ATI LPN
Timby's Introductory Medical-Surgical Nursing Thirteenth, North American Edition
Chapter 11 : Pain Management Questions
Question 1 of 5
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 appropriate action by the nurse?
Correct Answer: D
Rationale: The most appropriate action by the nurse would be to consult with the physician regarding the need for an increased dose of the drug and not to reduce its frequency of administration. As a rule of thumb, an ineffective dose should be increased by 25% to 50%. Informing the client that they will not be able to receive more medication is not acting as a client advocate nor acting in the best interest of the client. Suggesting a psychiatrist consultation would not be an appropriate action because the client has a chronic illness that requires medication. Taking a non-narcotic analgesic would not provide the client with the pain relief needed.
Question 2 of 5
The nurse is obtaining data regarding medications the client is taking on a regular basis. The client reports taking duloxetine, an antidepressant for the treatment of neuropathic pain. What type of therapy does the nurse understand the client is receiving?
Correct Answer: A
Rationale: Adjuvant drugs are medications that are ordinarily administered for reasons other than treating pain. Duloxetine is used to treat depression but is being used for neuropathic pain for this client.
Question 3 of 5
A client arrives in the orthopedic clinic with complaints of twisting the right ankle while playing softball. The nurse collects data including complaints of pain and swelling in the right ankle. What intervention will the nurse provide that will decrease vasodilation and reduce localized swelling?
Correct Answer: B
Rationale: Pain associated with injury is best treated initially with cold applications such as an ice bag or chemical pack. The cold decreases vasodilation which reduces localized swelling, which may be useful for minor or moderate pain. Heat will increase vasodilation. Elevation of the extremity will not decrease vasodilation. It is beyond the scope of practice for the nurse to inject steroids into the joint space.
Question 4 of 5
The client will be using transcutaneous electrical nerve stimulation (TENS) for the treatment of lower back pain. What does the nurse explain to the client that this will do for the back pain?
Correct Answer: A
Rationale: TENS is a pain management technique that delivers bursts of electricity to the skin and underlying nerves. It is safe for managing acute and chronic pain and does not produce systemic side effects or addiction. The electricity is delivered from a battery-operated TENS unit through electrode patches that are placed at appropriate sites, such as directly over the affected area, at areas along a nerve pathway, or at points distal to the painful area. Cold compresses cause decrease in vasodilation. Warm compresses cause heat to the skin and subcutaneous tissues. A cordotomy interrupts the pain pathways in the spinal cord.
Question 5 of 5
The nurse is providing a gentle massage on a painful area of a client's hip. What is the goal of the nurse in providing this intervention?
Correct Answer: C
Rationale: Gently massaging a painful area or the same area on the opposite side of the body will promote the release of endorphins and enkephalins that moderate the sensation. Warm or cool compresses to a painful sensory site will flood the brain with alternative stimuli closes the spinal gates that transmit pain. Visualizing a pleasant experience will interrupt the pain perception. Administration of an analgesic will keep the pain at a manageable level.