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You are the emergency department (ED) nurse caring for an adult patient who was in a motor vehicle accident. Radiography reveals an ulnar fracture. What type of pain are you addressing when you provide care for this patient?
- A. Chronic
- B. Acute
- C. Intermittent
- D. Osteopenic
Correct Answer: B
Rationale: Acute pain is usually of recent onset and commonly associated with a specific injury. Acute pain indicates that damage or injury has occurred. Chronic pain is constant or intermittent pain that persists beyond the expected healing time and that can seldom be attributed to a specific cause or injury. Phantom pain occurs when the body experiences a loss, such as an amputation, and still feels pain in the missing part. Osteopenic pain is not a recognized category of pain.
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The nurse caring for a 91-year-old patient with osteoarthritis is reviewing the patients chart. This patient is on a variety of medications prescribed by different care providers in the community. In light of the QSEN competency of safety, what is the nurse most concerned about with this patient?
- A. Depression
- B. Chronic illness
- C. Inadequate pain control
- D. Drug interactions
Correct Answer: D
Rationale: Drug interactions are more likely to occur in older adults because of the higher incidence of chronic illness and the increased use of prescription and OTC medications. The other options are all good answers for this patient because of the patients age and disease process. However, they are not what the nurse would be most concerned about in terms of ensuring safety.
You are caring for a 20-year-old patient with a diagnosis of cerebral palsy who has been admitted for the relief of painful contractures in his lower extremities. When creating a nursing care plan for this patient, what variables should the nurse consider? Select all that apply.
- A. Patients gender
- B. Patients comorbid conditions
- C. Type of procedure be performed
- D. Changes in neurologic function due to the procedure
- E. Prior effectiveness in relieving the pain
Correct Answer: B,C,D,E
Rationale: The nursing care of patients who undergo procedures for the relief of chronic pain depends on the type of procedure performed, its effectiveness in relieving the pain, and the changes in neurologic function that accompany the procedure. The patients comorbid conditions will also affect care, but his gender is not a key consideration.
You are the nurse caring for the 25-year-old victim of a motor vehicle accident with a fractured pelvis and a ruptured bladder. The nurses aide (NA) tells you that she is concerned because the patients resting heart rate is 110 beats per minute, her respirations are 24 breaths per minute, temperature is 99.1 F axillary, and the blood pressure is 125/85 mm Hg. What other information is most important as you assess this patients physiologic status?
- A. The patients understanding of pain physiology
- B. The patients serum glucose level
- C. The patients white blood cell count
- D. The patients rating of her pain
Correct Answer: D
Rationale: The nurses assessment of the patients pain is a priority. There is no suggestion of diabetes and leukocytosis would not occur at this early stage of recovery. The patient does not need to fully understand pain physiology in order to communicate the presence, absence, or severity of pain.
The nurse is applying knowledge of the pathophysiology of pain when planning this patients nursing care. What is the physiologic process by which noxious stimuli, such as burns, activate nociceptors?
- A. Transduction
- B. Transmission
- C. Perception
- D. Modulation
Correct Answer: A
Rationale: Transduction refers to the processes by which noxious stimuli, such as a surgical incision or burn, activate primary afferent neurons called nociceptors. Transmission, perception, and modulation are subsequent to this process.
The nurse is caring for a male patient whose diagnosis of bone cancer is causing severe and increasing pain. Before introducing nonpharmacological pain control interventions into the patients plan of care, the nurse should teach the patient which of the following?
- A. Nonpharmacological interventions must be provided by individuals other than members of the healthcare team.
- B. These interventions will not directly reduce pain, but will refocus him on positive stimuli.
- C. These interventions carry similar risks of adverse effects as analgesics.
- D. Reducing his use of analgesics is not the purpose of these interventions.
Correct Answer: D
Rationale: Patients who have been taking analgesic agents may mistakenly assume that clinicians suggest a nonpharmacolgical method to reduce the use or dose of analgesic agents. Nonpharmacological interventions indeed reduce pain and their use is not limited to practitioners outside the healthcare team. In general, adverse effects are minimal.