Chapter 12 Quiz

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Question #1

Prior to starting a peripheral intravenous line on a patient, what intervention can the nurse provide to decrease the pain from the needle puncture?

A Inject lidocaine 2% with epinephrine locally around the potential procedure site.

B Apply diclofenac gel over the site 1 hour before the procedure.

C Apply eutectic mixture of local anesthetic cream 30 minutes prior to the procedure.

D Give an oral opioid analgesic 30 minutes before the procedure.

Question #2

A client with appendicitis has had an appendectomy. After surgery, what type of pain does the nurse anticipate the client will have?

A Referred pain

B Neuropathic pain

C Chronic pain

D Acute pain

Question #3

The client is taking oxycodone (Oxycontin) for chronic back pain and reports decreased pain relief when he began taking a herb to improve his physical stamina. The nurse asks if the herb is

A valerian

B ginseng

C chamomile

D kava–kava

Question #4

A client is being treated in a substance abuse unit of a local hospital. The nurse understands that when this client has compulsive behavior to use a drug for its psychic effect, the client needs to be monitored for which effect?

A Placebo

B Addiction

C Dependence

D Tolerance

Question #5

A nurse is caring for a client with pain. What should the nurse monitor for when administering intravenous acetaminophen?

A hepatotoxicity

B renal toxicity

C gastrointestinal effects

D bleeding

Question #6

The nurse informs the patient that a preventive approach for pain relief will be used, involving nonsteroidal anti-inflammatory drugs. What will this mean for the patient?

A The pain medication will be administered before the pain is experienced.

B The pain medication will be administered when the pain is at its peak.

C The pain medication will be administered before the pain becomes severe.

D The pain medication will be administered when the level of pain tolerance has been exceeded.

Question #7

The nurse is monitoring a client who is in the hospital and has a fentanyl patch in place for the control of breakthrough pain for breast cancer. What would be a concern for the nurse when she obtains vital signs for this client?

A Respiratory rate of 10 breaths/minute

B Blood pressure 100/60 mm Hg

C Temperature of 99F

D Heart rate of 96 beats/minute

Question #8

A client who has undergone extensive fracture repair continues to request opioid pain medication with increasing frequency. The initial surgeries occurred more than 2 months ago, and the nurse is concerned about the repeated requests. What does the nurse suspect to be the cause of the client’s frequent appeals for pain medication?

A tolerance

B poor quality control by the drug manufacturer

C addiction

D drug allergy

Question #9

A client is recovering from abdominal surgery and sleeping. The client had received an opioid medication 3 hours ago. The client’s son requests pain medication for the client, stating “I do not want her to wake up in pain.” The first nursing action is

A Refuse to administer the pain medication.

B Administer the prescribed medication.

C Instruct the son about lack of client consent.

D Wake the client and ask about her pain rating.

Question #10

How should the administration of analgesics be scheduled to provide a uniform level of pain relief to a client?

A Administering the analgesics every three hours

B Administering the analgesics on an as-needed basis

C Administering the analgesics intravenously

D Administering analgesics with increased dosage

Question #11

A client is reporting her pain as “8” on a 0-to-10 pain intensity scale. Then, the client states the pain is “3.” Before the nurse leaves the room, the client states her pain is “6.” The best action of the nurse is to

A Average the numbers and report that number as the client’s level of pain.

B Obtain a pain scale with faces for the client to measure her pain.

C Record each of the numbers the client stated for her pain.

D Medicate the client for pain based on the highest number of “8.”

Question #12

Which substance reduces the transmission of pain?

A Acetylcholine

B Substance P

C Serotonin

D Endorphins

Question #13

In which case it is most likely that pain management may not be readily forthcoming to an adult client who is in pain?

A When the pain is chronic

B When a numeric scale is used to assess pain intensity

C When analgesics are contraindicated for the client’s condition

D When the client’s expressions of pain are incongruent with the nurse’s expectations

Question #14

A client with end-stage dementia is admitted to the orthopedic unit after undergoing internal fixation of the right hip. How should the nurse manage the client’s postoperative pain?

A Administer pain medication through a transdermal patch.

B Administer analgesics around the clock.

C Provide patient-controlled analgesia.

