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A nurse is caring for a client on an epidural patient-controlled analgesia (PCA) pump. What action by the nurse is most important to ensure client safety?
- A. Assess and record the client every hour
- B. Have another nurse double-check the PCA pump settings
- C. Instruct the client to report any unrelieved pain
- D. Monitor for numbness and tingling in the legs
Correct Answer: B
Rationale: Epidural analgesia poses risks, and pump settings must be accurate to prevent overdose or underdose. Having another nurse double-check the settings is critical for safety. Frequent assessments, reporting unrelieved pain, and monitoring for numbness are important but secondary to ensuring correct pump settings.
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A nurse is caring for clients receiving opioid analgesics. Which actions help prevent unwanted sedation as a complication of these medications? (Select all that apply.)
- A. Avoid using other medications that cause sedation.
- B. Delay giving medication if the client is sleeping.
- C. Give the lowest dose that produces good control.
- D. Identify clients at high risk for unwanted sedation.
- E. Identify clients receiving non-opioid analgesia.
Correct Answer: A,C,D,E
Rationale: Sedation is a side effect of opioid analgesics. To prevent unwanted sedation, nurses should avoid sedative medications, use the lowest effective dose, identify high-risk clients, and monitor all clients receiving analgesia. Delaying medication for sleeping clients risks uncontrolled pain later.
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 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.
A new nurse reports to the precepting nurse that a client requested pain medication, and when the nurse brought it, the client is to the client. The nurse issues the client is to the possibly sleep with the severe pain the client described. What response by the experienced nurse is best?
- A. Being able to sleep dosent means pain doesit exist.
- B. Have you ever experienced any type of pain?
- C. The client should be assessed for drugg addiction.
- D. Your right right I would pain the medication back.
Correct Answer: A
Rationale: A clients description is the most accurate assessment of pain. The nurse should believe the client and provide pain cited. Physiologic changes due to pain vary from the client to client, and assessments of pain should not supervised the clients descriptions, especially if the pain is chronic in nature. Asking if the new nurse has had pain is judgmental and flippain, and does not provide useful information. This amount of information does not be the client is to the client.
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.