Nokea
The nurse applies the gate control theory of pain to provide pain relief to a patient with chronic lower back pain. What nursing intervention will help relieve pain by 'closing the gate'?
- A. Encouraging regular use of analgesics
- B. Applying moist heat to the area at intervals
- C. Reviewing the pain experience with the patient
- D. Ambulating the patient after administering medication
Correct Answer: B
Rationale: The gate control theory suggests stimulating large nerve fibers to block pain signals. Applying moist heat (B) stimulates these fibers to 'close the gate,' reducing pain perception. Analgesics (A), reviewing pain (C), or ambulation post-medication (D) do not directly target this mechanism.
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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 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.
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.
When the nurse assists a patient recovering from abdominal surgery to walk, the nurse observes that the patient grimaces, moves stiffly, and becomes pale. The nurse received in shift report that the patient has consistently refused pain medication. To help promote comfort, which additional data will the nurse gather? Select all that apply.
- A. Patient's understanding of or fear of taking prescribed analgesics
- B. Assessment of any current pain
- C. Presence of anxiety or additional stressors
- D. Assessment of the surgical incision for infection
- E. What the patient has eaten to this point
- F. Whether the patient is using the incentive spirometer
Correct Answer: A,B,C,D
Rationale: To promote comfort, the nurse should assess fears of analgesics (A), current pain (B), anxiety or stressors (C), and incision for infection (D), as these may explain refusal and pain behaviors. Diet (E) and spirometer use (F) are less directly related to pain management.