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Chapter 31 Pain, Comfort, and Sleep

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Chapter 31 Pain, Comfort, and Sleep










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Chapter 31: Pain, Comfort, and Sleep



MULTIPLE CHOICE

1. The nurse assesses a patient’s sleep for NREM (non–rapid eye movement) sleep because
this sleep has the characteristics of:
a. daytime activity.
b. offering the most rest.
c. irregular respirations.
d. increased heart rate.
ANS: B
NREM sleep is the stage of sleep when the body receives the most rest.

DIF: Cognitive Level: Comprehension REF: p. 609 OBJ: Theory #5
TOP: NREM Sleep KEY: Nursing Process Step: Assessment
MSC: NCLEX: Physiological Integrity: Basic Care and Comfort

2. A patient experiencing discomfort because of severe arthritis would be described as having
pain.
a. acute
b. chronic
c. phantom
d. episodic
ANS: B
Chronic pain is pain in which symptoms are controlled, but there is no cure, such as in
arthritis.

DIF: Cognitive Level: Comprehension REF: p. 594
OBJ: Clinical Practice #2 TOP: Types of Pain
KEY: Nursing Process Step: Assessment
MSC: NCLEX: Physiological Integrity: Basic Care and Comfort

3. A patient is beginning treatment for pain with a transcutaneous electrical nerve stimulator
(TENS) unit. The nurse will initially:
a. apply conductive jelly to uncoated electrodes.
b. turn the unit on before attaching it to the patient.
c. place electrodes on all four extremities.
d. adjust the settings below the level at which a tingling sensation is felt.
ANS: A
Conductive jelly is applied to electrodes that are not precoated to assure conductivity.

DIF: Cognitive Level: Application REF: p. 601
OBJ: Clinical Practice #4 TOP: TENS
KEY: Nursing Process Step: Implementation
MSC: NCLEX: Physiological Integrity: Basic Care and Comfort

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4. The patient with a recent abdominal incision has an abdominal binder applied. The nurse
explains that this appliance helps reduce pain by:
a. increasing warmth to the incision site.
b. keeping sutures and staples in place.
c. supporting surface and internal tissues.
d. adding back support to enhance early ambulation.
ANS: C
Binders are cloths wrapped around a limb or body part that have an incision and are
effective in reducing pain associated with strains, sprains, and surgical incisions by
providing support to the surface of the area as well as the internal tissues.

DIF: Cognitive Level: Comprehension REF: p. 601
OBJ: Clinical Practice #4 TOP: Pain Control
KEY: Nursing Process Step: Assessment
MSC: NCLEX: Physiological Integrity: Basic Care and Comfort

5. A nurse evaluating the effectiveness of an Aquathermia K pad for the leg is aware that the
patient who has the least risk for burn injury from this device would be the patient with:
a. impaired peripheral circulation.
b. severely sprained ankle.
c. decreased level of consciousness from a stroke.
d. neuritis secondary to diabetes.
ANS: B
Patients with poor circulation, impaired movement or feeling, or decreased level of
consciousness are more at risk for injury from burns when applications of heat are used.

DIF: Cognitive Level: Analysis REF: p. 602
OBJ: Clinical Practice #4 TOP: Heat Application
KEY: Nursing Process Step: Planning
MSC: NCLEX: Safe, Effective Care Environment: Safety and Infection Control

6. A nurse caring for a patient who suffered a severe sprain and has an order for a cold pack
application to the injured area would prevent patient injury by:
a. using heavy pressure on the cold pack for greater effectiveness.
b. preparing to apply heat instead if cold is not effective.
c. leaving the pack in place for over 30 minutes at a time.
d. placing a towel between the pack and the skin.
ANS: D
A protective towel or pad should be placed between the pack and the skin to avoid cold
injury.

DIF: Cognitive Level: Application REF: p. 602
OBJ: Clinical Practice #4 TOP: Cold Application
KEY: Nursing Process Step: Implementation
MSC: NCLEX: Safe, Effective Care Environment: Safety and Infection Control

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