NCLEX Questions on Pain: Nursing Care of Patients in Pain Chapter 10

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Questions and Answers

What is the preferred method of administering pain medication for Arab Americans?

Intramuscular or IV

How do Vietnamese people tend to view the numerical scale of rating pain?

They may not understand it

What is the cultural significance of bearing pain for many Asian Americans?

A virtue and a matter of family honor

How do Filipinos tend to view pain?

As an invasion of privacy Signup and view all the answers

What is the concern of some older African Americans regarding pain medication?

It may be addictive Signup and view all the answers

How do Koreans tend to express pain?

Through diverse body symptoms Signup and view all the answers

What is a characteristic of acute pain?

It is typically associated with short-term, objective, physical signs Signup and view all the answers

Why is it important for the nurse to be cautious when assessing patients with acute pain?

Because the patient's vital signs may return to normal as the body adapts Signup and view all the answers

What is the primary difference between acute and chronic pain?

The duration of time the pain persists Signup and view all the answers

What is a characteristic of patients with chronic pain?

They may not appear to be in pain due to the body's adaptation Signup and view all the answers

What is the term for medications that relieve pain?

Analgesics Signup and view all the answers

What may occur if acute pain persists?

It becomes chronic pain Signup and view all the answers

What is the primary concern when administering naloxone to a patient receiving opioids for pain control?

Reversing the analgesic effect Signup and view all the answers

What is the purpose of administering naloxone in an emergency department?

To counteract the effects of opioid overdose Signup and view all the answers

What is a characteristic of some opioid antagonists?

They are always shorter acting than the opioid Signup and view all the answers

What is the purpose of continuing the maintenance dose of opioids even when additional pain medications are required?

To avoid withdrawal symptoms Signup and view all the answers

What is the mechanism of action of combined agonists and antagonists or partial agonists?

They bind to some opioid receptors and block others Signup and view all the answers

What is the potential consequence of administering butorphanol to a patient receiving sustained-release morphine?

Reversed analgesic effect Signup and view all the answers

What is the primary objective of establishing a pain control goal during the planning phase?

To determine an acceptable level of pain for the patient Signup and view all the answers

Why is it important to establish pain goals for patients with cognitive deficits?

To include behavioral indicators in the goal-setting process Signup and view all the answers

What is a potential consequence of setting a pain goal that is too low?

Patients may be unable to achieve their activity goals Signup and view all the answers

Why is education important when helping patients and caregivers set realistic pain control goals?

To help patients and caregivers understand the complexities of pain management Signup and view all the answers

What is a potential goal for a patient with chronic pain after surgery?

To ambulate and achieve restful sleep Signup and view all the answers

What is the name of the assessment tool developed by clinicians and researchers at the New England Geriatric Research Education and Clinical Center?

PAINAD Signup and view all the answers

What is the primary benefit of giving pain medication on a routine schedule around the clock?

To avoid breakthrough pain Signup and view all the answers

What is the main reason Mrs. Shepard's epidural infusion should be continued for a time after it is discontinued?

To allow the oral medication to take effect Signup and view all the answers

Why is it important to consider the maximum safe dose of hydrocodone/acetaminophen for Mrs. Shepard?

Because older adult patients metabolize and excrete medications more slowly Signup and view all the answers

What is the purpose of instructing Mrs. Shepard about her role in her pain management regimen?

To allow her to request pain medication as needed Signup and view all the answers

Why is effective pain management important in preventing postoperative complications?

It prevents retained pulmonary secretions and ileus Signup and view all the answers

What is the consideration for older adult patients when giving hydrocodone/acetaminophen for more than a few days?

They should be given the opioid and acetaminophen separately Signup and view all the answers

What is the primary benefit of effective pain management in healthcare?

To reduce costs by minimizing the side effects of opioids and reducing the length of hospital stay Signup and view all the answers

Which of the following is NOT a consideration in cultural pain management?

Using a universal pain assessment tool for all patients Signup and view all the answers

What is the primary objective of regulatory bodies in pain management?

To review and incorporate organizational pain management practices into accreditation and review processes Signup and view all the answers

What is the role of the healthcare team in pain management?