D Administer oral opioids as needed.

Question #15

The nurse is administering an analgesic to an older adult patient. Why is it important for the nurse to assess the patient carefully?

A Older people metabolize drugs more rapidly.

B Older people have lower ratios of body fat and muscle mass.

C Older people are more sensitive to drugs.

D Older people have increased hepatic, renal, and gastrointestinal function.

Question #16

The advance nurse practitioner, who is treating a client diagnosed with neuropathic pain, decides to start adjuvant analgesic agent therapy. Which medication is appropriate for the nurse practitioner to prescribe?

A Tramadol

B Ketamine

C Gabapentin

D Hydromorphone

Question #17

A client informs the nurse that he has been taking ibuprofen every 6 hours for 3 weeks to help alleviate the pain of arthritis. The client has a history of a gastric ulcer and is taking a proton pump inhibitor for the treatment of this disorder. What should the nurse instruct the client about the use of the ibuprofen?

A “Ibuprofen is contraindicated when taking a proton pump inhibitor.”

B “It would be best to contact the physician prior to take any over-the-counter medications.”

C “Don’t you know that you can cause bleeding when you take that medication so often?”

D “You should never take ibuprofen; it can cause considerable problems.”

Question #18

Which of the following is a physiologic response to pain?

A Dry skin

B Hypotension

C Pallor

D Bradycardia

Question #19

Regarding tolerance and addiction, the nurse understands that

A tolerance to opioids is uncommon.

B addiction to opioids often develops.

C the nurse must be primarily concerned about the development of addiction by a client in pain.

D although clients may need increasing levels of opioids, they are not addicted.

Question #20

The nurse is assisting the anesthesiologist with the insertion of an epidural catheter and the administration of an epidural opioid for pain control. What adverse effect of epidural opioids should the nurse monitor for?

A Hypertension

B Tachycardia

C Asystole

D Bradypnea

Question #21

When a nurse asks a patient to describe the quality of the pain, what type of descriptive term does the nurse expect the patient to use?

A Intermittent

B Burning

C Chronic

D Severe

Question #22

The nurse is caring for a client with kidney stones who is complaining of severe pain. What type of pain does the nurse understand this client is experiencing?

A Chronic Pain

B Visceral Pain

C Neuropathic Pain

D Somatic Pain

Question #23

A client is admitted with generalized abdominal pain, nausea, vomiting, and hypotension. The client has not passed stool in over 1 week and has been in pain for the past 4 days. Which type of pain would you expect the client to be experiencing?

A neuropathic

B deeper somatic

C chronic

D visceral

Question #24

Which of the following is the appropriate intervention to avoid physical dependence on drugs in a client?

A Administer subtherapeutic doses.

B Administer adjuvant drugs along with the prescribed drug.

C Increase dosage of the drug.

D Discontinue drugs gradually.

Question #25

A client reports abdominal pain as “8” on a pain intensity scale of 0–10 thirty minutes after receiving an opioid intravenously. Her past medical history includes partial–thickness burns to approximately 60% of her body several years ago. The nurse assesses

A That the client is experiencing pain relating to the burn injuries from several years ago

B That the client has become dependent on drugs from her previous experience of burns

C That based on her past experiences the client’s perception of pain should be less

D That the client’s past experiences with pain may influence her perception of current pain

Question #26

A client is prescribed morphine for a possible ankle fracture. When the nurse brings in a second dose of the medication, the client states, “This medicine made me sick.” The nurse replies

A “What do you mean by the word sick?”

B “A lot of people have a similar problem with this medication.”

C “A nausea medication has been prescribed that I will give you.”

D “I will notify your physician.”

Question #27

A client is receiving morphine through a patient–controlled analgesia (PCA) system following surgery. The nurse states to the client

A “Only you are to push the button for medication.”

B “Wait until your pain is severe before pushing the button.”

C “Whenever you hurt, push the button.”

D “This will completely relieve your pain.”

Question #28

When taking a client history, the nurse notes that the client is taking herbal remedies in addition to acetaminophen. Which herb, when taken in conjunction with acetaminophen, enhances the risk of bleeding?

