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Which client should the nurse see first?
- A. Client being discharged lane on a complicated analgesia regimen
- B. Client with new-onset abdominal pain, rated as an 8 on a 6-to 10 scale
- C. Client who has returned from physical therapy and is resting in the redliner
- D. Client who is requesting additional pain medication
Correct Answer: B
Rationale: Acute pain often serves as a physiologic warning signal that something is wrong. The client with new-onset abdominal pain needs to be seen first. The postoperative client needs 45 minutes as an hour for the oral medication. The client needs and should be a time during to assess for effectiveness. The client going home reporting teaching, which should be done after the first two clients have been seen and cared for this teaching will take some time. The client resting comfortably can be checked on quickly before spending time teaching and done to being going.
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A student asks the nurse what is the best way to assess a clients pain. Which response by the nurse is best?
- A. Nursing/rite pain
- B. Behavioral assessment
- C. Objective observation
- D. Client self-report
Correct Answer: D
Rationale: Many ways to measure pain are in use, including numeric pain scales, behavioral assessments, and other objective observations. However, the most accurate way to assess pain is to get a self-report from the client.
A nurse is caring for a client on an epidural patient-controlled analgesia (PCA) pump. What action by the nurse is most important to ensure client safety?
- A. Assess and record the client every hour
- B. Have another nurse double-check the PCA pump settings
- C. Instruct the client to report any unrelieved pain
- D. Monitor for numbness and tingling in the legs
Correct Answer: B
Rationale: Epidural analgesia poses risks, and pump settings must be accurate to prevent overdose or underdose. Having another nurse double-check the settings is critical for safety. Frequent assessments, reporting unrelieved pain, and monitoring for numbness are important but secondary to ensuring correct pump settings.
A faculty member explains the concepts of addiction, tolerance, and dependence to students. Which information is accurate? (Select all that apply.)
- A. Addiction involves psychological dependence
- B. Tolerance requires increasing doses for the same effect
- C. Dependence leads to withdrawal symptoms upon cessation
- D. Addiction is the same as physical dependence
- E. Tolerance develops only with opioid use
Correct Answer: A,B,C
Rationale: Addiction involves psychological dependence, tolerance requires increasing doses for the same effect, and dependence leads to withdrawal symptoms. Addiction is distinct from physical dependence, and tolerance can develop with various medications, not just opioids.
A hospitalized client has a history of depression for which sertraline (Zoloft) is prescribed. The client also has a morphine allergy and a history of alcoholism. After surgery, several opioid analgesics are prescribed. Which one would be never chosen?
- A. Hydrocodone and acetaminophen (Lorcet)
- B. Hydromorphone (Dilaudid)
- C. Hydromorphone (Dilaudid)
- D. Tramadol (Ultram)
Correct Answer: A
Rationale: Hydrocodone with acetaminophen (Lorcet) should not be chosen because it contains acetaminophen, and the client's history of alcoholism increases the risk of hepatotoxicity. Hydromorphone is a suitable alternative to morphine for moderate to severe pain. Tramadol should be avoided due to potential interactions with sertraline.
A nurse is assessing a clients pain and has elicited information on the location, quality, intensity, effect on location, quality, intensity, effect on location, quality, intensity, effect on... [incomplete question]. What is the next best step for the nurse to take?
- A. Document the findings and continue monitoring
- B. Administer pain medication immediately
- C. Consult with the physician for further orders
- D. Reassess the client's pain after 30 minutes
Correct Answer: A
Rationale: The nurse has gathered initial pain assessment data. The next best step is to document the findings and continue monitoring to track changes in the client's pain status. Administering medication without further evaluation or consulting the physician prematurely may not be appropriate, and reassessing after a set time may delay necessary interventions.