ATI LPN
Lewis's Medical Surgical Nursing in Canada, 5th Edition
Chapter 10 Questions
Question 1 of 5
When doing a pain assessment for a patient who has been admitted with metastatic breast cancer, which question asked by the nurse will give the most information about the patient's pain?
Correct Answer: B
Rationale: Because pain is a multidimensional experience, asking a question that addresses the patient's experience with the pain is likely to elicit more information than the more specific information asked in the other three responses. All of these questions are appropriate, but the response beginning 'How would you describe your pain' is the best initial question.
Question 2 of 5
A patient who uses a fentanyl patch for persistent cancer pain complains to the nurse of the rapid onset of pain at a level 9 (0-10 scale) and requests 'something for pain that will work quickly.' Which of the following types of pain is the most appropriate for the nurse to document for this patient?
Correct Answer: D
Rationale: Pain that occurs beyond the persistent pain already being treated by appropriate analgesics is termed breakthrough pain. Neuropathic pain is caused by damage to peripheral nerves or the central nervous system (CNS). Somatic pain is localized and arises from bone, joint, muscle, skin, or connective tissue. Referred pain is pain that is localized in uninjured tissue.
Question 3 of 5
A postoperative patient asks the nurse how the prescribed ibuprofen will control the incisional pain. The nurse will teach the patient that ibuprofen interferes with the pain process by decreasing which of the following physiological responses?
Correct Answer: C
Rationale: Nonsteroidal anti-inflammatory drugs (NSAIDs) provide analgesic effects by decreasing the production of pain-sensitizing chemicals such as prostaglandins at the site of injury. Transmission of impulses through the spinal cord, brain sensitivity to pain, and the descending nerve pathways are not affected by the NSAIDs.
Question 4 of 5
The nurse is caring for a patient who is taking an opioid for postoperative pain. Which of the following interventions should the nurse include in the patients plan of care to manage possible adverse effects of opioids?
Correct Answer: B
Rationale: Examples of ways to manage anticipated adverse effects of opioids are to administer stool softeners to prevent constipation and an antiemetic to prevent nausea. The medication should have a scheduling dosage regimen to maintain blood levels rather than only PRN. Changing to a different medication in the same classification may be appropriate rather than changing the drug classification. Another way to manage an adverse effect is to use an administration route that minimizes rather than maximizes drug concentrations at the site of the adverse effect.
Question 5 of 5
A patient with persistent abdominal pain has learned to control the pain with the use of imagery and hypnosis. A family member asks the nurse how these techniques work. Which of the following reasons provide the basis for the nurse's response in relation to the effectiveness of these strategies?
Correct Answer: A
Rationale: Cognitive therapies impact on the perception of pain by the brain rather than affecting efferent or afferent pathways or influencing the release of chemical transmitters in the dorsal horn.