ATI Med-Surg Proctored Exam Question Bank

ATI Med-Surg Proctored Exam Question BankMULTIPLE CHOICE 1. Which question asked by the nurse will give the most information about the patient’s metastaticbone cancer pain? a. “How long have you had this pain?” b. “How would you describe your pain?” c. “How much medication do you take forthe pain?” d. “How many times a day do you takemedication for the pain?” ANS: B 2. A patient who uses a fentanyl (Duragesic) patch for chronic cancer pain suddenly complains of rapid onset pain at a level 9 (0 to 10 scale) and requests “something for pain that will work now.”How will the nurse document the type of pain reported by this patient? a. Somatic pain b. Referred pain c. Neuropathic pain d. Breakthrough pain ANS: D 3. The nurse teaches a student nurse about the action of ibuprofen. Which statement, if made by thestudent, indicates that teaching was effective? a. “The drug decreases pain impulses in thespinal cord.” b. “The drug decreases sensitivity of thebrain to painful stimuli.” c. “The drug decreases production of pain-sensitizing chemicals.” d. “The drug decreases the modulating effectof descending nerves.” ANS: C 4. A nurse assesses a patient with chronic cancer pain who is receiving imipramine (Tofranil) in addition to long-acting morphine. Which statement, if made by the patient, indicates to the nursethat the patient is receiving adequate pain control? a. “I’m not anxious at all.” b. “I sleep 8 hours every night.” c. “I feel much less depressed since I’ve agradestuvia been taking the Tofranil.” d. “The pain is manageable and I canaccomplish my desired activities. ANS: D 5. A patient with chronic back pain has learned to control the pain with the use of imagery and hypnosis. The patient’s spouse asks the nurse how these techniques work. Which response by thenurse is best? a. “The strategies work by affecting theperception of pain.” b. “These techniques block the painpathways of the nerves.” c. “Both strategies prevent transmission ofpainful stimuli to the brain.” d. “The therapies slow the release of chemicals in the spinal cord that causepain.” ANS: A 6. A patient who is receiving sustained-release morphine sulfate (MS Contin) every 12 hours for chronic pain experiences level 9 (0 to 10 scale) breakthrough pain and anxiety. Which action bythe nurse is best? a. Provide amitriptyline (Elavil) 10 mgorally. b. Administer lorazepam (Ativan) 1 mgorally. c. Offer ibuprofen (Motrin) 400 to 800 mgorally. d. Give immediate-release morphine 30 mgorally. ANS: D 7. A patient with chronic neck pain is seen in the pain clinic for follow-up. In order to evaluatewhether the pain management is effective, which question is best for the nurse to ask? a. “Can you describe the quality of yourpain?” b. “Has there been a change in the painlocation?” c. “How would you rate your pain on a 0 to10 scale?” d. “Does the pain keep you from doingthings you enjoy?” ANS: D agradestuvia 8. A patient with second-degree burns has been receiving hydromorphone through patient- controlled analgesia (PCA) for a week. The patient wakes up frequently during the nightcomplaining of pain. What action by the nurse is most appropriate? a. Administer a dose of morphine every 1 to 2 hours from the PCA machine while the patient is sleeping. b. Consult with the health care provider about using a different treatment protocolto control the patient’s pain. c. Request that the health care provider ordera bolus dose of morphine to be given when the patient awakens with pain. d. Teach the patient to push the button every10 minutes for an hour before going to sleep, even if the pain is minimal. ANS: B 9. The nurse assesses that a patient receiving epidural morphine has not voided for over 10 hours.What action should the nurse take initially? a. Monitor for withdrawal symptoms. b. Place an indwelling urinary catheter. c. Ask if the patient feels the need to void. d. Document this allergic reaction in thepatient’s chart. ANS: C 10. When visiting a hospice patient, the nurse assesses that the patient has a respiratory rate of 11breaths/minute and complains of severe pain. Which action is best for the nurse to take? a. Inform the patient that increasing the morphine will cause the respiratory driveto fail. b. Tell the patient that additional morphine can be administered when the respirationsare 12. c. Titrate the prescribed morphine doseupward until the patient indicates adequate pain relief. d. Administer a nonopioid analgesic, such asa nonsteroidal antiinflammatory drug (NSAID), to improve patient pain control. ANS: C 11. The nurse is completing the medication reconciliation form for a patient admitted with chronic agradestuvia cancer pain. Which medication is of most concern to the nurse? a. Amitriptyline (Elavil) 50 mg at bedtime b. Ibuprofen (Advil) 800 mg 3 times daily c. Oxycodone (OxyContin) 80 mg twicedaily d. Meperidine (Demerol) 25 mg every 4hours ANS: D 12. The nurse reviews the medication administration record in order to choose the most appropriate pain medication for a patient with cancer who describes the pain as “deep, aching and at a level 8on a 0 to 10 scale”. Which medication should the nurse administer? a. Fentanyl (Duragesic) patch b. Ketorolac (Toradol) tablets c. Hydromorphone (Dilaudid) IV d. Acetaminophen (Tylenol) suppository ANS: C 13. The nurse is caring for a patient who has diabetes and complains of chronic burning leg pain even when taking oxycodone (OxyContin) twice daily. When reviewing the orders, which prescribed medication is the best choice for the nurse to administer as an adjuvant to decreasethe patient’s pain? a. Aspirin (Ecotrin) b. Celecoxib (Celebrex) c. Amitriptyline (Elavil) d. Acetaminophen (Tylenol) ANS: C 14. A patient who uses a fentanyl (Duragesic) patch for chronic abdominal pain caused by ovarian cancer asks the nurse to administer the prescribed hydrocodone (Vicodin) tablets, but the patientis asleep when the nurse returns w