CLIENTS WITH PAIN
4.In caring for a person receiving an opioid
1.The most effective way for the nurse to
administer pain medication to a client who is
experiencing severe pain related to metastatic liver
cancer is to
a. administer medication only when other methods
of pain relief are ineffective.
b. give only intravenous pain medications.
c. dispense pain medications on a regular basis.
d. respond promptly to as-needed (prn) pain requests.
ANS: c
Patients experiencing pain caused by widespread
cancer require routine pain-relieving medication in
order to function, often at higher doses.
DIF: Cognitive Level: Application REF:
Text Reference: 445
TOP: Nursing Process Step: Intervention
MSC: NCLEX: Physiological Integrity
2.A client who has been dealing with a chronic pain
for the past 2 years would like to try biofeedback as
a method of pain relief. The statement that
indicates that the client understands this method of
treatment is
a. It will be nice to try something that wont cost me
anything.
b. I work really well with groups. I think that support
will be just what I need.
c. Im willing to try to control how blood flows to
different parts of my body.
d. I want to give my attention to something other
than my pain.
ANS: c
The purpose of biofeedback in pain management is
to teach the client self-control over physiologic
variables that relate to the pain, such as muscle
contraction and blood flow.
DIF: Cognitive Level: Analysis REF: Text
Reference: 480
TOP: Nursing Process Step: Evaluation
MSC: NCLEX: Physiological Integrity
3.A client who has been in chronic pain after an
automobile accident successfully reduces his pain
through a combination of biofeedback and
meditation. The conclusion the nurse may draw
from his success is that the
a. pain was psychological in nature.
b. placebo effect occurred.
c. therapy caused physiologic changes.
d. pain was acute in nature.
ANS: c
Many nonpharmaceutical interventions have been
used clinically with positive results. The therapies
are thought to cause physiologic changes.
DIF: Cognitive Level: Analysis REF: Text
Reference: 480
TOP: Nursing Process Step: Assessment
MSC: NCLEX: Physiological Integrity
analgesic through an epidural catheter, the nursing
responsibility of prime importance is
a. assisting the client with frequent position changes.
b. establishing a baseline laboratory profile.
c. hourly inspection of the catheter insertion site.
d. assessing for respiratory depression.
ANS: d
Possible side effects of epidural opioids are
pruritus, urinary retention, and delayed respiratory
depression, occurring 4 to 12 hours after a dose.
DIF: Cognitive Level: Application REF: Text
Reference: 470
TOP: Nursing Process Step: Assessment
MSC: NCLEX: Physiological Integrity
5.A client is having a small wart removed from his
index finger. The nurse assisting with this
procedure would question the use of
a. procaine.
b. lidocaine.
c. Xylocaine.
d. Novocain with epinephrine.
ANS: d
Epinephrine-containing solutions are not used for
nerve blocks of the penis, fingers, or toes, where
vasoconstriction could cause inadequate blood flow
and necrosis of the distal extremity.
DIF: Cognitive Level: Analysis REF: Text
Reference: 461
TOP: Nursing Process Step: Intervention
MSC: NCLEX: Safe, Effective Care Environment;
6.The nurse practitioner (NP) infiltrates the area
around a lesion to be incised with procaine. The NP
should anticipate a waiting period of
a. no significant time.
b. 3 to 10 minutes.
c. to hour.
d. optimally, 1 hour.
ANS: b
Procaine produces its effect in 3 to 10 minutes and
usually lasts under 1 hour.
DIF: Cognitive Level: Application REF: Text
Reference: 461
TOP: Nursing Process Step: Assessment
MSC: NCLEX: Physiological Integrity
7.A client who is receiving morphine (IM) 10 mg prn
for severe postoperative pain should have a
respiratory assessment
a. immediately after the morphine is given.
b. 10 minutes after the morphine is given.
c. 30 minutes after the client has been medicated.
d. continuously with an apnea monitor.
ANS: c
Deaths from narcotic poisoning are usually caused
by respiratory depression and usually occur in
clients who have not received opioids in the past.
With morphine, maximal respiratory depression
usually occurs within 15 minutes of intravenous
administration, within 30 minutes of intramuscular
administration, within 90 minutes of subcutaneous
administration, and within 4 to 12 hours of epidural
administration. The nurse should remember these
time ranges when assessing the clients respiratory
status after administration of opioids.
Allodynia is pain that is evoked by stimuli that does
not normally cause pain.
DIF: Cognitive Level: Knowledge REF: Text
Reference: 449
TOP: Nursing Process Step: N/A MSC:
NCLEX: N/A

DIF: Cognitive Level: Application REF: Text

Reference: 470
TOP: Nursing Process Step: Assessment
MSC: NCLEX: Physiological Integrity

8.Because of the need to reverse respiratory

depression after administration of a narcotic
analgesic, the charge nurse keeps on hand the
drug
a. aminophylline (Amoline).
b. furosemide (Lasix).
c. naloxone (Narcan).
d. oxymorphone (Numorphan).

ANS: c
Treatment of respiratory depression includes
arousing the client, establishing a patent airway,
administering an opiate antagonist such as
naloxone, and providing artificial ventilation as
necessary.

DIF: Cognitive Level: Application REF: Text

Reference: 469, Table 22-6;
TOP: Nursing Process Step: Intervention
MSC: NCLEX: Safe, Effective Care Environment;

9.The teaching plan for an individual receiving

transcutaneous electrical nerve stimulation (TENS)
should include the information that
a. one electrode only is used over the painful site.
b. the electrode wires should be visible to detect early problems.
c. the client can adjust both voltage and pulsation.
d. this therapy is useful for very few clients.

ANS: c
Voltage and pulsation are controlled by the person
wearing the device. Positive and negative poles
(electrodes) are placed within several inches of
each other. TENS has been shown to relieve pain
effectively in many people.

DIF: Cognitive Level: Application REF: Text

Reference: 477
TOP: Nursing Process Step: Intervention
MSC: NCLEX: Physiological Integrity

10.The client with neuropathic pain develops

allodynia, which
a. is relieved by daily doses of opioids.
b. responds to NSAIDs taken several times a day.
c. is pain due to a stimulus that does not normally
cause pain.
d. is a vague pain that is difficult for the client to
describe.

ANS: c