Chapter 32: Pain Management

Essentials for Nursing Practice, 8th Edition by Patricia A. Potter, Anne Griffin Perry, Patricia Stockert, Amy Hall

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Chapter 32: Pain Management

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

MULTIPLE CHOICE

 

  1. A patient is admitted to the trauma unit with the diagnosis of spinal cord injury resulting from an ATV accident. The health care provider has diagnosed the patient as a paraplegic. Which of the following is one of the most important topics for patient teaching to prevent further injury to the patient?
a. Reminding him that he can be injured and not feel pain below his waist
b. Suggesting that his parents purchase a motorized wheelchair to prevent arm muscle strain
c. Reminding the patient to decrease fluid intake due to lack of mobility
d. Reminding the patient to drink plenty of fluids to maintain hydration

 

 

ANS:   A

Some patients such as those with spinal cord injuries are unable to sense painful stimuli. You must take special precautions to protect them from additional injury. Safety is the number one priority for this patient due to lack of sensation and movement in the lower extremities.  Providing precautions against taking too much pain medication and reminding the patient to drink plenty of fluids to maintain hydration are important interventions. Determination of which type of wheelchair the patient will need would be determined by the health care team closer to discharge. Pain processes require an intact peripheral nervous system and spinal cord. Common factors that disrupt the pain experience include trauma, drugs, tumor growth, and metabolic disorders.

 

PTS:    1                      DIF:    Cognitive Level: Analyzing (Analysis)

REF:    871                  OBJ:    Describe the physiology of pain.

TOP:    Nursing Process: Implementation      MSC:   Client Needs: Physiological Integrity

 

  1. A graduate nurse is working for a diabetes unit. The nurse manager has prepared a very thorough orientation, which includes check-offs for taking vital signs. The nurse manager has informed the graduate nurse that their hospital has adopted the Joint Commission’s pain standard and that they will be assessing five vital signs. The graduate nurse knows that the fifth vital sign is which of the following?
a. Arterial blood gasses
b. Blood sugar
c. Blood pressure
d. Pain

 

 

ANS:   D

National and international organizations have made efforts to correct this problem. The Joint Commission (2013) has a pain standard for health care workers to assess all patients for pain on a regular basis. Many health care institutions have adopted this standard by recommending that pain be assessed as the “fifth vital sign.”

 

PTS:    1                      DIF:    Cognitive Level: Remembering (Knowledge)

REF:    874                  OBJ:    Assess a patient experiencing pain.

TOP:    Nursing Process: Implementation

MSC:   Client Needs: Safe and Effective Care Environment

 

  1. A registered nurse working for the emergency department sees a lot of patients who seek services because of pain. The nurse is aware that pain is which of the following?
a. Caused by a single physiological sensation
b. Caused by a specific stimulus
c. Subjective
d. Universally the same for everyone

 

 

ANS:   C

Pain is more than a single physiological sensation caused by a specific stimulus. It is subjective and highly individualized. The person having pain is the only authority on it.

According to McCaffery’s classic definition, “Pain is whatever the experiencing person says it is, existing whenever he says it does.”

 

PTS:    1                      DIF:    Cognitive Level: Remembering (Knowledge)

REF:    870                  OBJ:    Assess a patient experiencing pain.

TOP:    Nursing Process: Assessment            MSC:   Client Needs: Physiological Integrity

 

  1. A registered nurse, who has practiced for more than 20 years and has had a lot of experience caring for postsurgical patients, was questioned by a student nurse about why many nurses do not give the full amount of pain medication ordered by surgeons. The nurse replied that the literature shows that many nurses do not give the full amount of pain medication because they:
a. do not believe that the patient is experiencing that much pain.
b. do not want to contribute to pain medication addiction.
c. believe that limiting the amount of pain medication lowers costs.
d. are concerned about drug interactions with pain medication and other postsurgical medications.

 

 

ANS:   B

Many nurses avoid acknowledging a patient’s pain because of their own fear of contributing to addiction. These fears and beliefs lead to mistrust between the nurse and patient, increased patient recovery time, increased complications and mortality, increased psychological problems, and increased cost.

 

PTS:    1                      DIF:    Cognitive Level: Applying (Application)

REF:    874                  OBJ:    Discuss nursing implications for administering analgesics.

TOP:    Nursing Process: Planning

MSC:   Client Needs: Safe and Effective Care Environment

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