Chapter 36 Pain Management Answers PDF

**Chapter 36 Pain Management** **Answers for Review Questions** 1\. When assessing the patient 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\....

**Chapter 36 Pain Management** **Answers for Review Questions** 1\. When assessing the patient 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 a pain assessment. LO: 36.4 Bloom's: Understanding NCLEX Client Needs: Health Promotion and Maintenance: Techniques of Physical Assessment 2\. Which statement best describes the dose of prescribed 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 patient'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. LO: 36.8 Bloom's: Applying NCLEX Client Needs: Physiologic Integrity: Pharmacologic and Parenteral Therapies 3\. Which method is the most accurate way to determine the pain level of a patient who is alert and oriented? a\. Evaluate whether the patient is crying or grimacing. b\. Assess the patient's heart rate and blood pressure. c\. Consider the seriousness of the patient's condition. d\. Ask the patient to describe the pain and rate its level. **Answer:** d Because pain is defined as what a patient says it is, a patient's report based on the pain scale is currently the most accurate way to determine the pain level of a cognitively alert patient. Crying or grimacing may be considered on a noncognitive scale for a nonverbal patient. Vital signs and the patient's condition contribute to a pain assessment, but they may not be the most accurate determinants. LO: 36.5 Bloom's: Analyzing NCLEX Client Needs: Health Promotion and Maintenance: Techniques of Physical Assessment 4\. A patient who has a serious back injury received intravenous medication for pain approximately 1 hour earlier. The patient practices relaxation techniques but still is reporting pain at a level of 9 of 10. What is the next action that should be taken by the nurse? a\. Report the lack of pain relief to the primary care provider. b\. Tell the patient to give the medication more time. c\. Reposition the patient and try diversion activities. d\. Document in the nurse's notes that the patient has a low pain tolerance. **Answer:** a If the patient with a serious injury is not obtaining pain relief from pharmacologic and nonpharmacologic interventions, the primary care provider should be notified. Waiting longer and using more nonpharmacologic interventions are not likely to relieve pain in this situation. LO: 36.8 Bloom's: Applying NCLEX Client Needs: Physiologic Integrity: Pharmacologic and Parenteral Therapies 5\. The nurse recognizes which cue from the patient as a physiologic response to acute pain? a\. Increased blood pressure b\. Decreased pulse c\. Increased temperature d\. Restlessness **Answer:** a Acute pain can increase blood pressure and pulse rate but may not affect temperature. Restlessness is a psychological response, not physiologic. LO: 36.5 Bloom's: Understanding NCLEX Client Needs: Health Promotion and Maintenance: Techniques of Physical Assessment 6\. When administering analgesics to elderly patients, what information does the nurse need to understand? a\. Start with a low dose, and increase the dose as needed for pain relief. b\. Start with a high dose and decrease the dose as pain is relieved. c\. Start with a midrange dose and increase or decrease the dose as needed for pain. d\. Start with a low dose and decrease the dose every other day. **Answer:** a Due to decreased metabolism and clearance of medications, start with a lower dose and increase as indicated for pain relief. A high dose may result in drug toxicity. Too low of a dose will not relieve pain. LO: 36.3 Bloom's: Applying NCLEX Client Needs: Physiologic Integrity: Pharmacologic and Parenteral Therapies 7\. The nurse administered intravenous morphine at 0830. At what time will the nurse evaluate the patient for pain relief? a\. 1000 b\. 1030 c\. 0900 d\. 0930 **Answer:** c After administering intravenous medication, check the patient in 15 to 30 minutes for relief from pain. Intravenous medication is injected directly into the bloodstream and bypasses the gastric system metabolism. LO: 36.8 Bloom's: Analyzing NCLEX Client Needs: Physiologic Integrity: Pharmacologic and Parenteral Therapies 8\. The endocrine system releases excessive hormones during episodes of acute pain. The nurse should monitor patients experiencing acute pain for which potential problem? a\. Hyperglycemia b\. Migraine headache c\. Hypokalemia d\. Diarrhea **Answer:** a Release of hormones causes the blood glucose level to increase, causing hyperglycemia. Hypokalemia may result from the metabolic effects of genitourinary injury. Constipation results from decreased intestinal motility. Migraine headaches are not a result of hormone release during acute pain. LO: 36.3 Bloom's: Applying TOP: Hormone Release NCLEX Client Needs: Physiologic Integrity: Reduction of Risk Potential 9\. The patient who had a below-the-knee amputation 3 days ago complains of pain from the amputated extremity. Which response by the nurse best explains what the patient is experiencing? a\. "Your phantom pain will subside when the brain realizes the lower extremity is no longer there." b\. "Your radiating pain will continue for months because the lower extremity is no longer there." c\. "You are suffering from referred pain, which you will always have, but it will lessen with time." d\. "You are experiencing psychogenic pain because loss of an extremity is an emotional loss." **Answer:** a Phantom pain occurs when the brain continues to receive messages from an area of amputation. Over time, the brain will adapt to the loss of the limb. Radiating pain extends from the source of pain to an adjacent area of the body. Referred pain originates in one area of the body but hurts in another area of the body. Psychogenic pain is pain perceived by the patient but has no physical pain. LO: 36.3 Bloom's: Understanding NCLEX Client Needs: Psychosocial Integrity: Sensory/Perceptual Alterations 10\. A patient who has type 2 diabetes is admitted to the hospital with a fractured left femur. What are the two highest-priority actions for the nurse to implement? a\. Starting an intravenous solution of lactated Ringer solution b\. Administering ordered pain medication after taking vital signs c\. Glucometer testing to monitor the patient's blood glucose level d\. Giving the ordered prophylactic antibiotic to prevent infection e\. Encouraging assisted ambulation to avoid blood clot formation **Answer:** b, c The highest-priority actions are to administer the patient's prescribed pain medication and checking the patient's blood glucose level. Pain control and blood glucose monitoring are very important as stress caused by pain can cause an increase in blood glucose. Starting an ordered IV solution and administering prophylactic antibiotics can follow analgesia administration and glucometer testing. Encouraging assisted ambulation is not indicated at this time. A sequential compression device (SCD) may be ordered for the patient's right, uninjured leg to prevent blood clot formation before the patient has surgery to repair the fractured femur. LO: 36.3 Bloom's: Application NCLEX Client Needs: Management of Care: Comfort Interventions