ATI LPN
Timby's Introductory Medical-Surgical Nursing Thirteenth, North American Edition
Chapter 11 : Pain Management Questions
Question 1 of 5
A client is receiving morphine sulfate intravenously (IV) every 4 hours as needed for the relief of pain related to a surgical procedure the client had 3 days previously. The physician is discontinuing the IV and will be starting the client on oral pain medication. What would provide the client with optimal pain relief when discontinuing the IV dose?
Correct Answer: B
Rationale: When changing from a parenteral to an oral route, it is best to administer an equianalgesic dose, an oral dose that provides the same level of pain relief as when the drug is given by a parenteral route. Administering a lower dose of the medication will not provide the client with an adequate pain relief. Administering an IM dose may decrease the absorption and not provide the client with adequate relief. Administering a higher dose may cause side effects that would be detrimental to the client.
Question 2 of 5
A client sustained severe burns over both lower extremities 1 week ago. The client informs the nurse of having had to wait for 30 minutes the night before 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?
Correct Answer: A
Rationale: Patient-controlled analgesia (PC
A) allows clients to self-administer their own narcotic analgesic by means of an intravenous pump system. The client infuses the drug by pressing a hand-held button. The dose and time intervals between doses are programmed into the device to prevent accidental overdose. The nurse should not be late when administering a pain medication; giving an extra dose, increasing the frequency, or increasing the dose also increases the risk of overdosing the client.
Question 3 of 5
A client is experiencing intractable pain related to terminal pancreatic cancer. What does the nurse understand is the goal of palliative sedation for this client?
Correct Answer: A
Rationale: Palliative sedation is a method of relieving intractable pain and suffering experienced by a dying client. The aim of this pain-relieving approach is to administer sedative medication at the minimum dosage necessary to decrease consciousness and relieve pain. It is used only when there is no other means available to alleviate suffering with speeding up or slowing down the dying process. The other options will either create respiratory depression or not give enough pain relief.
Question 4 of 5
A client sustained second- and third-degree burns to the chest and neck 4 days ago and is now refusing analgesics stating, 'I don't want to become addicted to pain medication.' What is the appropriate response by the nurse?
Correct Answer: C
Rationale: The American Society for Pain Management Nursing describes addiction as a chronic, relapsing, treatable disease-characterized by craving, dysfunctional behaviors, inability to control impulses regarding consumption of a substance, and compulsive use despite harmful consequences (Oliver et al., 2012). Although opioid drugs can result in addiction, there is very little evidence that those who require narcotics for legitimate pain actually become addicted. The other options are nontherapeutic responses to the client's concern about addiction.
Question 5 of 5
A client comes to the clinic expressing the need for more analgesics for chronic pain. Stating that the medication is not as strong, the client reports requiring more than the prescribed dose. What does the nurse suspect is occurring with the client?
Correct Answer: B
Rationale:
Tolerance is a condition in which a client needs increasingly larger doses of a drug to achieve the same effect as when the drug was first administered. Addiction refers to a chronic, relapsing, treatable disease characterized by craving, dysfunctional behaviors, inability to control impulses regarding consumption of a substance, and compulsive use despite harmful consequences (Oliver et al., 2012). Physical dependence means that a person experiences physical discomfort, known as withdrawal symptoms.