PrioritizationeDelegationeand Assignment4th Edition

, Prioritization Delegation and Assignment4th Edition LaCharity Test Bank
e e i# i# i# i# i#




Chapteri#1.i#Paini#MULT
i#IPLECHOICE

1.A i#client i#tells i#the nurse i#that i#she i#rarelyexperiencespain, i#but i#when i#she i#does, i#she i#seeks i#medical
e


i#attent i#ion. i#The i#nurse i#realizes i#this i#client understands i#that i#pain i#is i#important i#because i#it:
e




1. isa i#protective i#system.
2. includes the i#automatic i#withdrawal i#reflex.
e




3. creates i#sensitivity i#to pain. e



4. helps with i#healing.
e



ANS:i#1
Pain i#is i#a i#protective i#system i#that i#includes i#protection i#from i#unsafe i#behaviors i#by i#use i#of i#reflexes,
i#memor i#y, i#and i#avoidance. i#Even though i#the i#automatic i#withdrawal i#reflex i#is i#a i#part i#of i#the pain
e e


i#response, i#it i#does i#not i#explain i#why i#pain i#is i#important. i#Pain does i#not create i#sensitivity i#to i#pain.
e e


i#Pain does i#not i#help with i#he i#aling.
e e


PTS:i#1 i#DIF: i#Analyze i#REF: i#Definitionsi#and i#Implicationsi#of i#Pain
2.A i#client i#complainsthat i#the i#bed sheets i#touching i#his i#skin i#are i#extremely i#painful. i#The i#nurse
e


i#realizes i#t i#his i#client i#is i#experiencing:




1. allodynia.
2. modulation.
3. kinesthesia.
4. proprioception.
ANS:i#1
Allodynia i#or i#hyperalgesia i#is i#a i#state where i#a i#slight i#or i#nonpainful i#stimulus i#is i#interpreted i#asvery
e


i#painf i#ul. i#Kinesthesia i#is the awareness of i#movement. i#Proprioception i#is i#the awareness of i#body
e e e e e


i#position. i#M i#odulation is i#an influencing factor i#in i#the i#perception i#of i#pain.
e e e


PTS: i#1 i#DIF: i#Analyze i#REF: i#Peripheral i#Nervous i#System
3. A i#client i#is complainingof i#severe i#abdomen i#pain. i#The i#nurse i#realizes this i#client i#is i#experiencing
e e


i#whic i#h i#type i#of i#pain?




1. Neuralgia
2. Pathological
3. Somatic
4. Visceral
ANS:i#4
Viscerali#paini#ispaini#arisingi#fromi#thei#bodyi#organsi#ori#gastrointestinali#tract.i#Somatici#pain isi#paini#that e


i#originates i#from i#the i#bone, i#joints, i#muscles, i#skin, i#or i#connective i#pain. i#Neuralgia and e

,pathological i#pain i#are i#both i#types i#of i#pain that result i#from i#injury i#to i#a i#nerve i#or i#malfunction i#ofthe
e e


i#neuro i#nal i#transmission i#process i#or i#due i#to impaired i#regulation. e


PTS:1DIF:AnalyzeREF:Types i#of i#Pain
4. Aclient, i#diagnosed i#withacute i#appendicitis, i#isi#experiencingabdominal i#pain.i#The i#best i#wayi#for
i#the i#nurse i#to describe i#this i#clients i#pain would i#be:
e e




1. chronic.
2. neuropathic.
3. referred.
4. acute.
ANS:i#4
Acute pain i#onset i#is i#sudden i#and i#of i#short duration. i#Chronic i#pain i#is i#a i#sudden i#orslow i#onset i#of
e e


i#mild i#to i#se i#vere i#pain i#that lasts longer i#than i#6 i#months. i#Referred i#pain i#is i#the i#result of i#the i#transfer
e e e


i#of i#visceral i#pain i#se i#nsations i#to i#a i#body i#surface i#at i#a i#distance from the i#actual i#origin. i#Neuropathic
e e


i#pain i#is i#paroxysmal i#pain t i#hat i#occurs i#along i#the i#branches of i#a i # nerve.
e e


