Nokea
How will the nurse and Carla know that the treatment plan has been effective?
- A. Carla is completely pain free but is taking large doses of OTC acetaminophen.
- B. Carla reports some pain but states she was able to engage in the full walking tour with occasional rest periods.
- C. Carla admits that she is not taking the medication because she has just learned to live with the pain.
- D. Carla tried a few nonpharmacologic recommendations but has opted to simply double the prescribed dose.
Correct Answer: B
Rationale: The treatment plan is effective if Carla achieves her functional goal of completing a walking tour with minimal pain and occasional rest (B), aligning with her stated goals of 1/10 pain at rest and 3/10 with activity. Complete pain relief with high acetaminophen doses (A) risks toxicity, ignoring medications (C) indicates nonadherence, and doubling doses (D) is unsafe.
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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.
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).
A nurse on an adult surgical floor enters a patient room and observes a family member pressing the button to administer a dose of PCA via the infusion pump. What response by the nurse is most appropriate?
- A. That dose will sure be helpful after their type of surgery.
- B. Having only the patient use the pump prevents respiratory complications.
- C. If the patient asked you to press the button, then it's OK.
- D. Since the pump has built in safeguards, you can help with pain management.
Correct Answer: B
Rationale: PCA by proxy (family administering doses) risks overdose, oversedation, and respiratory depression (B). Only the patient should press the PCA button, regardless of safeguards (D) or patient requests (C), and option A ignores the safety issue.
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.