Fundamental Skills - Pain

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Author:
nursedaisy98
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256726
Filename:
Fundamental Skills - Pain
Updated:
2014-04-20 10:17:02
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NCLEX RN
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Fundamental Skills
Description:
Pain
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  1. The home health care nurse is caring for a client with cancer who is complaining of acute pain. The most appropriate determination of the client's pain should include which assessment? 
    1. The client's pain rating 
    2. Nonverbal cues from the client 
    3. The nurse's impression of the client's pain 
    4. Pain relief after appropriate nursing intervention
    1. The client's pain rating
  2. A nurse is caring for a client who is receiving morphine sulfate by the intravenous route for acute pain. The nurse ensures that which medication is available in the event that the client's respiratory status and level of consciousness deteriorate? 
    1. Atropine sulfate 
    2. Protamine sulfate 
    3. Naloxone (Narcan) 
    4. Promethazine (Phenergan)
    3. Naloxone (Narcan)
  3. The nurse is setting up a transcutaneous electrical nerve stimulation (TENS) unit on a client with chronic pain. As the nurse turns up the level of stimulation, the client complains of discomfort. Based on this finding, the nurse should make which interpretation? 
    1. The maximal stimulation has been reached, and it should be decreased slightly. 
    2. This is a temporary effect, and the stimulation should continue to be increased. 
    3. The maximal stimulation has been far exceeded, and it should be decreased by half. 
    4. This is a complication of the device's use, and it should be discontinued immediately.
    1. The maximal stimulation has been reached, and it should be decreased slightly.
  4. The nurse is assessing the status of pain in a client who was recently admitted to the hospital with a diagnosis of chronic back pain. The nurse plans care, knowing that physiological responses to chronic pain include which finding? 
    1. Dry skin 
    2. Perspiration 
    3. Dilated pupils 
    4. Increased pulse rate
    1. Dry skin
  5. The nurse is caring for a client who had a cholecystectomy 1 day ago. The nurse plans pain-management techniques, knowing that the severity of the client's pain can be related to which factor? 
    1. Positioning of the client during surgery 
    2. How long the client had pain before surgery 
    3. The type of general anesthesia used during surgery 
    4. The use of nonsteroidal anti-inflammatory drugs (NSAIDs) before surgery
    1. Positioning of the client during surgery
  6. The nurse is assessing the status of pain in a cognitively impaired older adult. The nurse understands which information about pain in the older adult? 
    1. Clients in this age group are less sensitive to pain and have a greater pain tolerance. 
    2. The prevalence of pain in this age group is about the same as among clients younger than 60 years of age. 
    3. Mental images of pain are a more effective means to assess pain in this group than visual representations. 
    4. Pain in the cognitively impaired older adult may require more frequent assessments than in clients who are not impaired.
    4. Pain in the cognitively impaired older adult may require more frequent assessments than in clients who are not impaired.
  7. Parenteral meperidine hydrochloride (Demerol) is prescribed postoperatively for an older adult who has just had a right hip repair. The nurse questions the prescription before administering the medication because of which factor? 
    1. It is just as effective as parenteral morphine sulfate. 
    2. It may accumulate with repeated dosing, leading to seizures. 
    3. It is recommended for use because of the medication's short half-life. 
    4. It is excreted more rapidly in older adults, thus necessitating more frequent dosing.
    2. It may accumulate with repeated dosing, leading to seizures.
  8. The nurse is caring for a postoperative client who had a small bowel repair 1 day earlier. Because the client is a known opioid substance abuser, the nurse plans care, knowing which piece of information? 
    1. Opioid substance abusers are less tolerant to opioids and require decreased doses. 
    2. These clients should be allowed to choose their pain medications and dosing regimen. 
    3. Nonopioid therapies such as cutaneous stimulation are generally effective if used alone. 
    4. These clients are at an increased risk for abrupt physiological withdrawal when opioid agonists are abruptly withdrawn.
    4. These clients are at an increased risk for abrupt physiological withdrawal when opioid agonists are abruptly withdrawn.
  9. A patient-controlled analgesia (PCA) system is prescribed for a postoperative client to control pain. The nurse understands that this method of pain relief alleviates pain and increases client satisfaction because of which factor? 
    1. Overdosing is totally eliminated because the PCA machine has a lockout system. 
    2. The need for naloxone to reverse the effects of the opioid analgesic is eliminated. 
    3. Compared with intermittent dosing, pain is relieved more effectively by increasing the amount of opioid consumption per day. 
    4. Clients are empowered to initiate administration of the medication, thereby eliminating the delay in waiting for the nurse to administer the medication.
    4. Clients are empowered to initiate administration of the medication, thereby eliminating the delay in waiting for the nurse to administer the medication.