A Gingko

B Echinacea

C Willow

D Kava

Question #29

When a client who has been taking opioids becomes less sensitive to the drug’s analgesic properties, that client is said to have developed a(n)

A balanced analgesia.

B tolerance.

C addiction.

D dependence.

Question #30

The nurse has given an older adult an oral opioid for postoperative pain. What should the nurse do first to make the pain medication more effective?

A Consult with the health care prescriber to include hydroxyzine with the opioid.

B Position the client for comfort.

C Provide the client with a fresh gown.

D Encourage the client to eat crackers.

Question #31

When drafting a nursing care plan for a patient in pain, it is important for the nurse to determine if the pain is acute or chronic. Choose an example of chronic pain.

A Intervertebral disk herniation

B Appendicitis

C A migraine headache

D Angina

Question #32

Nociception includes four specific processes: transduction, transmission, perception, and modulation. Which action illustrates the nociception process of pain transmission?

A A mother in labor utilizing imagery to reduce pain

B A patient taking tramadol to enhance pain management

C A child quickly removing a hand when touching a hot object

D A surgeon making an incision to perform surgery

Question #33

The nurse is caring for a client in the hospital who has been taking an analgesic for pain related to a chronic illness and has developed a tolerance to the medication. What is the most appropriate action by the nurse?

A Inform the client that you will ask the physician to order a non-narcotic analgesic.

B Inform the client that he will not be able to receive more medication than the physician has ordered.

C Consult with the prescriber regarding the need for an increased dose of the drug and not to reduce the frequency of administration.

D Suggest a consultation with a psychiatrist to treat the client’s addiction.

Question #34

When using transdermal Fentanyl, the nurse and patient should be aware of which sign or symptom of Fentanyl overdose?

A Hyperalertness

B Insomnia

C Hyperventilation

D Confusion

Question #35

A client is prescribed methadone 10 mg three times a day for neuralgia following chemotherapy treatment. The client reports that he is experiencing constipation and asks the nurse for information about preventing constipation. The nurse recommends

A using milk of magnesia 30 mL every day

B ingesting up to 6 glasses of fluids per day

C inserting a bisacodyl (Dulcolax) rectal suppository every morning

D increasing the amount of bran and fresh fruits and vegetables

Question #36

A client receives hydromorphone 2 mg intravenously for report of postoperative pain. Fifteen minutes later, the nurse notes respirations are 6 breaths/minute and the client is nonresponsive. The nurse administers prescribed naloxone. The next time the client reports pain, the best nursing action is:

A Ensure naloxone is available.

B Withhold the hydromorphone.

C Consult with the healthcare provider to reduce the dose.

D Administer one–half of the prescribed opioid dose.

Question #37

Which condition is a heightened response that occurs after exposure to a noxious stimulus?

A Pain tolerance

B Dependence

C Sensitization

D Pain threshold

Question #38

Which of the following is a disadvantage to using the IV route of administration for analgesics?

A Slower entry into bloodstream

B No risk of respiratory depression

C Short duration

D Long duration

Question #39

The client is scheduled for surgery. The nurse is reviewing with the client about postoperative pain management. The client states her goal after receiving treatment is “0.” The first action of the nurse is to

A Educate the client that this goal may not be achievable.

B Notify the surgeon of the client’s goal of “0.”

C Ensure the client is prescribed large doses of opioids postoperatively.

D Plan to use medication and nonpharmacologic interventions.

Question #40

A teenage client is undergoing a dressing change to burns on the thigh. The client refuses pain medication and states, “I do not hurt, and I don’t need it.” He is withdrawn, grimaces, and turns away during the dressing change. He was last medicated 8 hours ago. What is the best statement by the nurse?

A “You are so brave to not take your pain medication when the dressing change will hurt.”

B “You are so right to not take your pain medication. You can become dependent on the medication.”

C “If you need pain relief, I can give you some medication when I have completed the dressing change.”

D “I saw you grimacing during the dressing change. Please explain the reason you refused the pain medication.”

Question #41

A Addiction

B Placebo

C Dependence

D Tolerance

Question #42

Which of the following is the most important potential nursing diagnosis for the client receiving opiate therapy?

