual & the character & quality of the pain often change over time. The body adapts to
persistent pain so vital signs, such as pulse rate & blood pressure, may actually be lower than normal in
people with chronic pain
Usually last longer than 3 months
May or may not have well-defined cause
Usually begins gradually & persists
Serves no useful purpose
Ranges from mild to severe intensity
, Often accompanied by multiple quality-of-life and functional adverse reactions, including
depression, fatigue, financial burden, and increased dependence on family, friends, & healthcare
system
Can impact the quality of life of family members & friends
3. Describe the placebo effect. Do you see any problems with using placebos? (Page 45-46)
Placebo is defined as any medication or procedure, including surgery, which produces an
effect on in a patient because of its implicit or explicit intent, not because of its specific
physical or chemical properties
Placebos are appropriately used as controls in a research evaluating the effects of new
medication. Patients or volunteers who participate in placebo-controlled research must
be able to give informed consent or have a guardian who can provide consent.
Deceitful administration of a placebo violates informed consent law and jeopardizes the
nurse-patient therapeutic relationship. Never administer a placebo to a patient.
Promptly contact your nurse supervisor if you are given an order to do so.
4. What is the best way to assess pain in a patient? (Page 28)
Subjective descriptions of the experience and measurement of pain intensity are more
accurate than observable qualities of pain.
The nurses primary role in pain management is to advocate for patients by accepting
their reports of pain and acting promptly to relieve it whole respecting patients’
preferences and values
5. As you assess patient’s pain, what question(s) can you ask to gather the information for each
component? (Page 30-32)
a. Location – “Can you state or point to the area(s) of pain on the body?”
b. Intensity – “On a scale from 0-10, can you can rate your pain, 10 being the worse pain
you’ve ever experienced?”
c. Quality – “Can you describe what kind of pain your having?”
d. Onset and duration – “When did the pain begin?” “Is this a constant or intermittent
pain?”
e. Aggravating and relieving factors – “Is there anything that makes the pain better or
worse?”
, f. Effect on quality of life – “How has this pain effected your life?” “What could you do
before the pain that you cannot do now?”
6. Identify the four categories of pain location. (Page 30)
Localized pain is confined to the site of origin
Projected pain is diffuse around the site of origin and is not well localized
Referred pain is felt in an area distant from the site of painful stimuli
Radiating pain is felt along a specific nerve or nerves
7. What options for pain assessment are available if the patient is cognitively impaired or non-
verbal? (page 33)
Key Components of the Hierarchy of Pain Measures requires the nurse to (1) attempt to
obtain self-report (2) consider underlying pathology or conditions & procedures that
might be painful (3) observe behaviors (4) evaluate physiologic indicators (5) conduct an
analgesic trial
Behavioral pain assessment tools are often used to systemically evaluate behaviors to
help determine the presence of pain. Improvement in the behavioral pain score helps
confirm suspicions that pain is present and provides a reference point for assessing the
effectiveness of interventions
Checklist for Nonverbal Pain Indicators (CNPI) - used for varying levels of cognitive
impairment
Pain Assessment in Advanced Dementia (PAINAD) – Used for severe dementia
For mechanically ventilated patient or ones that may not be able to use other tools for
communication: establish yes/no signals, communication boards, picture boards,
computers, alphabet boards, or interpreting lip reading
8. What drug options are available to treat pain? (Page 34-45)
Non Opioid Analgesics- EX: acetaminophen & NSAIDS
Opioid Analgesics- EX: morphine, hydromorphone, fentanyl, & oxycodone
Adjuvant Analgesics (Co-analgesics) - EX: local anesthetics, anticonvulsants, antidepressants
9. What non-pharmacological interventions can nurses use with pain patients? (Page 46-48)
Physical:
, Physical, Occupational, & Aqua therapy
Functional restoration
Acupuncture
Low-impact exercise program
Cutaneous:
Application of heat, cold, or pressure
Therapeutic massage
Vibration
TENS
Imagery
Reading
Tap to a rhythm or singing while listening to music
Follow the logic & participate in sustained conversation
Have an interest in environmental surroundings
Physical Relaxation
Relaxation breathing
Body massage, back rub, or warm bath
Modifying environment to reduce distractions
Moving into comfortable position
Psychological Relaxation
Pleasant conversation
Laughter & humor
