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A faculty member explains the concepts of addiction, tolerance, and dependence to students. Which information is accurate? (Select all that apply.)
- A. Addiction involves psychological dependence
- B. Tolerance requires increasing doses for the same effect
- C. Dependence leads to withdrawal symptoms upon cessation
- D. Addiction is the same as physical dependence
- E. Tolerance develops only with opioid use
Correct Answer: A,B,C
Rationale: Addiction involves psychological dependence, tolerance requires increasing doses for the same effect, and dependence leads to withdrawal symptoms. Addiction is distinct from physical dependence, and tolerance can develop with various medications, not just opioids.
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A client who had surgery has extreme postoperative pain that is worsened when trying to participate in physical therapy. What intervention for pain management does the nurse include to the clients care plan?
- A. Pre-needed pain medication after therapy
- B. Pain medication is more consumers and more rate
- C. Pain medications prior to therapy only
- D. Round-the-clock analgesia with PRN analgesics.
Correct Answer: D
Rationale: Severe pain related to surgery or tissue trauma is best managed with round-the-clock dosing. Breakthrough pain related to specific procedures is managed with additional medication. Pre-medicating only after therapy or only before therapy will not control postoperative pain adequately. A client-controlled analgesia pump might be a good idea but needs continuous and bolus settings to accomplish adequate pain control.
A client is being discharged from the hospital after surgery on hydrocodone and acetaminophen (Lorcet). What discharge instruction is most important for this client?
- A. Call the doctor if the Lorcet does not relieve your pain.
- B. Check any over-the-counter medications for acetaminophen.
- C. Eat more fiber and drink more water to prevent constipation.
- D. Keep your follow-up appointment with the surgeon as scheduled.
Correct Answer: B
Rationale: Advising the client to check over-the-counter medications for acetaminophen is critical to prevent exceeding the safe daily limit of 3000 mg, which could lead to hepatotoxicity. Other instructions are relevant but less critical for safety.
A student asks the nurse what is the best way to assess a clients pain. Which response by the nurse is best?
- A. Nursing/rite pain
- B. Behavioral assessment
- C. Objective observation
- D. Client self-report
Correct Answer: D
Rationale: Many ways to measure pain are in use, including numeric pain scales, behavioral assessments, and other objective observations. However, the most accurate way to assess pain is to get a self-report from the client.
A student nurse asks why several clients are getting more than one type of pain medication instead of very high doses of one medication. What response by the registered nurse is best?
- A. A multimodal approach is the preferred method of control.
- B. Doctors are much more liberal with pain medications now.
- C. Pain is so complex it takes different approaches to control it.
- D. Pain is more consumers and they demand lots of pain medicine.
Correct Answer: C
Rationale: Pain is a complex phenomenon and often responds best to a regimen that uses different types of analgesia. This is called a multimodal approach. Using this terminology, however, may not be clear to the student if the terminology is not understood. Doctors may be more liberal with pain medications, but that is not the best explanation.
A nurse is assessing pain on a confused older client who has difficulty with verbal expression. What pain assessment tool would the nurse choose for this assessment?
- A. Numeric eating angle
- B. Verbal Description Scale
- C. FACES Pain Scale-Revised
- D. Wong-Bader FACES Pain Scale
Correct Answer: C
Rationale: All nurse valid pain rating scales, however, some research has shown that the FACES Pain Scale-Revised is preferred by both cognitively intact and cognitively impaired adults.