Nokea
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.
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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.
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.
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).
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.
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.