Understanding Medical Surgical Nursing 5th Edition by Linda S. Williams Paula D. Hopper
Understanding Medical Surgical Nursing 5th Edition by Linda S. Williams Paula D. Hopper
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Chapter 10. Nursing Care of Patients in Pain
Complete Chapter Questions With Answers
Sample Questions Are Posted Below
Multiple Choice
Identify the choice that best completes the statement or answers the question.
____ 1. The nurse is preparing to assess a patient’s pain level. Which definition of pain should the nurse use to guide practice?
| a. | Pain is whatever the experiencing person says it is. |
| b. | Pain is an unpleasant sensation caused by physical injury. |
| c. | Pain is a sensation that causes the patient to avoid its source. |
| d. | Pain is discomfort manifested by elevated vital signs and grimacing. |
____ 2. The nurse answers a patient’s call for pain medication, only to find the patient laughing and joking with visitors. Which response by the nurse is appropriate?
| a. | “You don’t need this pain medication after all, do you?” |
| b. | “I’ll bring your medication back later after your visitors are gone.” |
| c. | “I can see your pain is better. Call again when you need your medication.” |
| d. | “Would you like your visitors to step out while I give you your pain medication?” |
____ 3. A nursing assistant, observing the licensed practical nurse (LPN) prepare medication for a patient asks why so much morphine is being provided since patients have quit breathing after receiving such a high dose. The patient has been receiving the same dose of medication for several days without respiratory compromise. Which response by the LPN is best?
| a. | “I am a licensed professional and am able to decide what a safe dose is for my patient.” |
| b. | “You are correct; several days of this high a dose could be cumulative and cause problems.” |
| c. | “As long as I monitor the patient closely after giving the dose, breathing will not be affected.” |
| d. | “As long as the dose is increased gradually, patients develop tolerance to the side effects of morphine.” |
____ 4. A patient has been on opioids for 3 months to control pain caused by injuries from a motor vehicle crash. The patient asks about the risk of withdrawal symptoms when the drugs are no longer needed. How should the nurse respond to the patient?
| a. | “Ask your doctor for a sedative to get you through the worst of the withdrawal symptoms.” |
| b. | “As long as you taper the drug dose down slowly, you should not experience withdrawal symptoms.” |
| c. | “You would have to be on these drugs much longer than 3 months to have problems with withdrawal.” |
| d. | “You were using the drugs for legitimate pain, so you will not have to go through withdrawal when you stop them.” |
____ 5. A patient has abdominal pain after gallbladder surgery. For which type of pain should the nurse provide care?
| a. | Chronic |
| b. | Nociceptive |
| c. | Neuropathic |
| d. | Non-physiological |
MULTIPLE CHOICE
All the definitions can be true, but however pain is whatever the experiencing person says it is because pain is subjective, and nurses must trust the patient’s report of pain as true in order to treat it appropriately.
PTS: 1 DIF: Moderate
KEY: Client Need: Physiological Integrity—Basic Care and Comfort | Cognitive Level: Analysis
Distraction (by the patient’s visitors) is an effective adjuvant treatment but does not replace analgesics for pain. The nurse should administer the analgesic. A. B. C. These actions withhold the pain medication and the patient may be in increased pain after the visitors leave, which will be more difficult to control.
PTS: 1 DIF: Moderate
KEY: Client Need: Physiological Integrity—Basic Care and Comfort | Cognitive Level: Application
Morphine is an opioid agonist. Opioid doses can be escalated (titrated upward) indefinitely as needed as the patient’s pain increases. B. As long as it is titrated slowly, tolerance to respiratory depression will develop. C. Monitoring may identify respiratory depression, but it will not prevent it. A. This statement blocks communication and does not take advantage of a teaching opportunity.
PTS: 1 DIF: Moderate
KEY: Client Need: Physiological Integrity—Pharmacological and Parenteral Therapies | Cognitive Level: Application
After 3 months of use, some withdrawal symptoms are likely; these can be minimized or eliminated by slowly tapering the dose. A. Sedatives are not usually necessary and may be addictive. C. The nurse has no way of knowing the patient’s potential response to withdrawing from the medication. D. The reason for the medication is not important.
PTS: 1 DIF: Moderate
KEY: Client Need: Physiological Integrity—Basic Care and Comfort | Cognitive Level: Application
Nociception refers to the body’s normal or physiological reaction to noxious stimuli, such as tissue damage (e.g., surgery), with the release of pain-producing substances. C. Neuropathic pain is associated with injury to either the peripheral or central nervous system. A. Surgery is associated with acute, not chronic, pain. D. Surgical pain has a physiological cause.
PTS: 1 DIF: Moderate
KEY: Client Need: Physiological Integrity—Basic Care and Comfort | Cognitive Level: Application
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