A Risk for injury

B Altered mobility

C Diarrhea

D Risk for impaired gas exchange

Question #43

An older adult is being treated with opioids for pain relief. Which of the following should the nurse strongly recommend to this client?

A Follow a bowel regimen.

B Exercise regularly.

C Avoid harsh sunlight.

D Reduce fiber intake.

Question #44

The nurse, as a member of the patient’s health care team, obtains pain assessment information to identify goals for pain management. Select the most important factor that the nurse would use for goal setting:

A Severity of the pain as judged by the patient

B Anticipated harmful effects of the pain experience

C Medical interventions for pain management

D Anticipated duration of the pain

Question #45

The nurse is obtaining data regarding the medication that the client is taking on a regular basis. The client states he is taking duloxetine, an antidepressant for the treatment of neuropathic pain. What type of therapy does the nurse understand the client is receiving?

A Adjuvant drug therapy

B Withdrawal therapy

C Alternate drug therapy

D Replacement drug therapy

Question #46

A client with appendicitis has had an appendectomy. After surgery, what type of pain does the nurse anticipate the client will have?

A Acute pain

B Chronic pain

C Referred pain

D Neuropathic pain

Question #47

According to The Joint Commission’s pain assessment and management standards, which of the following are essential components of a comprehensive pain assessment?

A quality, location, intensity, and family history

B location, onset, alleviating factors, and aggravating factors

C intensity, variations, range of motion, and the client’s goal for pain control

D nutritional deficiencies, onset, duration, and effects of pain

Question #48

When completing a teaching plan for a client receiving patient-controlled analgesia (PCA), which component would be important for the nurse to stress?

A The pump will deliver a preset amount of medication.

B Teach the client to avoid pushing the button multiple times because additional doses will be given.

C Chance of sedation is rare when using a PCA pump.

D The client should wait until the pain is severe to push the button to prevent overdose.

Question #49

A new surgical patient has been prescribed an opioid analgesic intravenously for pain control. The nurse should be aware of which most serious adverse effect of this medication?

A Respiratory depression

B Pruritus

C Constipation

D Nausea and vomiting

Question #50

Which is a gastrointestinal route for administration of analgesics?

A Rectal

B Epidural space

C Subcutaneous

D Oral mucosa

Question #51

About which issue should the nurse inform clients who use pain medications on a regular basis?

A Avoid harsh sunlight for 2 hours after administering analgesic agents or salicylates.

B Inform the primary health care provider about the use of salicylates before any procedure, and avoid over-the-counter analgesics consistently without consulting a physician.

C Consume the medications just before or along with meals.

D Minimize fiber intake during the therapy.

Question #52

Which is a true statement regarding placebos?

A A placebo effect is an indication that the client does not have pain.

B A placebo should be used as the first line of treatment for a client.

C Placebos should never be used to test a client’s truthfulness about pain.

D A positive response to a placebo indicates that the client’s pain is not real.

Question #53

A nurse is caring for client receiving fentanyl through an epidural catheter. What medication should be readily available for the client who is experiencing respiratory depression?

A diphenhydramine

B ibuprofen

C aspirin

D naloxone

Question #54

A Asystole

B Bradypnea

C Tachycardia

D Hypertension

Question #55

A client sustained severe burns over both lower extremities 1 week ago. The client informs the nurse that he had to wait for 30 minutes last night to receive pain medication, which caused the pain not to be relieved after administration. What suggestions could the nurse make to the physician to provide adequate relief of pain?

A Provide the client with a patient-controlled analgesia (PCA) pump.

B If the nurse is going to be late with administration, have an extra dose of medication available.

C Increase the frequency of the medication so that the client will have less time to wait.

D Increase the dosage of the medication so the client will stay medicated longer.

Question #56

Which phase of pain transmission occurs when the one is made aware of pain?

A Perception

B Transduction

C Modulation

D Transmission

Question #57

A client is being taught to self-administer a narcotic analgesic by means of an intravenous PCA pump system. Which of the following would help prevent accidental overdosage?

A Reducing the frequency of administration of the narcotic analgesic

B Reducing the dosage of the narcotic analgesic

C Programming the dosage and time interval into the device

D Reducing the dosage of the narcotic analgesic

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