Chapter 36: Pain Management

When assessing the patient for pain, which factors should the nurse consider? (Select all that apply.)

a. Previous medical history

b. Physical appearance

c. Age, gender, and culture

d. Lifestyle and loss of appetite

e. Hair color and style

a. Previous medical history

b. Physical appearance

c. Age, gender, and culture

Which statement best describes the dosage of prescribed pain medication that a nurse should administer given pharmacologic treatment considerations?

a. The smallest dose possible to avoid opioid addiction

b. The smallest dose possible to decrease adverse effects

c. A dose that best manages pain with fewest side effects

d. A large dose initially to decrease the initial level of pain

c. A dose that best manages pain with fewest side effects

Which method is the most accurate way to determine the pain level of a patient who is alert and oriented?

a. Evaluate whether the patient is crying or grimacing.

b. Assess the patient’s heart rate and blood pressure.

c. Consider the seriousness of the patient’s condition.

d. Ask the patient to describe the pain and rate its level.

d. Ask the patient to describe the pain and rate its level.

A patient who has a serious back injury received intravenous medication for pain approximately 1 hour earlier. The patient practices relaxation techniques but still is reporting pain at a level of 9 of 10. What is the next action that should be taken by the nurse?

a. Report the lack of pain relief to the primary care provider.

b. Tell the patient to give the medication more time.

c. Reposition the patient and try diversion activities.

d. Document in the nurse’s notes that the patient has a low pain tolerance.

a. Report the lack of pain relief to the primary care provider.

The nurse recognizes which cue from the patient as a physiologic response to acute pain?

a. Increased blood pressure

b. Decreased pulse

c. Increased temperature

d. Restlessness

a. Increased blood pressure

When administering analgesics to elderly patients, what information does the nurse need to understand?

a. Start with a low dose and increase the dose as needed for pain relief.

b. Start with a high dose and decrease the dose as pain is relieved.

c. Start with a midrange dose and increase or decrease the dose as needed for pain.

d. Start with a low dose and decrease the dose every other day.

a. Start with a low dose and increase the dose as needed for pain relief

The nurse administered intravenous morphine at 0830. At what time will the nurse evaluate the patient for pain relief?

a. 1000

b. 1030

c. 0900

d. 0930

c. 0900

The endocrine system releases excessive hormones during episodes of acute pain. The nurse should monitor patients experiencing acute pain for which potential problem?

a. Hyperglycemia

b. Migraine headache

c. Hypokalemia

d. Diarrhea

a. Hyperglycemia

Due to increased stress hormones like cortisol and adrenaline.

The patient who had a below-the-knee amputation 3 days ago complains of pain from the amputated extremity. Which response by the nurse best explains what the patient is experiencing?

a. “Your phantom pain will subside when the brain realizes the lower extremity is no longer there.”

b. “Your radiating pain will continue for months because the lower extremity is no longer there.”

c. “You are suffering from referred pain, which you will always have, but it will lessen with time.”

d. “You are experiencing psychogenic pain because loss of an extremity is an emotional loss.”

a. “Your phantom pain will subside when the brain realizes the lower extremity is no longer there.”

A patient who has type 2 diabetes is admitted to the hospital with a fractured left femur. What are the two highest-priority actions for the nurse to implement?

a. Starting an intravenous solution of lactated Ringer solution

b. Administering ordered pain medication after taking vital signs

c. Glucometer testing to monitor the patient’s blood glucose level

d. Giving the ordered prophylactic antibiotic to prevent infection

e. Encouraging assisted ambulation to avoid blood clot formation

b. Administering ordered pain medication after taking vital signs

c. Glucometer testing to monitor the patient’s blood glucose level