  10. The nurse plans care for an older client admitted with a fractured hip. Which analgesic, prescribed by the health care provider at standard doses and frequencies, would the nurse question? 
    1. Ibuprofen (Motrin IB) by oral route 
    2. Morphine sulfate by intravenous (IV) route 
    3. Tramadol hydrochloride (Ultram) by oral route 
    4. Meperidine hydrochloride (Demerol) by intramuscular route
    4. Meperidine hydrochloride (Demerol) by intramuscular route
  11. A client who had abdominal surgery is receiving epidural analgesia. The nurse monitors the client closely, knowing that which is a potential complication of this therapy? 
    1. Constipation because of the location of the epidural catheter 
    2. Dislodgement of the epidural catheter because the catheter is not sutured in place 
    3. Permanent lower motor weakness because of the proximity of the catheter to the sciatic nerve 
    4. Chronic addiction to the epidural medication because epidural analgesia is a more powerful means of pain relief than patient-controlled analgesia therapy
    2. Dislodgement of the epidural catheter because the catheter is not sutured in place
  12. A nurse works in a long-term care facility, caring for older clients. The nurse should make which interpretation when an older client complains of pain? 
    1. Pain is a natural and expected outcome of aging. 
    2. Something is wrong and an assessment should be made. 
    3. Nonpharmacological relief measures are not effective in older clients. 
    4. It is best to treat the symptom of pain immediately rather than focus on identifying the cause.
    2. Something is wrong and an assessment should be made.
  13. The health care provider (HCP) writes a prescription for acetylsalicylic acid (ASA), or aspirin, for a client who was admitted to the hospital with joint pain from rheumatoid arthritis. The nurse contacts the HCP to verify the prescription if which finding is noted in the assessment data? 
    1. Renal colic 
    2. Hypertension 
    3. Diabetes mellitus 
    4. Gastric ulceration
    4. Gastric ulceration
  14. To prevent postoperative atelectasis in a client recovering from an open cholecystectomy, what should the nurse do first? 
    1. Request a cardiopulmonary consult. 
    2. Teach the client to splint the incision. 
    3. Teach the proper technique for huff coughing. 
    4. Ensure that the client is experiencing adequate pain control.
    4. Ensure that the client is experiencing adequate pain control.
  15. A client with a fractured femur who has had an open reduction–internal fixation is receiving ketorolac. Which assessment measurement will assist the nurse in determining the effectiveness of this medication? 
    1. Pain rating 
    2. Temperature 
    3. Serum calcium level 
    4. White blood cell count
    1. Pain rating
  16. The nurse is caring for a client with a back injury sustained 1 year ago. To obtain the most complete assessment data about the client's chronic pain pattern, what should the nurse ask the client? 
    1. "Can you describe what makes your pain worse?" 
    2. "What is the intensity of your pain on a scale of 0 to 10?" 
    3. "Can you describe your daily activities in relation to your pain?" 
    4. "Would you describe your pain as aching, throbbing, or stabbing?"
    3. "Can you describe your daily activities in relation to your pain?"
  17. A child is seen in the school nurse's office with complaints of pain in his right forearm. In reviewing the child's record the nurse notes that he has a history of being physically abused by the mother. Which would be the initial intervention with this child? 
    1. Assess the child's physical status. 
    2. Ask the child how the injury occurred. 
    3. Report the case as suspected child abuse. 
    4. Observe the interactions between the child and his friends.
    1. Assess the child's physical status.
  18. A client is being started on tramadol (Ultram) therapy for pain management after a back injury. When educating this client on tramadol therapy, what is the priority? 
    1. The client cannot drink alcohol while taking tramadol. 
    2. The client cannot smoke cigarettes while taking tramadol. 
    3. The client should increase the intake of calcium-rich foods. 
    4. The client should avoid additional over-the-counter cough syrups.
    1. The client cannot drink alcohol while taking tramadol.
  19. The nurse is assessing a client's postoperative pain using the PQRSTU method. Using this method, which questions would the nurse ask the client?
    1. "Where is the pain located?" 
    2. "Does pain medication help?" 
    3. "What does the pain feel like?" 
    4. "How does the pain affect you?" 
    5. "Do you have the pain when you sleep?" 
    6. "What makes your pain better or worse?"
    • 1. "Where is the pain located?"
    • 3. "What does the pain feel like?"
    • 4. "How does the pain affect you?"
    • 6. "What makes your pain better or worse?"
  20. A nurse is making initial rounds on the nursing unit to check the condition of assigned clients. The client complains of discomfort at the intravenous (IV) and the nurse notes that the site is cool, pale, and swollen, and the solution is not infusing. What IV therapy complication has the client most likely experienced? 
    1. Phlebitis 
    2. Infection 
    3. Infiltration 
    4. Thrombosis
    3. Infiltration

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