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A patient is receiving a multimodal medication regimen as part of the treatment plan for neuropathic phantom limb pain. When the patient reports a bloody bowel movement, which medication prescription requires notification of the provider?
- A. Acetaminophen
- B. Nonsteroidal antiinflammatory
- C. Opioid medication
- D. Antianxiety medication
Correct Answer: B
Rationale: NSAIDs (B) can interfere with platelet function and increase bleeding risk, necessitating provider notification for a bloody bowel movement. Acetaminophen (A), opioids (C), and antianxiety medications (D) are less likely to cause gastrointestinal bleeding.
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When assessing pain in a child, the nurse needs to be aware of what considerations?
- A. Immature neurologic development results in reduced pain sensation
- B. Inadequate or inconsistent relief of pain is widespread
- C. Reliable assessment tools are currently unavailable
- D. Narcotic analgesic use should be avoided
Correct Answer: B
Rationale: Inadequate or inconsistent pain relief in children is a widespread issue (B). Children feel pain, reliable assessment tools exist, and opioids can be used safely with careful monitoring, making A, C, and D incorrect.
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).
During postconference, nursing students are exploring definitions of pain and its nature. Which statements should be included in this discussion? Select all that apply.
- A. It is whatever the health care provider treating the pain says it is.
- B. Pain exists whenever the person experiencing it says it is present.
- C. It is an emotional and sensory reaction to tissue damage.
- D. Pain is a simple, universal, and easy-to-describe phenomenon.
- E. When a cause cannot be identified, pain is psychological in nature.
- F. It is classified by duration, location, source, transmission, and etiology.
Correct Answer: B,C,F
Rationale: Pain is defined as whatever the patient says it is (B), an emotional and sensory reaction to tissue damage (C), and classified by duration, location, source, transmission, and etiology (F). It is not defined by the provider (A), nor is it simple or universal (D). Pain without an identifiable cause is not necessarily psychological (E).
Based on the objective and subjective assessment of this patient, where should the nurse focus the initial efforts of the interprofessional team?
- A. Collaborating with the endocrinologist to manage the patient's blood glucose and A1c
- B. Consulting psychiatry to set up a medication regimen to treat the patient's anxiety and depression
- C. Working with the provider, the patient, and the patient's wife to address functional pain goals
- D. Providing detailed information on the microvascular and macrovascular complications of type 2 diabetes
Correct Answer: C
Rationale: The priority is addressing Carla's functional pain goals (C) to improve her quality of life, as her pain impacts her daily functioning and stress affects her diabetes management. While glucose control (A) and psychiatric consultation (B) are relevant, pain management is the immediate focus. Education on complications (D) is secondary to addressing current pain.
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.