Exam #3: Check your knowing Flashcards
It is most important for the nurse to understand the various ways in which pain is classified so that he or she can…
A.) Document the client’s pain using accurate terms
B.) Be clear in communication with the physician
C.) Develop an effective pain management plan
D.) Educate the client thoroughly
C.) Develop an effective pain management plan
Different modalities are used in treatment/ management of pain and are often on how the pain is classified (e.g., acute versus chronic)
Which Pain assessment scale is most appropriate for a verbal, alert adult with no cognitive impairment
A.) Visual Analog scale (VAS)
B.) 1-10 Numeric Pain Intensity Scale
C.) FACES
D.) FLACC
B.) 1-10 Numeric Pain intensity scale
Which pain assessment scale is most appropriate for a 13 month-old patient
A.) Visual Analog scale (VAS)
B.) 1-10 Numeric Pain Intensity Scale
C.) FACES
D.) FLACC
D.) FLACC
The Nurse is assessing the confused client. In trying to determine the client’s level of pain, the nurse should
A.) Be aware that confused clients do not feel as much pain due to their confusion
B.) Observe the client carefully for changes in behaviors or vital signs
C.) Ask the client’s family how much pain the client normally has
D.) Use only pain scales that feature numbers or “faces” the client can point to
B.) Observe the client carefully for changes in behavior or vital signs
-The nurse should observe the confused client for nonverbal cues to pain
Mr. Zenobia’s chronic cancer pain has recently increased and asks the home health nurse what can be done. In relation to his long-acting opioid, which is an appropriate response by the nurse?
A.)”If you take more opioid, it will not change your pain relief.”
B.) “I’ll call the primary care provider and ask for an increased dose.”
C.) “The amount you are taking now is all I can give you.”
D.) “I’m worried if we increase your dose that you will stop breathing.”
B. “I’ll call the primary care provider and ask for an increased dose.”
-There is no ceiling on the analgesic effect of opioid narcotics. Patients develop a tolerance to the effects, which often necessitates an increase in the dose.
The Nurse is completing an admission assessment. Which interview question best reflects a belief related to holistic healthcare?
A.) “Can you tell me the names of the medications you are taking?”
B.) “Can you tell me how you normally handle stress?”
C.) “Can you tell me how long you have had your symptoms?”
D.) “Can you tell me your age and where you live?”
B. “Can you tell me how you normally handle stress?”
-By asking the patient how she handles stress, the nurse is eliciting information about the patient’s personality traits, health practices, and possibly spirituality, as well as the potential use of alternative modalities.
In order to provide safe, effective care, when assessing a client’s use of alternative therapies, the nurse should ask:
A.) “what herbal supplements have you taken?”
B.) “Have you ever used relaxation therapy?”
C.) “What types of activities or remedies do you use when you do not feel well?”
D.) “Do you use holistic treatments?’
a.) “What herbal supplements have you taken?”
-Phrasing the question in a nonjudgemental way allows the patient to provide an answer that they are comfortable with. It also encourages honesty and acceptance of the patient’s chosen activities.
Which healing modalities would be least appropriate for the patient receiving chemotherapy to use?
A.) Acupuncture
B.) Meditation
C.) Biofeedback
D.) Yoga
A.) Acupuncture
-Patients receiving chemotherapy are at risk of developing thrombocytopenia. Even the small needs used in acupuncture may cause undue bleeding if the thrombocytopenia is significant
You are assessing an older adult experiencing intense, acute pain related to a hip fracture. Her health record includes documented abuse of prescription narcotics. One hour after receiving the opioid dose she is moaning loudly in pain while rattling the bed rails. She repeatedly calls you for more pain reliever, even though you have already administrated analgesics as prescribed. What might you assume about what is going on in this situation?
