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When discussing effective pain management with a group of nursing students, the instructor would include barriers that need to be overcome. Which of the following would the instructor most likely include? Select all that apply.
- A. Pharmacists do not provide an adequate supply of pain medication.
- B. Primary health care providers prescribe improper pain medicine doses.
- C. Nurses do not administer adequate medication for pain relief.
- D. Clients do not report accurate levels of pain.
- E. Clients have misperceptions about receiving pain medication.
Correct Answer: B,C,D
Rationale: The main barriers a nurse must overcome to obtain effective pain management in a client are primary health care providers who do not prescribe proper pain medicine doses, nurses who do not administer adequate medication for pain relief, and clients who do not report accurate levels of pain.
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A nurse informs a client who is prescribed meloxicam that he might experience visual disturbances. The client asks the nurse what types of visual disturbances may occur. Which of the following would the nurse include in the response? Select all that apply.
- A. Double vision
- B. Irreversible loss of color vision
- C. Sensitivity to light
- D. Blurred vision
- E. Halos around objects
Correct Answer: A,C,D
Rationale: The nurse should tell the client that NSAIDs like meloxicam can cause visual disturbances including blurred or diminished vision, double vision, swollen or irritated eyes, photophobia, and reversible loss of color vision.
A nurse is reviewing the medical records of several clients. In which of the following clients would the nurse identify that the use of an NSAID would be contraindicated? Select all that apply.
- A. A female client who is lactating
- B. A female client with a hypersensitivity to aspirin
- C. A female client in the first trimester of pregnancy
- D. A female client in the second trimester of pregnancy
- E. A female client in the third trimester of pregnancy
Correct Answer: A,B,E
Rationale: NSAIDs are contraindicated in clients with a hypersensitivity to aspirin. In general, NSAIDs are contraindicated during the third trimester of pregnancy (because they can induce labor) and during lactation.
A nurse is assessing a client's pain. When reporting the assessment findings to the primary health care provider to ensure the proper prescription for analgesic therapy for effective pain management, which of the following would be most important for the nurse to report? Select all that apply.
- A. Duration
- B. Aggravating factors
- C. Location
- D. Remitting factors
- E. Intensity
Correct Answer: C,E
Rationale: Although duration, aggravating and remitting factors, location, and intensity are important to assess, to ensure that the primary health care provider prescribes effective analgesics for pain management, the nurse needs to report two key assessments about pain: location and intensity.
A nurse is performing discharge teaching for a client who is prescribed ibuprofen. After teaching the client about the possible cardiovascular effects of the drug, the nurse determines that additional teaching is needed when the client states which of the following?
- A. My blood pressure may increase.
- B. My blood pressure won't change.
- C. I could develop congestive heart failure.
- D. I could experience a heart attack.
Correct Answer: B
Rationale: The client should be counseled that NSAIDs including ibuprofen may result in the following cardiovascular effects: increased or decreased blood pressure, congestive heart failure, cardiac arrhythmias, and myocardial infarction.
A client who is receiving ibuprofen asks the nurse, 'What should I take the drug with?' Which of the following would the nurse suggest in the response? Select all that apply.
- A. Milk
- B. Orange juice
- C. Food
- D. Clear liquids
- E. Antacids
Correct Answer: A,C,E
Rationale: The nurse should advise the patient to take ibuprofen (Motrin) with food, milk, or antacids.