ATI LPN
Brunner & Suddarth's Textbook of Medical-Surgical Nursing 14e (Hinkle 2017)
Chapter 12 : Pain Management Questions
Question 1 of 5
You are assessing an 86-year-old postoperative patient who has an unexpressive, stoic demeanor. When you enter the room, the patient is curled into the fetal position and your assessment reveals that his vital signs are elevated and he is diaphoretic. You ask the patient what his pain level is on a 0-to-10 scale that you explained to the patient prior to surgery. The patient indicates a pain level of three or so. You review your pain-management orders and find that all medications are ordered PRN. How would you treat this patients pain?
Correct Answer: C
Rationale: As always, the best guide to pain management and administration of analgesic agents in all patients, regardless of age, is what the individual patient says. However, further education and assessment are appropriate. You cannot usually treat pain the patient denies having if the orders are PRN only. The scenario does not indicate the present pain-management orders are not working for this patient. The familys insights do not override the patients self-report.
Question 2 of 5
The nurse caring for a 91-year-old patient with osteoarthritis is reviewing the patients chart. This patient is on a variety of medications prescribed by different care providers in the community. In light of the QSEN competency of safety, what is the nurse most concerned about with this patient?
Correct Answer: D
Rationale: Drug interactions are more likely to occur in older adults because of the higher incidence of chronic illness and the increased use of prescription and OTC medications. The other options are all good answers for this patient because of the patients age and disease process. However, they are not what the nurse would be most concerned about in terms of ensuring safety.
Question 3 of 5
You are caring for a patient with sickle cell disease in her home. Over the years, there has been joint damage, and the patient is in chronic pain. The patient has developed a tolerance to her usual pain medication. When does the tolerance to pain medication become the most significant problem?
Correct Answer: A
Rationale:
Tolerance to opioids is common and becomes a problem primarily in terms of maintaining adequate pain control. Symptoms of physical dependence may occur when opiates are discontinued, but there is no indication that the patients medication will be discontinued. This patient does not have an addiction and the familys concerns are secondary to those of the patient.
Question 4 of 5
You are admitting a patient to your rehabilitation unit who has a diagnosis of persistent, severe pain. According to the patients history, the patients pain has not responded to conventional approaches to pain management. What treatment would you expect might be tried with this patient?
Correct Answer: B
Rationale: For patients who have persistent, severe pain that fails to respond to other treatments or who obtain pain relief only with the risk of serious side effects, medication administered by a long-term intrathecal or epidural catheter may be effective. The other listed means of pain control would already have been tried in a patient with persistent severe pain that has not responded to previous treatment.
Question 5 of 5
You are caring for a 20-year-old patient with a diagnosis of cerebral palsy who has been admitted for the relief of painful contractures in his lower extremities. When creating a nursing care plan for this patient, what variables should the nurse consider? Select all that apply.
Correct Answer: B,C,D,E
Rationale: The nursing care of patients who undergo procedures for the relief of chronic pain depends on the type of procedure performed, its effectiveness in relieving the pain, and the changes in neurologic function that accompany the procedure. The patients comorbid conditions will also affect care, but his gender is not a key consideration.