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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.
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A faculty member explains to students the process by which pain is perceived by the client. Which processes does the faculty member include in the discussion? (Select all that apply.)
- A. Induction
- B. Modulation
- C. Sensory perception
- D. Transduction
- E. Transmission
Correct Answer: B,C,D,E
Rationale: The four processes involved in making pain a conscious experience are modulation, sensory perception, transduction, and transmission. Induction is not a recognized process in pain perception.
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.
A hospitalized client uses a transdermal fentanyl (Duragesic) patch for chronic pain. What action by the nurse is most important for client safety?
- A. Assess and record the client pain every 4 hours.
- B. Ensure the client is eating a high-fiber diet.
- C. Monitor the clients bowel function every shift.
- D. Remove the old patch when applying the new one.
Correct Answer: D
Rationale: The old fentanyl patch should be removed when applying a new patch to prevent accidental overdose. The other actions are appropriate but not as critical for safety.
A nurse on the postoperative inpatient unit receives a hand-off report on four clients using patient-controlled analgesia (PCA) pump. Which client should the nurse see first?
- A. Client who is presses to be sleeping soundly
- B. Client who no bolus request in 6 hours
- C. Client who is pressing the button every 10 minutes
- D. Client with a respiratory rate of a breathing rate.
Correct Answer: D
Rationale: Continuous delivery of opioid analgesia can lead to respiratory depression and extreme sedation. A respiratory rate of 8 breaths/min is below normal, so the nurse should first check this client. The client sleeping soundly could either be overly sedated or just comfortable and should be checked next. Pressing the button every 10 minutes indicates high pain levels, but the device prevents overdose. The client with no bolus request has well-controlled pain.
A nurse is assessing a clients pain and has elicited information on the location, quality, intensity, effect on location, quality, intensity, effect on location, quality, intensity, effect on... [incomplete question]. What is the next best step for the nurse to take?
- A. Document the findings and continue monitoring
- B. Administer pain medication immediately
- C. Consult with the physician for further orders
- D. Reassess the client's pain after 30 minutes
Correct Answer: A
Rationale: The nurse has gathered initial pain assessment data. The next best step is to document the findings and continue monitoring to track changes in the client's pain status. Administering medication without further evaluation or consulting the physician prematurely may not be appropriate, and reassessing after a set time may delay necessary interventions.