Chapter 08: Pain

Chapter 08: Pain

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

MULTIPLE CHOICE

 

1. Which question asked by the nurse will give the most information about the patient’s metastatic bone cancer pain?

a.	“How long have you had this pain?”
b.	“How would you describe your pain?”
c.	“How often do you take pain medication?”
d.	“How much medication do you take for the pain?”

 

 

ANS:  B

Because pain is a multidimensional experience, asking a question that addresses the patient’s experience with the pain will elicit more information than the more specific information asked in the other three responses. All of these questions are appropriate, but the response beginning “How would you describe your pain?” is the best initial question.

 

DIF:    Cognitive Level: Analysis (analyze)                                  REF:   102

TOP:   Nursing Process: Assessment           MSC:  NCLEX: Physiological Integrity

 

2. A patient who has had good control for chronic pain using a fentanyl (Duragesic) patch reports rapid onset pain at a level 9 (0 to 10 scale) and requests “something for pain that will work quickly.” How will the nurse document the type of pain reported by this patient?

a.	Somatic pain	c.	Neuropathic pain
b.	Referred pain	d.	Breakthrough pain

 

 

ANS:  D

Pain that occurs beyond the chronic pain already being treated by appropriate analgesics is termed breakthrough pain. Neuropathic pain is caused by damage to peripheral nerves or the central nervous system. Somatic pain is localized and arises from bone, joint, muscle, skin, or connective tissue. Referred pain is pain that is localized in uninjured tissue.

 

DIF:    Cognitive Level: Apply (application)           REF:               108

TOP:   Nursing Process: Implementation     MSC:  NCLEX: Physiological Integrity

 

3. The nurse teaches a student nurse about the action of ibuprofen. Which statement, if made by the student, indicates that teaching was effective?

a.	“The drug decreases pain impulses in the spinal cord.”
b.	“The drug decreases sensitivity of the brain to painful stimuli.”
c.	“The drug decreases production of pain-sensitizing chemicals.”
d.	“The drug decreases the modulating effect of descending nerves.”

 

 

ANS:  C

Nonsteroidal antiinflammatory drugs (NSAIDs) provide analgesic effects by decreasing the production of pain-sensitizing chemicals such as prostaglandins at the site of injury. Transmission of impulses through the spinal cord, brain sensitivity to pain, and the descending nerve pathways are not affected by NSAIDs.

 

DIF:    Cognitive Level: Understand (comprehension)                   REF:   104

TOP:   Nursing Process: Implementation     MSC:  NCLEX: Physiological Integrity

 

4. A nurse assesses a patient with chronic cancer pain who is receiving imipramine (Tofranil) in addition to long-acting morphine (MS Contin). Which statement, if made by the patient, indicates to the nurse that the patient is receiving adequate pain control?

a.	“I’m not anxious during the day.”
b.	“Every night I get 8 hours of sleep.”
c.	“I can accomplish activities without much discomfort.”
d.	“I feel less depressed since I’ve been taking the Tofranil.”

 

 

ANS:  C

Imipramine is being used in this patient to manage chronic pain and improve functional ability. Although the medication is also prescribed for patients with depression, insomnia, and anxiety, the evaluation for this patient is based on improved pain control and activity level.

 

DIF:    Cognitive Level: Apply (application)           REF:               116

TOP:   Nursing Process: Evaluation            MSC:  NCLEX: Physiological Integrity

 

5. A patient with chronic back pain has learned to control the pain with the use of imagery and hypnosis. The patient’s spouse asks the nurse how these techniques work. Which response by the nurse is accurate?

a.	“The strategies work by affecting the perception of pain.”
b.	“These techniques block the pain pathways of the nerves.”
c.	“These strategies prevent transmission of stimuli from the back to the brain.”
d.	“The therapies slow the release of chemicals in the spinal cord that cause pain.”

 

 

ANS:  A

Cognitive therapies affect the perception of pain by the brain rather than affecting efferent or afferent pathways or influencing the release of chemical transmitters in the dorsal horn.

 

DIF:    Cognitive Level: Apply (application)           REF:               121