To be responsible for the entire pain management process Signup and view all the answers

What is the importance of patient education in pain management?

To help patients and caregivers set realistic pain control goals Signup and view all the answers

What is the primary benefit of assessing pain in patients?

To determine the degree of pain and provide effective management Signup and view all the answers

What is the primary focus of accepting a patient's report of pain?

To establish trust between the patient and the healthcare provider Signup and view all the answers

Why may patients try to hide their pain from healthcare providers?

They fear being thought of as complainers or drug seekers Signup and view all the answers

What is a key aspect of obtaining a pain history from a patient?

Letting the patient describe their pain in their own words Signup and view all the answers

What is an important consideration when assessing the effects of pain on a patient's quality of life?

The patient's emotional and spiritual distress Signup and view all the answers

What is a potential consequence of a healthcare provider distrusts a patient's report of pain?

The patient underreports or overreports their pain Signup and view all the answers

What is the purpose of using the WHAT'S UP? format in pain assessment?

To facilitate a complete and effective assessment of pain Signup and view all the answers

What is the primary difference between Joanne's pain and the author's pain?

The type of pain, acute versus chronic Signup and view all the answers

What is the significance of Joanne's comment about the author's appearance?

It emphasizes the difference between acute and chronic pain Signup and view all the answers

What is the author's advice to nurses regarding patients with pain?

To believe patients when they say they are in pain, even if they don't look like it Signup and view all the answers

What is the outcome of Joanne's surgery for her herniated disc?

Evident relief from nerve pain in the recovery room Signup and view all the answers

What is the significance of the author's comparison of their pain to Joanne's pain?

It emphasizes the difference between acute and chronic pain Signup and view all the answers

What is the author's attitude towards their chronic pain?

The author is worn down by their chronic pain Signup and view all the answers

What is the significance of keeping a pain diary for patients?

To document pain ratings, interventions, and responses for effective intervention Signup and view all the answers

What is the primary source of pain assessment for patients with cognitive impairments?

The patient's self-report Signup and view all the answers

Why do older adults frequently have unmet pain needs?

They are hesitant to take strong medications for pain Signup and view all the answers

What is the importance of a thorough physical assessment in pain management?

To determine the effect of the pain and pain treatments on the body Signup and view all the answers

What should be reported promptly to the RN or HCP?

Any unexpected increase in the patient's level of sedation Signup and view all the answers

What is the significance of identifying all pain sites in patients?

To help patients achieve acceptable pain relief and good quality of life Signup and view all the answers

What is the reason for decreasing opioid analgesic doses by 25% to 50% in older patients?

Because they work longer and stronger in older patients Signup and view all the answers

What is the primary purpose of the PAINAD Scale?

To assess the level of pain in patients with dementia Signup and view all the answers

What is the range of total scores in the PAINAD Scale?

0 to 10 Signup and view all the answers

What is indicated by a score of 0 in the PAINAD Scale?

No pain Signup and view all the answers

What is the purpose of the FACES-R Pain Scale?

To measure the self-reported pain intensity Signup and view all the answers

What is the significance of the breathing component in the PAINAD Scale?

It assesses the patient's pain behavior Signup and view all the answers

What is the minimum amount of uninterrupted sleep required for patients to break the cycle of sleeplessness and pain?

6 to 7 hours Signup and view all the answers

What is the purpose of adding a sedative or sleep aid to a patient's medication?

To allow the patient to sleep and break the cycle of pain and sleeplessness Signup and view all the answers

What is the benefit of using controlled-release opioids in pain management?

They help maintain pain relief throughout the night Signup and view all the answers

What is the role of the interdisciplinary pain management team?

To create a comprehensive plan for pain management Signup and view all the answers

What is the importance of communication among team members in pain management?

It is the essential link that allows the team to be effective in creating a comprehensive plan Signup and view all the answers

What can increase productive sleep in patients with chronic pain?

Using aromatherapy such as lavender and ensuring patient comfort Signup and view all the answers

What is the benefit of helping patients with chronic pain get at least 6 to 7 hours of uninterrupted sleep?

