Chapter 13: Pain Management

Chapter 13: Pain Management

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

Multiple Choice

 

 

 

 

1. The nurse in a pain clinic is assessing a palliative patient. The patient indicates that he has been saving his analgesics until the pain is intense because the pain control has been poor. What teaching does the nurse knows should be done with this patient?
2. A) Medication should be taken when pain levels are low so the pain is easier to reduce.
3. B) Pain medication can be increased when the pain is intense.
4. C) It is difficult to control chronic pain, so little can be done.
5. D) Instruct the patient to lie still and think of something else during intense pain.

 

Ans:  A

Chapter:  13

Client Needs:  D-2

Cognitive Level:  Application

Difficulty:  Moderate

Integrated Process:  Teaching/Learning

Objective:  6

Page and Header:  249, Pain Management Strategies

 

Feedback:  Better pain control can be achieved with a preventive approach, reducing the amount of time patients are in pain. Low levels of pain are easier to reduce or control than intense levels of pain. Pain medication is used to prevent pain so pain medication is not increased when pain becomes intense. Chronic pain is treatable. Giving the patient alternative methods to control pain is good, but it will not work if the patient is in so much pain that he cannot institute reliable alternative methods.

 

 

 

 

2. Two patients on your unit have returned from right knee arthroscopies. Patient A is reporting pain of an eight to nine on a zero-to-ten pain scale. Patient B is reporting a pain level of three to four on the same pain scale. What may provide a rationale for the different perceptions of pain?
3. A) Endorphin levels may vary between patients, affecting the perception of pain.
4. B) One of the patients is exaggerating her sense of pain.
5. C) The patients are likely experiencing a variance in vasoconstriction.
6. D) One of the patients may be experiencing opiate tolerance.

 

Ans:  A

Chapter:  13

Client Needs:  D-4

Cognitive Level:  Analysis

Difficulty:  Difficult

Integrated Process:  Nursing Process

Objective:  3

Page and Header:  234, Pathophysiology of Pain

 

Feedback:  The existence of enkephalins and endorphins helps explain why different people feel different amounts of pain from similar stimuli. Endorphin levels vary among individuals as do factors that influence endorphin levels, such as anxiety. People with more endorphins feel less pain; those with fewer endorphins feel more pain. Opioid tolerance is associated with chronic pain treatment and would not apply to this patient. The nurse should not assume the patient is exaggerating the pain as the patient is the best authority of her existence of pain, and definitions for pain state that pain is “whatever the person says it is, existing whenever the experiencing person says it does.”

 

 

 

 

3. You are discussing pain relief in the elderly with your senior nursing students. When administering an analgesic to an elderly patient for pain, what interventions would you teach your students should be implemented in the plan of care for the patient?
4. A) Monitor for signs of drug toxicity due to a decrease in metabolism.
5. B) Monitor for an increase in absorption of the drug due to increased metabolism.
6. C) Monitor for an increase in respiratory rates.
7. D) Analgesics should be given every 4 to 6 hours as ordered to control pain.

 

Ans:  A

Chapter:  13

Client Needs:  D-2

Cognitive Level:  Application

Difficulty:  Moderate

Integrated Process:  Nursing Process

Objective:  9

Page and Header:  237, Factors Influencing Pain Response

 

Feedback:  Older people may respond differently to pain than younger people. Because elderly people have a slower metabolism and a greater ratio of body fat to muscle mass compared to younger people, small doses of analgesic agents may be sufficient to relieve pain, and these doses may be effective longer. This makes option B and D incorrect. Pain medication can decrease respiratory rates, not increase them.

 

 

 

 

4. The nurse is assessing a patient’s pain. The patient is tearful, hesitant to move, and grimacing. When asked, the patient rates the pain as a two at this time using a zero-to-ten pain scale. What conclusion would be most accurate?
5. A) The patient has rated the pain as minimal according to the scale.
6. B) The nurse should reinforce teaching about the pain scale number system.
7. C) The nurse should reassess the pain in 30 minutes.
8. D) The medication the patient is receiving is not adequate for pain relief.

 

Ans:  B

Chapter:  13

Client Needs:  D-1

Cognitive Level:  Analysis

Difficulty:  Difficult

Integrated Process:  Nursing Process

Objective:  5

Page and Header:  239, The Nurse’s Role in Assessment and Care of Patients with Pain

 

Feedback:  The patient is physically exhibiting signs and symptoms of pain. Further teaching may need to be done so the patient can correctly rate the pain. The nurse may also verify that the same scale is being used by the patient and caregiver to promote continuity. All answers are correct, however, the most accurate conclusion would be to reinforce teaching about the pain scale. This makes the other options incorrect.

 

 

 

 

5. You are caring for a patient with a diagnosis of cellulitis. Your patient has a secondary diagnosis of chronic pain. You know that patients who experience chronic pain can be expected to
6. A) be less anxious.
7. B) have a lower pain threshold.
8. C) have an increased tolerance of pain.
9. D) ask for pain medication before the next dose is due.

 

Ans:  D

Chapter:  13

Client Needs:  D-1

Cognitive Level:  Comprehension

Difficulty:  Difficult

Integrated Process:  Nursing Process

Objective:  4

Page and Header:  236, Factors Influencing Pain Response

 

Feedback:  It is tempting to expect that people who have had multiple or prolonged experiences with pain will be less anxious and more tolerant of pain than those who have had little experience with pain. However, this is not true for many people. The more experience a person has had with pain, the more frightened he or she is likely to be about subsequent painful events. People with multiple or past experiences with pain are generally more frightened, anxious, and less able to tolerate pain. They may ask for pain relief before the next dose is due because of the fear of intense pain. Therefore, options A, B, and C are incorrect.