Nokea
The nurse is trying to establish an effective relationship with a patient in pain. What is the best statement for the nurse to make when beginning the assessment?
- A. I'll check to see if you can have anything.
- B. Let me give you a backrub and see if it helps.
- C. I believe you are in pain.
- D. When was your last medication for pain?
Correct Answer: C
Rationale: A nursing intervention to establish an effective relationship is to believe the patient. Although the other options are not wrong, they do not help establish an effective relationship.
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The home health nurse is caring for a patient with an implanted pacemaker. What type of pain management would be contraindicated?
- A. Peripheral analgesics
- B. A TENS unit
- C. Opioid analgesics
- D. Adjuvant analgesics
Correct Answer: B
Rationale: A TENS unit may interfere with the function of the pacemaker.
The nurse should administer an analgesic to an unconscious patient after observing which signs?
- A. Increased heart rate from 82 to 94
- B. Decreased systolic blood pressure
- C. Increased muscle tension
- D. Perspiration on upper lip
- E. Facial grimacing
Correct Answer: A,C,D,E
Rationale: Pain indicators in the unconscious patient might include increased heart rate, blood pressure, and muscle tension; diaphoresis; and grimacing.
The nurse is using a pain scale of 0 to 10 to assess pain in a postoperative patient. What is considered the maximum pain level at which a patient can usually function effectively?
- A. 2
- B. 3
- C. 4
- D. 5
Correct Answer: C
Rationale: Most patients do not function effectively if the pain level exceeds 4 on a scale of 10.
Why should a nurse promptly administer a prescribed analgesic after a pain assessment?
- A. The health care provider has ordered it.
- B. It is an efficient use of time.
- C. Unrelieved pain can cause setbacks.
- D. It meets the goals of the nursing care plan.
Correct Answer: C
Rationale: Appropriate pain management can bring about quicker recoveries, shorter hospital stays, fewer readmissions, and can improve the quality of life.
The nurse explains that transcutaneous electric nerve stimulation provides a continuous mild electric current to the skin. How does the TENS unit act to reduce pain?
- A. Distracts the patient.
- B. Blocks endorphin production.
- C. Warms the skin.
- D. Blocks pain impulses.
Correct Answer: D
Rationale: TENS works by blocking pain impulses.