Nurs 421 Final Exam questions with correct answers
1. Pain management in the acute care setting Correct Answer-
a. What are the characteristics of acute pain? Correct Answer-
identifiable cause, injury to body tissues, protective, temporary, causes
activation of the SNS
b. What are the 3 types of acute pain? Correct Answer-Somatic pain-
When nerves from skin, subcutaneous tissue, bones, muscle, and blood
vessels are activated.
c. Visceral pain- Involves internal organs or body cavity linings.
d. Neuropathic pain-When there is direct injury to a peripheral nerve,
spinal cord, or brain
e. What happens to the SNS with regards to prolonged pain? Correct
Answer-With prolonged pain, sns response will diminish and eventually
not respond (reason why you cant use vital signs for pain assessment)
f. How do cultural implications affect the patinet's response to pain?
Correct Answer-Think about the cultural implications for this
person/patient (NBA player will be much more distressed about
breaking leg/achilles versus the average joe)
g. What are some notes to know about the acute pain assessment?
Correct Answer-5th v/s, subjective, primary source is the patient, most
accurate is the self-report, most patients in the high acuity setting cannot
self report and you must use other tools
,h. What are some things to gather with a pain hx assessment? Correct
Answer-Location
i. Intensity
j. Quality
k. Chronology/Pattern
l. Precipitating/Alleviating Factors
m. Associated Symptoms
n. Medications/Interventions
o. What are some behavioral observations made with pain? Correct
Answer-Restlessness
p. Muscle Tension
q. Facial Expression
r. Vocalization
s. Wound Guarding
t. SNS Stimulation
u. Restlessness is big indicator for pain and impending complications
v. What are some unidimensional pain assessment scales and what are
the advantage(s)? Correct Answer-Visual analog scale- VAS
w. Numeric rating scale- NRS
x. Verbal pain intensity scale- VPIS
y. Faces Pain Scale
,z. Behavioral Observation Scale
aa. Advantage is that it is quick
bb. What are the multidimensional tools for pain? What is the
advantage? Correct Answer-McGill Pain Questionnaire
cc. Sensory (1-10)
dd. Affective (11-15)
ee. Evaluative (16)
ff. Miscellaneous (17-20)
gg. The higher the score, the greater the pain
hh.
ii. Short-form McGill Pain Questionnaire
jj. Conscious patients
kk. Adequate vocabulary and cognitive function
ll. Advantage is more in depth and used for conscious patients (?)
mm. What is the relationship with pain and vital sign changes? Correct
Answer-Respiratory rate increase potential indicator of pain in
nonverbal patient
nn. Vital signs not specific for detection of pain
oo. Nervous system returns to homeostasis despite pain
pp. Absence of physiologic indicators does not preclude pain
qq. Other factors influencing vital signs
, rr. How does a nonverbal patient affect the pain assessment? Correct
Answer-don't want to have the wrong delivery method (decreased LOC
doesn't mean PCA)
ss. What is the multimodal method of pain management? Correct
Answer-Multimodal analgesia: using multiple agents to interrupt
transmission of pain via different pathways
tt. What are opioid analgesics, opium, opiates, and opioids? Correct
Answer-Opium: mixture of alkaloids from poppy seed
uu. Opiates: naturally occurring alkaloids (morphine or codeine
vv. Opioids: all compounds that work at opioid receptor sites
ww. What is nonopioid analgesics? Correct Answer-Pain management
enhanced by combination of opioid and nonopioid therapy
xx. Acetaminophen
yy. Aspirin
zz. Nonsteroidal anti-inflammatory drugs (N S A I Ds)
aaa. What is the best route for administration of pain relievers? Correct
Answer-oral along with NG tube, IV is the most rapid, IM/SC is the
least desired
bbb. Where do the epidural and intrathecal catheters sit? What are the
contraindications? Correct Answer-Epidural catheter: epidural space
ccc. Intrathecal catheter: subarachnoid space
1. Pain management in the acute care setting Correct Answer-
a. What are the characteristics of acute pain? Correct Answer-
identifiable cause, injury to body tissues, protective, temporary, causes
activation of the SNS
b. What are the 3 types of acute pain? Correct Answer-Somatic pain-
When nerves from skin, subcutaneous tissue, bones, muscle, and blood
vessels are activated.
