Chapter 10: Pain Assessment: The Fifth Vital Sign

Chapter 10: Pain Assessment: The Fifth Vital Sign

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

MULTIPLE CHOICE

 

1. When evaluating a patient’s pain, the nurse knows that an example of acute pain would be:

a.	Arthritic pain.
b.	Fibromyalgia.
c.	Kidney stones.
d.	Low back pain.

 

 

ANS:  C

Acute pain is short-term and dissipates after an injury heals, such as with kidney stones. The other conditions are examples of chronic pain during which the pain continues for 6 months or longer and does not stop when the injury heals.

 

DIF:    Cognitive Level: Understanding (Comprehension)             REF:   p. 164

MSC:  Client Needs: Physiologic Integrity: Basic Care and Comfort

 

2. Which statement indicates that the nurse understands the pain experienced by an older adult?

a.	“Older adults must learn to tolerate pain.”
b.	“Pain is a normal process of aging and is to be expected.”
c.	“Pain indicates a pathologic condition or an injury and is not a normal process of aging.”
d.	“Older individuals perceive pain to a lesser degree than do younger individuals.”

 

 

ANS:  C

Pain indicates a pathologic condition or an injury and should never be considered something that an older adult should expect or tolerate. Pain is not a normal process of aging, and no evidence suggests that pain perception is reduced with aging.

 

DIF:    Cognitive Level: Applying (Application)                           REF:   p. 165

MSC:  Client Needs: Physiologic Integrity: Basic Care and Comfort

 

3. A 4-year-old boy is brought to the emergency department by his mother. She says he points to his stomach and says, “It hurts so bad.” Which pain assessment tool would be the best choice when assessing this child’s pain?

a.	Descriptor Scale
b.	Numeric rating scale
c.	Brief Pain Inventory
d.	Faces Pain Scale—Revised (FPS-R)

 

 

ANS:  D

Rating scales can be introduced at the age of 4 or 5 years. The FPS-R is designed for use by children and asks the child to choose a face that shows “how much hurt (or pain) you have now.” Young children should not be asked to rate pain by using numbers.

 

DIF:    Cognitive Level: Applying (Application)                           REF:   p. 170

MSC:  Client Needs: Physiologic Integrity: Basic Care and Comfort

 

4. A patient states that the pain medication is “not working” and rates his postoperative pain at a 10 on a 1-to-10 scale. Which of these assessment findings indicates an acute pain response to poorly controlled pain?

a.	Confusion
b.	Hyperventilation
c.	Increased blood pressure and pulse
d.	Depression

 

 

ANS:  C

Responses to poorly controlled acute pain include tachycardia, elevated blood pressure, and hypoventilation. Confusion and depression are associated with poorly controlled chronic pain (see Table 10-1).

 

DIF:    Cognitive Level: Analyzing (Analysis)                              REF:   p. 172

MSC:  Client Needs: Physiologic Integrity: Basic Care and Comfort

 

5. A 60-year-old woman has developed reflexive sympathetic dystrophy after arthroscopic repair of her shoulder. A key feature of this condition is that the:

a.	Affected extremity will eventually regain its function.
b.	Pain is felt at one site but originates from another location.
c.	Patient’s pain will be associated with nausea, pallor, and diaphoresis.
d.	Slightest touch, such as a sleeve brushing against her arm, causes severe and intense pain.

 

 

ANS:  D

A key feature of reflexive sympathetic dystrophy is that a typically innocuous stimulus can create a severe, intensely painful response. The affected extremity becomes less functional over time.

 

DIF:    Cognitive Level: Understanding (Comprehension)             REF:   p. 178

MSC:   Client Needs: Physiologic Integrity: Basic Care and Comfort