It helps break the cycle of sleeplessness and pain Signup and view all the answers

Why may patients with chronic pain need to wake up during the night to take pain medication?

Because they may not get enough pain relief throughout the night Signup and view all the answers

What is the underlying assumption of Margo McCaffery's definition of pain?

Pain is a subjective experience that can only be defined by the individual experiencing it Signup and view all the answers

What is the primary purpose of pain as a protective mechanism?

To prevent further injury or tissue damage Signup and view all the answers

What is the significance of the International Association for the Study of Pain's (IASP) definition of pain?

It highlights the importance of emotional components of pain Signup and view all the answers

What is the implication of accepting a patient's report of pain?

The nurse is acknowledging the patient's autonomy and experience Signup and view all the answers

What is the relationship between pain and suffering?

Pain is a cause of suffering Signup and view all the answers

What is the significance of the concept of nonmaleficence in pain management?

It promotes the idea of doing no harm to the patient Signup and view all the answers

What is the implication of the phrase 'Pain is whatever the experiencing person says it is'?

Pain is a subjective experience that can only be defined by the individual experiencing it Signup and view all the answers

What is the primary goal of pain management in healthcare?

To alleviate suffering and improve the patient's quality of life Signup and view all the answers

Which aspect of pain management is crucial to reduce costs?

Minimizing the length of hospital stay Signup and view all the answers

What is the responsibility of the entire health team in terms of pain management?

Managing pain in a cost-effective manner Signup and view all the answers

Why is cultural consideration important in pain management?

Because people within cultural groups vary in their pain experiences Signup and view all the answers

What is the purpose of regulatory bodies reviewing organizational pain management practices?

To support the importance of appropriate and effective management of pain Signup and view all the answers

How can pain management help to reduce complications related to inadequate pain control?

By minimizing the side effects of opioids Signup and view all the answers

What is the focus of patient and family teaching in pain management?

Assessment and safe pharmacological management of pain, as well as patient and family teaching Signup and view all the answers

Why is effective pain management important in healthcare?

It helps to reduce costs and improve patient outcomes Signup and view all the answers

What is the primary goal of the healthcare team in pain management?

To provide the best quality of care while minimizing costs Signup and view all the answers

What is the primary benefit of giving Mrs. Shepard pain medication on a routine schedule around the clock?

To prevent breakthrough pain Signup and view all the answers

Why is it important to consider Mrs. Shepard's history when managing her pain?

To determine the appropriate dosage of pain medication Signup and view all the answers

What is the primary reason for continuing Mrs. Shepard's epidural infusion for a time after it is discontinued?

To ensure the patient's comfort during the transition to oral medication Signup and view all the answers

Why is it important to instruct Mrs. Shepard about her role in her pain management regimen?

To empower her to take an active role in her pain management Signup and view all the answers

What is the maximum safe dose of hydrocodone/acetaminophen that Mrs. Shepard can receive in 24 hours?

4 g Signup and view all the answers

Why is it important to consider the effects of immobility on Mrs. Shepard's postoperative recovery?

To prevent retained pulmonary secretions and ileus Signup and view all the answers

What is the potential consequence of not considering Mrs. Shepard's age when giving her hydrocodone/acetaminophen?

Accumulation of the medication due to slower metabolism Signup and view all the answers

What is the benefit of giving Mrs. Shepard oral medication at the time the epidural is stopped?

To ensure a smooth transition to oral medication Signup and view all the answers

What is the primary purpose of providing information about what to do and whom to contact if pain becomes unmanageable?

To prevent readmissions to the hospital Signup and view all the answers

According to McCaffery's definition of pain, what assumption is most likely correct about a patient who reports a pain level of 6 on a scale of 0 to 10?

The patient is having pain at a level of 6 on a scale of 0 to 10. Signup and view all the answers

What is the most likely explanation for a patient with terminal cancer who appears to be in no pain while watching a movie on television?

Distraction can be an effective treatment for pain when used with appropriate drug treatments. Signup and view all the answers

What action should the nurse take when a patient develops tolerance to opioid analgesics?

