ATI LPN
Lewis's Medical Surgical Nursing in Canada, 5th Edition
Chapter 10 Questions
Question 1 of 5
The nurse assesses a postoperative patient who is receiving morphine through patientcontrolled analgesia (PCA). Which information is most important to report to the health care provider?
Correct Answer: B
Rationale: The patient's respiratory rate indicates a need to decrease the PCA dose or change the medication in order to avoid further respiratory depression. The other information also may require intervention, but is not as urgent to report as the respiratory rate.
Question 2 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.
Question 3 of 5
The health care provider plans to titrate a patient-controlled analgesia (PCA) machine to provide pain relief for a patient with acute surgical pain who has never received opioids in the past. Which of the following nursing actions regarding opioid administration are appropriate at this time?
Correct Answer: B,D
Rationale: Monitoring for pain relief and teaching the patient about how opioid use will improve postoperative outcomes are appropriate actions when administering opioids for acute pain. Although postoperative patients usually need decreasing amount of opioids by the second postoperative day, each patient's response is individual.
Tolerance may occur, but addiction to opioids will not develop in the acute postoperative period. The patient should use the opioids to achieve adequate pain control, and so the nurse should not emphasize the adverse effects.
Question 4 of 5
The nurse is caring for a patient with cancer pain that the patient describes as at 'level 8 (0-10 scale), deep, and aching.' Which of the following prescribed medications should the nurse administer first?
Correct Answer: C
Rationale: The patient's pain level indicates that a rapidly acting medication such as an IV opioid is needed. The other medications also may be appropriate to use, but will not work as rapidly or as effectively as hydromorphone IV.
Question 5 of 5
The nurse is caring for a patient who is receiving epidural morphine. Which of the following information obtained by the nurse indicates that the patient may be experiencing an adverse effect of the medication?
Correct Answer: C
Rationale: Urinary retention is a common adverse effect of epidural opioids. Headache is not an anticipated adverse effect of morphine, although if there is a cerebrospinal fluid leak, the patient may develop a 'spinal' headache. Sedation (rather than restlessness or agitation) would be a possible adverse effect. Hypotonic bowel sounds and constipation (rather than abdominal cramping) are concerns.