c. Visceral pain- Involves internal organs or body cavity linings.
d. Neuropathic pain-When there is direct injury to a peripheral nerve,
spinal cord, or brain
e. What happens to the SNS with regards to prolonged pain? Correct
Answer-With prolonged pain, sns response will diminish and eventually
not respond (reason why you cant use vital signs for pain assessment)
f. How do cultural implications affect the patinet's response to pain?
Correct Answer-Think about the cultural implications for this
person/patient (NBA player will be much more distressed about
breaking leg/achilles versus the average joe)
g. What are some notes to know about the acute pain assessment?
Correct Answer-5th v/s, subjective, primary source is the patient, most
accurate is the self-report, most patients in the high acuity setting cannot
self report and you must use other tools
,h. What are some things to gather with a pain hx assessment? Correct
Answer-Location
i. Intensity
j. Quality
k. Chronology/Pattern
l. Precipitating/Alleviating Factors
m. Associated Symptoms
n. Medications/Interventions
o. What are some behavioral observations made with pain? Correct
Answer-Restlessness
p. Muscle Tension
q. Facial Expression
r. Vocalization
s. Wound Guarding
t. SNS Stimulation
u. Restlessness is big indicator for pain and impending complications
v. What are some unidimensional pain assessment scales and what are
the advantage(s)? Correct Answer-Visual analog scale- VAS
w. Numeric rating scale- NRS
x. Verbal pain intensity scale- VPIS
y. Faces Pain Scale
,z. Behavioral Observation Scale
aa. Advantage is that it is quick
bb. What are the multidimensional tools for pain? What is the
advantage? Correct Answer-McGill Pain Questionnaire
cc. Sensory (1-10)
dd. Affective (11-15)
ee. Evaluative (16)
ff. Miscellaneous (17-20)
gg. The higher the score, the greater the pain
hh.
ii. Short-form McGill Pain Questionnaire
jj. Conscious patients
kk. Adequate vocabulary and cognitive function
ll. Advantage is more in depth and used for conscious patients (?)
mm. What is the relationship with pain and vital sign changes? Correct
Answer-Respiratory rate increase potential indicator of pain in
nonverbal patient
nn. Vital signs not specific for detection of pain
oo. Nervous system returns to homeostasis despite pain
pp. Absence of physiologic indicators does not preclude pain
qq. Other factors influencing vital signs
, rr. How does a nonverbal patient affect the pain assessment? Correct
Answer-don't want to have the wrong delivery method (decreased LOC
doesn't mean PCA)
ss. What is the multimodal method of pain management? Correct
Answer-Multimodal analgesia: using multiple agents to interrupt
transmission of pain via different pathways
tt. What are opioid analgesics, opium, opiates, and opioids? Correct
Answer-Opium: mixture of alkaloids from poppy seed
uu. Opiates: naturally occurring alkaloids (morphine or codeine
vv. Opioids: all compounds that work at opioid receptor sites
ww. What is nonopioid analgesics? Correct Answer-Pain management
enhanced by combination of opioid and nonopioid therapy
xx. Acetaminophen
yy. Aspirin
zz. Nonsteroidal anti-inflammatory drugs (N S A I Ds)
aaa. What is the best route for administration of pain relievers? Correct
Answer-oral along with NG tube, IV is the most rapid, IM/SC is the
least desired
bbb. Where do the epidural and intrathecal catheters sit? What are the
contraindications? Correct Answer-Epidural catheter: epidural space
ccc. Intrathecal catheter: subarachnoid space