-The healthcare provider and prescriber might be uncomfortable asking questions about alcohol and ilicit drug use and failed to obtain a thorough assessment of past history for narcotic use. However, gathering a reliable substance use history is important to provide a foundation for good pain management
-Previously the patient developed a tolerance to the opioid analgesic, based on prior exposure to the medication before this hospitalization (hip fracture)
-Healthcare providers and prescribers might be underdosing the patient in fear of contributing further to narcotic addition
-Healthcare providers might not have provided sufficient nonpharmacological therapies as an adjunct to opioid pain relievers
-There might e additional factors contributing to and aggravating the patient’s intensity of pain (e.g., fear and anxiety related to hospitalization, surgery, medical expenses, etc., past experience with pain; sociocultural expression of pain; insufficient family/social support system)
An obese, 65-year-old patient suffers with chronic back pain dur to a herniated disk that developed after a motor vehicle accident. How might you help him to achieve better pain control?
Following are some types of treatment for chronic back pain:
-Hot or cold therapy to soothe sore, stiff backs. Heat reduces muscle spasms and pain. Cold helps reduce swelling and numbs deep pain. Using hot or cold packs may relieve pain, but this treatment does not fix the cause of chronic back pain
-Exercise: helps to ease chronic pain but should not be used for acute back pain. Your doctor of physical therapist can tell you the best types of exercise to do
-Medications:
-Over-the counter drugs (acetaminophen, aspirin) or prescription pain medications
-Topical analgesics are creams, ointments, and salves that can be rubbed onto the skin over the site of pain.
-NSAIDs are drugs that reduce both pain and swelling. NSAIDs include over-the-counter drugs (e.g., ibuprofen, naproxen) or prescription-strength NSAIDs.
-Muscle relaxants
-Antidepressants
-Injections (e.g., corticosteroid) to lessen chronic pain.
-Complementary and alternative medical (CAM) therapy
-Manipulation: Chiropractic or soft tissue massage or active release therapy for the spine or supporting muscles and tissues.
-Transcutaneous electrical nerve stimulation (TENS) sends mild electrical pulses to nerves to interrupt the transmission of pain impulses. However, TENS treatments are not always effective for reducing pain.
-Acupuncture or acupressure may be effective when used as a part of a comprehensive treatment plan for low back pain.
-Surgery: Spinal fusion, laminectomy, foraminotomy, discectomy, disk replacement, interlaminar implant.
-Patient teaching: Instruct patients how to lift, push, and pull with less stress on the back. You can also help your patient to modify the way he moves his back, exercises, relaxes, and sleeps in order to lessen back pain. Eating a healthy diet and not smoking also helps.
A 45-year-old female patient with chronic pain secondary to fibromyalgia tells you that she is not having any relief from the pain medication she received 1 hour ago. the charge nurse has suggested additional pain medication. Based on theoretical knowledge and your own personal experiences what other interventions can you suggest, and why do you think they might work?
Massage Therapy
Maria is pregnant for the fourth time. She had one abortion at 8 weeks’ gestation. She has a daughter who was born at 40 weeks’ gestation and a son born at 34 weeks. What is her 5-digit and 2-digit system?
Five:
Gravida: 4
Term: 1
Preterm: 1
Abortion/miscarriage: 1
Living: 2
Two:
Gravida: 4
Para: 2
A woman’s cousin gave birth to an infant with a congenital heart anomaly. The woman asks the nurse when such anomalies occur during development Which response by the nurse is most accurate?
1.) “It depends on what caused the defect.”
2.) “We don’t really know when such defects occur.”
3.) They usually occur in the first 2 weeks of development.”
4.) “They occur between the third and fifth weeks of development.”
4.) “They occur between the third and fifth weeks of development.”
The hormonal reports of a pregnant female reveal increased estrogen levels in the body. Which related signs would the nurse find in the patient? Select all that apply.
1.) Mucoid discharge from the cervix
2.) Heaviness in the patient’s breast
3.) Well-defined pink blotches on the palm
4.) Milk discharge from the patient’s nipples
5.) Decreased chest expansion of the patient
1,2,5
A pregnant patient complains of constipation. While checking the patient’s history, the nurse learns that the patient is taking oral iron supplements. What instruction does the nurse give the patient to relieve constipation?
1.) To raise the woman’s legs
2.) To turn the woman on her side
3.) To have the woman breathe into a paper bag
4.) To assess the woman’s blood pressure and pulse