Switch to a different opioid analgesic Signup and view all the answers

What is the primary benefit of using a combination of pharmacological and non-pharmacological interventions in pain management?

Improving the effectiveness of pain management Signup and view all the answers

What is the primary goal of pain assessment in patients with cognitive impairments?

To develop a individualized pain management plan Signup and view all the answers

What is the primary benefit of using the PAINAD Scale in pain assessment?

It can be used in patients with cognitive impairments Signup and view all the answers

What is the primary concern when administering opioids to patients with a history of substance abuse?

The risk of addiction Signup and view all the answers

What is the primary purpose of obtaining a patient's pain history?

To individualize pain interventions to fit the patient's needs Signup and view all the answers

Why is it important to use a consistent pain rating scale for a particular patient?

To ensure all healthcare personnel are using the same scale Signup and view all the answers

What is the primary advantage of using the FACES-R scale in pain assessment?

It was initially developed for use in children and has been revised for adults Signup and view all the answers

What is the primary benefit of using the PAINAD scale in pain assessment?

It is more effective for patients with cognitive impairments Signup and view all the answers

What is a key consideration when selecting a pain assessment tool?

The tool's validity and reliability in research Signup and view all the answers

Why is it important to involve family members in pain assessment for non-verbal or cognitively impaired patients?

To ensure accurate pain assessment Signup and view all the answers

What is the primary consequence of not using a consistent pain rating scale for a particular patient?

Inconsistent pain management Signup and view all the answers

What is the primary goal of pain assessment in healthcare?

To individualize pain interventions to fit the patient's needs Signup and view all the answers

What is the primary advantage of using intraspinal opioids for pain relief?

To reduce the risk of systemic side effects Signup and view all the answers

What is the primary goal of cognitive-behavioral interventions in pain management?

To alter physiological responses to pain Signup and view all the answers

What is the significance of educating patients about their pain and its management?

To decrease patients' reports of postoperative pain Signup and view all the answers

What is the primary consideration while establishing a pain control goal during the planning phase?

Identifying activity goals Signup and view all the answers

Why is it important to educate patients and caregivers about pain control goals?

To enable them to set realistic pain control goals Signup and view all the answers

What is the primary benefit of using non-pharmacological therapies in pain management?

To enhance the effectiveness of pharmacological therapies Signup and view all the answers

What is the primary role of physical agents in pain management?

To correct physical dysfunction Signup and view all the answers

What is the significance of identifying behavioral indicators in patients with cognitive deficits?

To establish pain control goals that include behavioral indicators Signup and view all the answers

What is the primary characteristic of cognitive-behavioral interventions?

They require detailed instruction and demonstration Signup and view all the answers

What is the primary benefit of involving patients and caregivers in setting pain control goals?

To enable patients to achieve their activity goals Signup and view all the answers

What is the implication of setting a pain control goal that is too high?

The patient may not be able to achieve their activity goals Signup and view all the answers

What is the primary benefit of using intraspinal opioids for orthopedic surgical procedures?

To reduce the risk of systemic side effects Signup and view all the answers

What is the primary goal of relaxation techniques in pain management?

To promote relaxation and reduce anxiety Signup and view all the answers

Why is it important to consider the patient's activity goals during the planning phase?

To enable patients to achieve their activity goals Signup and view all the answers

What is the primary benefit of establishing pain control goals that are realistic and achievable?

To enable patients to achieve their activity goals Signup and view all the answers

What is the implication of setting a pain control goal that is too low?

The patient may experience inadequate pain control Signup and view all the answers

What is the primary reason for ensuring patients with chronic pain get at least 6 to 7 hours of uninterrupted sleep?

To break the cycle of sleeplessness and pain Signup and view all the answers

What is the benefit of using controlled-release opioids in patients with chronic pain?

They help maintain pain relief throughout the night Signup and view all the answers

What is the role of the interdisciplinary pain management team in patient care?

To create a comprehensive plan for pain management Signup and view all the answers

Why may the addition of a sedative or sleep aid be necessary in patients with chronic pain?

To help the patient sleep and break the cycle of sleeplessness and pain Signup and view all the answers

What is the importance of aromatherapy in pain management?

