Chapter 23: Limb Pain: Lower Extremity
1. A patient has had arthritic pain in her hips for several years since a hip fracture. She is able to
move around in her room and has not offered any complaints so far this morning. However, when asked, she
states that her pain is bad this morning and rates it at an 8 on a 1-to-10 scale.
What does the nurse suspect? The patient:
a. Is addicted to her pain medications and cannot obtain pain relief. b. Does not want to trouble
the nursing staff with her complaints.
c. Is not in pain but rates it high to receive pain medication.
d. Has experienced chronic pain for years and has adapted to it. ANS: D
Persons with chronic pain typically try to give little indication that they are in pain and, over
time, adapt to the pain. As a result, they are at risk for underdetection.
2. The nurse is reviewing the principles of pain. Which type of pain is due to an abnormal processing of the
pain impulse through the peripheral or central nervous system?
a. Visceral b. Referred
c. Cutaneous
d. Neuropathic
ANS: D
Neuropathic pain implies an abnormal processing of the pain message. The other types of pain are named
according to their sources.
3. A patient is complaining of severe knee pain after twisting it during a basketball game and is
requesting pain medication. Which action by the nurse is appropriate?
a. Completing the physical examination first and then giving the pain medication
b. Telling the patient that the pain medication must wait until after the x-ray images are completed c.
Evaluating the full range of motion of the knee and then medicating for pain
d. Administering pain medication and then proceeding with the assessment
ANS: D
According to the American Pain Society (1992), In cases in which the cause of acute pain is uncertain,
establishing a diagnosis is a priority, but symptomatic treatment of pain should be given while the
investigation is proceeding. With occasional exceptions, (e.g.,
the initial examination of the patient with an acute condition of the abdomen), it is rarely justified to defer
analgesia until a diagnosis is made. In fact, a comfortable patient is better able to cooperate with diagnostic
procedures.
4. A patient who has just returned from abdominal surgery states, I learned relaxation exercises, so I wont
need any drugs. Which statement about relaxation therapy should the nurse use to guide care for this
patient?
a. Relaxation therapy works much the same as a placebo.
b. Relaxation therapy is not useful for postoperative patients or for severe pain.
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1. A patient has had arthritic pain in her hips for several years since a hip fracture. She is able to
move around in her room and has not offered any complaints so far this morning. However, when asked, she
states that her pain is bad this morning and rates it at an 8 on a 1-to-10 scale.
What does the nurse suspect? The patient:
a. Is addicted to her pain medications and cannot obtain pain relief. b. Does not want to trouble
the nursing staff with her complaints.
c. Is not in pain but rates it high to receive pain medication.
d. Has experienced chronic pain for years and has adapted to it. ANS: D
Persons with chronic pain typically try to give little indication that they are in pain and, over
time, adapt to the pain. As a result, they are at risk for underdetection.
2. The nurse is reviewing the principles of pain. Which type of pain is due to an abnormal processing of the
pain impulse through the peripheral or central nervous system?
a. Visceral b. Referred
c. Cutaneous
d. Neuropathic
ANS: D
Neuropathic pain implies an abnormal processing of the pain message. The other types of pain are named
according to their sources.
3. A patient is complaining of severe knee pain after twisting it during a basketball game and is
requesting pain medication. Which action by the nurse is appropriate?
a. Completing the physical examination first and then giving the pain medication
b. Telling the patient that the pain medication must wait until after the x-ray images are completed c.
Evaluating the full range of motion of the knee and then medicating for pain
d. Administering pain medication and then proceeding with the assessment
ANS: D
According to the American Pain Society (1992), In cases in which the cause of acute pain is uncertain,
establishing a diagnosis is a priority, but symptomatic treatment of pain should be given while the
investigation is proceeding. With occasional exceptions, (e.g.,
the initial examination of the patient with an acute condition of the abdomen), it is rarely justified to defer
analgesia until a diagnosis is made. In fact, a comfortable patient is better able to cooperate with diagnostic
procedures.
4. A patient who has just returned from abdominal surgery states, I learned relaxation exercises, so I wont
need any drugs. Which statement about relaxation therapy should the nurse use to guide care for this
patient?
a. Relaxation therapy works much the same as a placebo.
b. Relaxation therapy is not useful for postoperative patients or for severe pain.
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