Nokea
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.
You may also like to solve these questions
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 pregnant woman has received an epidural analgesic prior to delivery. Assessment for which outcome to the medication will the nurse prioritize?
- A. Pruritus
- B. Urinary retention
- C. Vomiting
- D. Respiratory depression
Correct Answer: D
Rationale: Respiratory depression (D) is the priority outcome to monitor with epidural opioids, as it is life-threatening. Pruritus, urinary retention, and vomiting (A, B, C) are less critical side effects.
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.
Which question by the nurse will be most helpful in determining whether a patient who is experiencing a myocardial infarction has referred pain?
- A. Did your chest pain last 2 minutes or less?
- B. Was the pain on the surface of your chest?
- C. Is this pain in your residual limb shooting or burning?
- D. Are you having any arm or shoulder pain?
Correct Answer: D
Rationale: Referred pain is perceived in an area distant from its origin, such as arm or shoulder pain during a myocardial infarction (D). Questions about duration (A), surface location (B), or phantom limb pain (C) are less relevant to identifying referred pain in this context.
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.