It helps to reduce anxiety and promote relaxation Signup and view all the answers

What is the primary goal of the healthcare team in managing pain in patients with chronic pain?

To reduce the patient's pain to a manageable level Signup and view all the answers

What is the significance of limiting caffeine intake after 1500 in patients with chronic pain?

It helps to establish a normal sleep pattern Signup and view all the answers

What is the role of the patient and family in the interdisciplinary pain management team?

To participate in the development of a comprehensive plan for pain management Signup and view all the answers

What is the primary goal of evaluation in the nursing process for patients in pain?

To determine the efficacy of the implemented plan of care Signup and view all the answers

How many milliliters of morphine should the nurse administer to Mr. Sebastian while he is in the hospital?

1.67 mL Signup and view all the answers

What may influence a patient's perception or report of pain?

Emotional or spiritual distress Signup and view all the answers

What is essential to consider when planning for Mr. Sebastian's discharge and home health care?

The patient's ability to manage pain at home Signup and view all the answers

Why may some patients underreport their pain?

Fear of being a burden to family caregivers Signup and view all the answers

What is the significance of continuously updating the plan of care based on evaluation?

To ensure the patient's goals are met Signup and view all the answers

What is the nurse's role in managing Mr. Sebastian's pain at home?

To educate Mr. Sebastian and his wife about pain management Signup and view all the answers

What may occur if a patient's pain is not managed effectively at home?

Readmission to the hospital Signup and view all the answers

Study Notes

• Arab American patients tend to view pain as something to be controlled, and may not openly express pain to caregivers, but may use elaborate verbal expressions to describe their pain to family members.

• Asian American patients, such as Chinese and Koreans, tend to be stoical and describe pain in terms of diverse body symptoms instead of locally, and may prefer warm compresses.

• Filipino patients may view pain as an invasion of privacy, and may not understand the concept of rating pain on a numerical scale.

• Vietnamese patients may not understand the numerical scale of rating pain, and observing facial expressions may provide an indicator of pain.

• African American patients may openly and publicly display pain, but this is highly variable, and many fear that medication may be addictive.

• Naloxone (Narcan) is a pure opioid antagonist that counteracts the effects of opioids and is often used in emergency departments to treat opioid overdose.

• Caution must be used when giving naloxone to a patient who is receiving opioids for pain control, as it can reverse not only the unwanted effects but also the desired effect of analgesia.

• Some analgesics are classified as combined agonists and antagonists or partial agonists, which bind with some opioid receptors and block others.

• The PAINAD (Pain Assessment in Advanced Dementia) scale was developed to assess pain in patients with dementia and is based on five items: breathing, vocalization, facial expression, body language, and consolability.

• The FACES-R Pain Scale is another tool used to assess pain in patients and is based on six faces that range from a neutral expression to a distressed expression.

• Acute pain is immediate and follows injury to the body, prompts an inflammatory response, and subsides as healing takes place.

• Chronic pain typically lasts three months or longer, persisting beyond the time when healing usually takes place.

• Patients with chronic pain may have both nociceptive and neuropathic components that require a combination of medications and nonpharmacological treatments.

• Effective pain management can help prevent postoperative complications such as retained pulmonary secretions and ileus.

• Older adult patients metabolize and excrete medications more slowly than younger patients, and may require adjusted dosages of pain medication.

• Opioid analgesic doses may need to be decreased by 25% to 50% initially in older patients because they tend to work longer and stronger in this population.

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MS CH 10 Nursing Care of Patients in Pain

Questions and Answers

What is the preferred method of administering pain medication for Arab Americans?

How do Vietnamese people tend to view the numerical scale of rating pain?

What is the cultural significance of bearing pain for many Asian Americans?

How do Filipinos tend to view pain?

What is the concern of some older African Americans regarding pain medication?

How do Koreans tend to express pain?

What is a characteristic of acute pain?

Why is it important for the nurse to be cautious when assessing patients with acute pain?

What is the primary difference between acute and chronic pain?

What is a characteristic of patients with chronic pain?

What is the term for medications that relieve pain?

What may occur if acute pain persists?