PTS:1DIF:ApplyREF:Types of i#Pain e


5. Ai#clienti#isobservedi#holdingi#ai#pillowi#overi#thei#abdominali#regioni#withi#bothi#knees flexedi#in a i#sid e e


i#e-

lying position.i#Vitali#signsi#assessmenti#revealsi#ani#elevatedi#bloodi#pressurei#andi#hearti#rate. i#Whichi#o
e


i#f i#the following i#should the i#nurse i#say i#to i#this i#client?
e e




1. Cani#I i#get i#you i#anything?
2. Would you i#like something i#for i#pain?
e e



3. You i#look i#comfortable.
4. Your i#blood pressure i#is i#up.
e



ANS:i#2
Sympathetic i#responsesi#toi#paini#includei#elevatedi#bloodi#pressurei#and heart rate.i#Andi#sincei#thei#clienti#is e e


i#hugging a pillow i#over i#the i#abdominal i#region i#with both i#knees i#flexed i#in i#a i#side-
e e e


lying position, i#the i#best i#thing i#for i#the i#nurse i#to i#sayi#to i#this client i#is i#Would i#you i#like i#something i#for
e e


i#pain? i#Thei#otheri#responses arei#incorrecti#becausei#theydoi#noti#acknowledgei#thati#thei#client
e


i#is experiencing pai i#n.
e e


PTS: i#1 i#DIF: i#Apply i#REF: i#Assessing i#the i#Clinical i#Manifestations i#of i#Pain
6. A i#client i#experiencingchronic i#pain i#asks i#the i#nursewhy i#she i#is i#not i#prescribed i#Demerol
i#like she recei i#ved when i#she i#had i#a total i#knee replacement. i#Which of i#the i#following i#should
e e e e e e


i#the nurse i#respond to i#this
e i # client?
e e




1. Youi#dont i#need i#somethingthat i#strong.
2. That medication i#does not i#exist i#anymore.
e e




3. Thatmedicationi#does noti#last i#very i#long.
e




4. It i#can i#cause i#you i#have i#high blood i#pressure. e e

, ANS:i#3
Meperidinei#isi#noi#longeri#ai#majori#drugi#fori#acutei#ori#chronic paini#duei#toi#itsi#shorti#analgesici#durationi#ofi#2
e


i#toi#3i#hoursi#andi#thei#potential i#for i#accumulative i#toxici#effects ofi#its metabolite, i#normeperidine. i#The
e e


i#best i#response i#for i#the i#nurse i#to i#make i#to i#the i#client i#would i#be i#that i#medication i#does i#not i#last very
e


i#long. i#The i#ot i#her i#responses i#are i#inaccurate.

PTS:1DIF:ApplyREF:Opioid i # Analgesics
7. Ai#clienti#is informedi#thati#ai#tricyclici#antidepressanti#medicationi#isi#goingi#toi#helpi#controli#his chronici#p
e e


i#ain. i#The i#nurse i#would i#expect the i#physician i#to i#prescribe:
e




1. Amitriptyline.
2. Baclofen.
3. Gabapentin.
4. Diazepam.
ANS:i#1
Amitriptylinei#isi#ani#antidepressant. i#Gabapentinisi#ani#anticonvulsant. i#Baclofenisi#ai#muscle i#relaxant.
i#Diazepam is i#a i#benzodiazepine.
e


PTS: i#1i#DIF: i#Analyze i#REF: i#Adjuvant i#Medications
8. Aclient i # receivingaround-the-
clocki#medication forterminali#canceri#experiencesi#additionali#paini#wheni#performingi#activities ofi#dail
e e


i#y i#living. i#The i#nurse realizes i#this i#client i#is i#experiencing:
e




1. breakthrough i#pain.
2. intractable i#pain.
3. psychosomatic i#pain.
4. acutei#pain.
ANS:i#1
Breakthrough i#pain i#is i#commonly i#seen i#in i#the i#advanced i#stages i#of i#cancer. i#It i#is i#spontaneous,
i#unpredicta i#ble, i#and i#can i#be i#initiated i#by i#certain i#activities i#such i#as i#during i#activities i#of i#daily

i#living. i#Intractable i#pain i#is resistant i#to i#some i#or i#all i#forms i#of i#therapy. i#Psychosomatic i#pain i#is
e


i#that i#which i#has a i#psychological i#orig i#in. i#The i#client i#is i#diagnosed i#with i#terminal i#cancer. i#Acute
e


i#pain has a i#sudden i#onset i#and i#resolves within i#6 i#months.
e e e


PTS:1DIF:AnalyzeREF:Breakthrough i # Pain
9. Aclienti#recoveringi#fromi#surgeryi#tellsi#thei#nursei#that she isi#nauseatedi#andi#isi#experiencingi#ani#increas
e e


i#e i#in i#pain. i#Which i#of i#the i#following i#does i#this clients i#symptoms suggest i#to i#the i#nurse?
e e




1 Theclienti#isi#becomingi#dependenti#upon thei#paini#medication.
e


.
2 The i#clients i#pain thresholdislower i#wheni#experiencing i#nausea.
e


.
3 Theclient i#isexperiencingwithdrawal i#symptoms i#from i#pain i#medication.
.