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A burn patient is experiencing anxiety over dressing changes. Which prescription should the nurse expect to be ordered to control anxiety?
- A. Lorazepam (Ativan)
- B. Oxycodone (OxyContin)
- C. Fentanyl (Sublimaze)
- D. Morphine Sulfate (Morphine)
Correct Answer: A
Rationale: A benzodiazepine such as lorazepam is prescribed as an antianxiety agent. Oxycodone, fentanyl, and morphine sulfate are opioid analgesics.
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A cancer patient is experiencing neuropathic cancer pain. Which prescription should the nurse expect to be ordered to control anxiety?
- A. Lorazepam (Ativan)
- B. Gabapentin (Neurontin)
- C. Hydromorphone (Dilaudid)
- D. Morphine sulfate (MS Contin)
Correct Answer: B
Rationale: Anticonvulsants (gabapentin, carbamazepine) have demonstrated effectiveness in neuropathic cancer pain. Ativan is an antianxiety agent, and Dilaudid and MS Contin are opioid analgesics.
The nurse is planning to administer a nonopioid for pain relief to a child. Which timing should the nurse plan to ensure maximum effect?
- A. 15 minutes until maximum effect
- B. 30 minutes until maximum effect
- C. 1 hour until maximum effect
- D. 1 1/2 hours until maximum effect
Correct Answer: C
Rationale: Nonsteroidal antiinflammatory drugs (NSAIDs) can provide safe and effective pain relief when dosed at appropriate levels with adequate frequency. Most NSAIDs take about 1 hour for effect, so timing is crucial.
The nurse is planning pain control for a child. Which is the advantage of administering pain medication by the intravenous (IV) bolus route?
- A. Less expensive than oral medications
- B. Produces a first-pass effect through the liver
- C. Does not need to be administered frequently
- D. Provides most rapid onset of effect, usually in about 5 minutes
Correct Answer: D
Rationale: The advantage of pain medication by the IV bolus route is that it provides the most rapid onset of effect, usually in about 5 minutes. IV medications are more expensive than oral medications, and the IV route bypasses the first-pass effect through the liver. Pain control with IV bolus medication needs to be repeated hourly for continuous pain control.
Which is the most consistent and commonly used data for assessment of pain in infants?
- A. Self-report
- B. Behavioral
- C. Physiologic
- D. Parental report
Correct Answer: B
Rationale: Behavioral assessment is useful for measuring pain in young children and preverbal children who do not have the language skills to communicate that they are in pain. Infants are not able to self-report. Physiologic measures are not able to distinguish between physical responses to pain and other forms of stress. Parental report without a structured tool may not accurately reflect the degree of discomfort.
The nurse is teaching a staff development program about levels of sedation in the pediatric population. Which statement by one of the participants should indicate a correct understanding of the teaching?
- A. With minimal sedation, the patients respiratory efforts are affected, and cognitive function is not impaired.
- B. With general anesthesia, the patients airway cannot be maintained, but cardiovascular function is maintained.
- C. During deep sedation, the patient can be easily aroused by loud verbal commands and tactile stimulation.
- D. During moderate sedation, the patient responds to verbal commands but may not respond to light tactile stimulation.
Correct Answer: D
Rationale: When discussing levels of sedation, the participants should understand that during moderate sedation, the patient responds to verbal commands but may not respond to light tactile stimulation, cognitive function is impaired, and respiratory function is adequate. In minimal sedation, the patient responds to verbal commands and may have impaired cognitive function; the respiratory and cardiovascular systems are unaffected. In deep sedation, the patient cannot be easily aroused except by painful stimuli; the airway and spontaneous ventilation may be impaired, but cardiovascular function is maintained. With general anesthesia, the patient loses consciousness and cannot be aroused with painful stimuli, the airway cannot be maintained, and ventilation is impaired; cardiovascular function may or may not be impaired.