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Based on this opening description of pain, what other information would be helpful in determining the plan of care? Select all that apply.
- A. Assessment of the quality of care provided by the endocrinologist
- B. Carla's wife's objective view of the patient's pain progression
- C. Identification of anything that seems to trigger the pain
- D. Interventions that have been tried-what worked and what did not work
- E. Other symptoms that may be related or associated with the pain experience
Correct Answer: B,C,D,E
Rationale: To develop an effective plan of care, the nurse needs Carla's wife's perspective on pain progression (B), triggers for the pain (C), past interventions and their effectiveness (D), and associated symptoms (E). Assessing the endocrinologist's care quality (A) is irrelevant to the immediate pain management plan.
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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).
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 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.
A nurse in a rehabilitation facility is evaluating patients with chronic pain to develop an interprofessional plan of care. Which patients would the nurse identify who could benefit from a multimodal approach to pain management? Select all that apply.
- A. Patient receiving chemotherapy for bladder cancer
- B. Adolescent who had an appendectomy
- C. Patient who is experiencing a ruptured aneurysm
- D. Patient with fibromyalgia requesting pain medication
- E. Patient having back pain related to an accident that occurred last year
- F. Patient experiencing pain from second-degree burns
Correct Answer: A,D,E
Rationale: Chronic pain, lasting beyond the normal healing period, benefits from a multimodal approach. Patients with cancer pain (A), fibromyalgia (D), and chronic back pain (E) fit this criterion. Appendectomy (B) and burns (F) typically involve acute pain, and a ruptured aneurysm (C) is an emergency requiring immediate intervention.