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A nurse is caring for patients in a hospital setting. Which patient would the nurse place at risk for pain related to the mechanical activation of pain receptors?
- A. Older adult on bedrest following cervical spine surgery
- B. Patient with a severe sunburn being treated for dehydration
- C. Industrial worker who has burns caused by a caustic acid
- D. Patient experiencing cardiac disturbances from an electrical shock
Correct Answer: A
Rationale: Mechanical activation of pain receptors occurs from friction or pressure, such as pressure sores from bedrest in an older adult post-cervical spine surgery (A). Sunburn (B) and acid burns (C) are thermal and chemical stimulants, respectively, while electrical shock (D) is an electrical stimulant.
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When the nurse assists a patient recovering from abdominal surgery to walk, the nurse observes that the patient grimaces, moves stiffly, and becomes pale. The nurse received in shift report that the patient has consistently refused pain medication. To help promote comfort, which additional data will the nurse gather? Select all that apply.
- A. Patient's understanding of or fear of taking prescribed analgesics
- B. Assessment of any current pain
- C. Presence of anxiety or additional stressors
- D. Assessment of the surgical incision for infection
- E. What the patient has eaten to this point
- F. Whether the patient is using the incentive spirometer
Correct Answer: A,B,C,D
Rationale: To promote comfort, the nurse should assess fears of analgesics (A), current pain (B), anxiety or stressors (C), and incision for infection (D), as these may explain refusal and pain behaviors. Diet (E) and spirometer use (F) are less directly related to pain management.
When developing the care plan for a patient with chronic pain, the nurse plans interventions based on the knowledge that chronic pain not related to cancer or palliative/end-of-life care is most effectively relieved through which method?
- A. Providing the highest effective dose of an opioid on a PRN (as needed) basis
- B. Using nonopioid drugs conservatively
- C. Applying multimodal nonpharmacologic and nonopioid pharmacologic therapies
- D. Administering a continuous intravenous infusion on a regular basis
Correct Answer: C
Rationale: Multimodal nonpharmacologic and nonopioid therapies (C) are preferred for chronic pain unrelated to cancer or palliative care. High-dose PRN opioids (A) are not ideal, nonopioids should not be used conservatively (B), and continuous IV infusions (D) are typically for acute or palliative settings.
A nurse plans to promote a patient's natural pain mediators by using a whirlpool following intensive physical therapy to the legs. What is a potent pain-blocking neuromodulator, released through relaxation techniques?
- A. Prostaglandins
- B. Substance P
- C. Endorphins
- D. Serotonin
Correct Answer: C
Rationale: Endorphins are powerful pain-blocking neuromodulators released through relaxation techniques like whirlpool therapy (C). Prostaglandins and substance P (A, B) enhance pain transmission, and serotonin (D) primarily affects mood and smooth muscle function.
A postoperative patient asks the nurse about pain management following surgery. What teaching will the nurse provide?
- A. Avoid asking for pain medication often, as it can be addictive.
- B. It is better to wait until the pain is severe before asking for pain medication.
- C. It's natural to have pain after surgery; it will lessen in intensity in a few days.
- D. You will be more comfortable if you take the medication at regular intervals.
Correct Answer: D
Rationale: Patients should take pain medication at regular intervals to prevent severe pain (D). Waiting until pain is severe (B) makes it harder to control, and addiction is rare with short-term use (A). Pain should be managed, not accepted as natural (C).
A nurse is caring for patients who are nonverbal. What are examples of behavioral responses to pain? Select all that apply.
- A. Cradling a wrist that was injured in a car accident
- B. Moaning and crying from abdominal pain
- C. Increasing pulse following a myocardial infarction
- D. Striking out at a nurse who attempts to provide a bath
- E. Acting depressed and withdrawn while experiencing chronic cancer pain
- F. Pulling away from a nurse trying to give an injection
Correct Answer: A,B,D,F
Rationale: Behavioral responses include cradling an injured area (A), moaning and crying (B), striking out (D), and pulling away (F). Increased pulse (C) is a physiologic response, and depression/withdrawal (E) is an affective response.