ATI RN
Client Comfort and End of Care Questions
Question 1 of 5
The nurse would expect which of the following clients to be a candidate for patient-controlled analgesia (PCA)?
Correct Answer: B
Rationale: The nurse expects a client with chronic cancer pain to be a candidate for patient-controlled analgesia (PCA), as PCA allows self-administration of opioids within safe limits, ideal for managing persistent, severe pain common in cancer. It empowers alert clients to control pain flare-ups, enhancing comfort. Choice A, a confused client, isn't suitablePCA requires cognitive clarity to operate safely, preventing overdose. Choice C, a client unable to push a button, can't use PCA due to physical limitation, needing alternative delivery like IV drips. Choice D, a client with drug addiction history, may be excluded due to misuse risk, though not absoluteit depends on oversight, but cancer pain trumps this concern typically. Choice B is correct, reflecting PCA's design for coherent, pain-afflicted clients, aligning with nursing goals to optimize pain relief in chronic conditions like cancer, where fluctuating pain needs responsive management.
Question 2 of 5
A client with chronic pain tells the nurse that nothing relieves the pain completely. What would the nurse do first?
Correct Answer: B
Rationale: The nurse would first assess the characteristics of the pain when a client says nothing relieves it completely, as chronic pain's persistence may reflect inadequate treatment, tolerance, or a new cause needing detailed evaluation (e.g., quality, duration). This informs next steps. Choice A, saying nothing more can be done, is defeatist and falseoptions like adjusting therapy exist post-assessment. Choice C, administering a placebo, is unethical and ineffective; it deceives without addressing the issue. Choice D, suggesting a specialist, may follow but skips initial nursing responsibility to gather data for referral. Choice B is correct, prioritizing assessmenta cornerstone of nursingto pinpoint why relief fails, enabling tailored solutions like altering medications, adding nonpharmacological methods, or escalating care, ensuring the client's ongoing pain is actively managed.
Question 3 of 5
The nurse would expect which client to be the best candidate for a transcutaneous electrical nerve stimulation (TENS) unit?
Correct Answer: B
Rationale: The nurse expects a client with chronic back pain to be the best candidate for a TENS unit, as it's most effective for localized, chronic musculoskeletal pain, like back issues, by stimulating nerves to block pain signals and release endorphins. It's less invasive and suits long-term management. Choice A, acute postoperative pain, may benefit briefly, but TENS isn't primaryopioids or PCA dominate early post-op. Choice C, a fractured leg, involves acute pain; TENS could help, but immobilization and analgesics are standard initially. Choice D, abdominal pain, is less idealvisceral pain responds poorly to TENS, needing systemic treatment. Choice B is correct, reflecting TENS' evidence-based use in chronic conditions, guiding nurses to apply it for back pain relief, adjusting settings for comfort, and monitoring efficacy in outpatient or home settings.
Question 4 of 5
The nurse would expect a client with neuropathic pain to report which of the following?
Correct Answer: B
Rationale: The nurse expects a burning sensation in neuropathic pain, as it arises from nerve damage (e.g., diabetes, shingles), producing distinct sensationsburning, tingling, or shootingunlike somatic pain's mechanical feel. This reflects altered nerve signaling. Choice A, dull ache, suits somatic pain (e.g., arthritis), not neuropathy's sharp, electric quality. Choice C, muscle spasms, may accompany somatic issues (e.g., injury), but neuropathic pain is sensory, not motor. Choice D, localized swelling, indicates somatic inflammation (e.g., sprains), not nerve-based pain, which lacks physical signs. Choice B is correct, guiding nurses to recognize neuropathic hallmarksburning prompts adjuvants like gabapentin over standard analgesics, ensuring treatment matches the pain's neural origin, distinct from musculoskeletal complaints.
Question 5 of 5
The nurse is caring for a client who reports chronic pain that is not relieved by medication. What would the nurse do next?
Correct Answer: B
Rationale: The nurse would assess for other pain relief methods when chronic pain persists despite medication, as unrelieved pain may need multimodal approachesnonpharmacological (e.g., heat, TENS) or adjuvants (e.g., gabapentin)tailored to pain type or tolerance. Assessment explores alternatives. Choice A, telling the client to try harder, is dismissive and unhelpfuleffort doesn't overcome ineffective treatment. Choice C, administering a placebo, is unethical and delays real care; it's not a clinical solution. Choice D, suggesting to ignore the pain, neglects the client's sufferingchronic pain demands action, not avoidance. Choice B is correct, reflecting nursing's proactive stanceassessing pain characteristics (e.g., neuropathic) or barriers (e.g., dose limits) ensures comprehensive management, potentially adding therapies to enhance relief, addressing the complexity of chronic pain beyond single-drug failure.