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Students in a leadership class are discussing how social determinants of health affect pain management. Which statement is correct and should be included in the discussion?
- A. Outcomes of pain management are generally satisfactory regardless of income.
- B. Minority patients often receive excess medication.
- C. Patients from minority groups often wait a long time before seeking treatment for pain.
- D. Social determinants of health are unrelated to pain management.
Correct Answer: C
Rationale: Social determinants impact pain management; minority patients often delay seeking treatment due to access barriers, cultural factors, or mistrust (C). Outcomes vary by income (A), minority patients often receive less medication (B), and social determinants are related to pain management (D).
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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.
What other intervention(s) can be implemented for Carla?
- A. Nothing quite yet-we need to see how the medications work before implementing other interventions.
- B. The nurse could collaborate with Carla's wife to substitute the medications for placebos to see if the idea of medication helps the pain.
- C. Carla could take any number of over-the-counter (OTC) and herbal supplements to augment the medications.
- D. The nurse could ask Carla if she is willing to incorporate imagery, mindfulness, or other nonpharmacologic interventions.
Correct Answer: D
Rationale: Nonpharmacologic interventions like imagery and mindfulness (D) align with Carla's preference to avoid medications and can complement pharmacologic strategies. Waiting to assess medication effects (A) delays holistic care, placebos (B) are unethical, and indiscriminate OTC/herbal use (C) risks interactions and lacks evidence.
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 is assessing a patient receiving a continuous opioid infusion. For which outcome of treatment would the nurse immediately notify the primary care provider?
- A. A respiratory rate of 11/min with normal depth
- B. A sedation level of 4
- C. Mild forgetfulness
- D. Reported constipation
Correct Answer: B
Rationale: A sedation level of 4 (somnolent, minimal/no response) indicates risk of respiratory depression, requiring immediate provider notification and possible naloxone (B). A respiratory rate of 11/min (A) is not alarming, and forgetfulness or constipation (C, D) are less urgent.
A patient reports diffuse abdominal pain that is difficult to localize. The nurse documents this as which type of pain?
- A. Cutaneous
- B. Visceral
- C. Superficial
- D. Somatic
Correct Answer: B
Rationale: Visceral pain is poorly localized and originates in body organs like the abdomen (B). Cutaneous and superficial pain (A, C) involve the skin or subcutaneous tissue, while somatic pain (D) originates in tendons, ligaments, bones, or nerves and is more localized.