What is the primary concern when administering naloxone to a patient receiving opioids for pain control?

What is the purpose of administering naloxone in an emergency department?

What is a characteristic of some opioid antagonists?

What is the purpose of continuing the maintenance dose of opioids even when additional pain medications are required?

What is the mechanism of action of combined agonists and antagonists or partial agonists?

What is the potential consequence of administering butorphanol to a patient receiving sustained-release morphine?

What is the primary objective of establishing a pain control goal during the planning phase?

Why is it important to establish pain goals for patients with cognitive deficits?

What is a potential consequence of setting a pain goal that is too low?

Why is education important when helping patients and caregivers set realistic pain control goals?

What is a potential goal for a patient with chronic pain after surgery?

What is the name of the assessment tool developed by clinicians and researchers at the New England Geriatric Research Education and Clinical Center?

What is the primary benefit of giving pain medication on a routine schedule around the clock?

What is the main reason Mrs. Shepard's epidural infusion should be continued for a time after it is discontinued?

Why is it important to consider the maximum safe dose of hydrocodone/acetaminophen for Mrs. Shepard?

What is the purpose of instructing Mrs. Shepard about her role in her pain management regimen?

Why is effective pain management important in preventing postoperative complications?

What is the consideration for older adult patients when giving hydrocodone/acetaminophen for more than a few days?

What is the primary benefit of effective pain management in healthcare?

Which of the following is NOT a consideration in cultural pain management?

What is the primary objective of regulatory bodies in pain management?

What is the role of the healthcare team in pain management?

What is the importance of patient education in pain management?

What is the primary benefit of assessing pain in patients?

What is the primary focus of accepting a patient's report of pain?

Why may patients try to hide their pain from healthcare providers?

What is a key aspect of obtaining a pain history from a patient?

What is an important consideration when assessing the effects of pain on a patient's quality of life?

What is a potential consequence of a healthcare provider distrusts a patient's report of pain?

What is the purpose of using the WHAT'S UP? format in pain assessment?

What is the primary difference between Joanne's pain and the author's pain?

What is the significance of Joanne's comment about the author's appearance?

What is the author's advice to nurses regarding patients with pain?

What is the outcome of Joanne's surgery for her herniated disc?

What is the significance of the author's comparison of their pain to Joanne's pain?

What is the author's attitude towards their chronic pain?

What is the significance of keeping a pain diary for patients?

What is the primary source of pain assessment for patients with cognitive impairments?

Why do older adults frequently have unmet pain needs?

What is the importance of a thorough physical assessment in pain management?

What should be reported promptly to the RN or HCP?

What is the significance of identifying all pain sites in patients?

What is the reason for decreasing opioid analgesic doses by 25% to 50% in older patients?

What is the primary purpose of the PAINAD Scale?

What is the range of total scores in the PAINAD Scale?

What is indicated by a score of 0 in the PAINAD Scale?

What is the purpose of the FACES-R Pain Scale?

What is the significance of the breathing component in the PAINAD Scale?

What is the minimum amount of uninterrupted sleep required for patients to break the cycle of sleeplessness and pain?

What is the purpose of adding a sedative or sleep aid to a patient's medication?

What is the benefit of using controlled-release opioids in pain management?

What is the role of the interdisciplinary pain management team?

What is the importance of communication among team members in pain management?

What can increase productive sleep in patients with chronic pain?

What is the benefit of helping patients with chronic pain get at least 6 to 7 hours of uninterrupted sleep?

Why may patients with chronic pain need to wake up during the night to take pain medication?

What is the underlying assumption of Margo McCaffery's definition of pain?

What is the primary purpose of pain as a protective mechanism?

What is the significance of the International Association for the Study of Pain's (IASP) definition of pain?

What is the implication of accepting a patient's report of pain?

What is the relationship between pain and suffering?

What is the significance of the concept of nonmaleficence in pain management?

What is the implication of the phrase 'Pain is whatever the experiencing person says it is'?

What is the primary goal of pain management in healthcare?

Which aspect of pain management is crucial to reduce costs?

What is the responsibility of the entire health team in terms of pain management?