HIM EXAM 4 QUESTIONS AND
ANSWERS29
A new nurse reports to the precepting nurse that a client requested pain medication, and when
the nurse brought it, the client was sound asleep. The nurse states the client cannot possibly
sleep with the severe pain the client described. What response by the experienced nurse is
best? - ANSWERS -being able to sleep doesn't mean pain does not exist
The nurse in the surgery clinic is discussing an upcoming surgical procedure with a client. What
information provided by the nurse is most appropriate for the clients long-term outcome? -
ANSWERS -Discuss acceptable pain control after your operation with the surgeon.
A nurse is assessing pain on a confused older client who has difficulty with verbal expression.
What pain assessment tool would the nurse choose for this assessment? - ANSWERS -FACES
Pain Scale-Revised
The nurse is assessing a clients pain and has elicited information on the location, quality,
intensity, effect on functioning, aggravating and relieving factors, and onset and duration. What
question by the nurse would be best to ask the client for completing a comprehensive pain
assessment? - ANSWERS -what pain rating would be acceptable for you?
A nurse is assessing pain in an older adult. What action by the nurse is best? - ANSWERS -Sit
down, ask one question at a time, and allow the client to answer.
The nurse receives a hand-off report. One client is described as a drug seeker who is obsessed
with even tiny changes in physical condition and is on the light constantly asking for more pain
medication. When assessing this clients pain, what statement or question by the nurse is most
appropriate? - ANSWERS -Help me understand how pain is affecting you right now.
,A nurse on the medical-surgical unit has received a hand-off report. Which client should the
nurse see first? - ANSWERS -Client with new-onset abdominal pain, rated as an 8 on a 0-to-10
scale
A nurse uses the Checklist of Nonverbal Pain Indicators to assess pain in a nonverbal client with
advanced dementia. The client scores a zero. What action by the nurse is best? - ANSWERS -
Assess physiologic indicators and vital signs.
A student asks the nurse what is the best way to assess a clients pain. Which response by the
nurse is best? - ANSWERS -clients self report
A student nurse asks why several clients are getting more than one type of pain medication
instead of very high doses of one medication. What response by the registered nurse is best? -
ANSWERS -Pain is so complex it takes different approaches to control it.
A client who had surgery has extreme postoperative pain that is worsened when trying to
participate in physical therapy. What intervention for pain management does the nurse include
in the clients care plan? - ANSWERS -Round-the-clock analgesia with PRN analgesics
A nurse on the postoperative inpatient unit receives a hand-off report on four clients using
patient- controlled analgesia (PCA) pumps. Which client should the nurse see first? - ANSWERS -
Client with a respiratory rate of 8 breaths/min
A registered nurse (RN) and nursing student are caring for a client who is receiving pain
medication via patient-controlled analgesia (PCA). What action by the student requires the RN
to intervene? - ANSWERS -presses the clients button when the patient cannot reach it
A client is put on twice-daily acetaminophen (Tylenol) for osteoarthritis. What finding in the
clients health history would lead the nurse to consult with the provider over the choice of
medication? - ANSWERS -drinking 3-5 beers a day
, A nurse is preparing to give a client ketorolac (Toradol) intravenously for pain. Which
assessment findings would lead the nurse to consult with the provider? - ANSWERS -urine
output of 20ml/2 hours
A hospitalized client uses a transdermal fentanyl (Duragesic) patch for chronic pain. What action
by the nurse is most important for client safety? - ANSWERS -Remove the old patch when
applying the new one.
A hospitalized client has a history of depression for which sertraline (Zoloft) is prescribed. The
client also has a morphine allergy and a history of alcoholism. After surgery, several opioid
analgesics are prescribed. Which one would the nurse choose? - ANSWERS -Hydromorphone
(Dilaudid)
A client has received an opioid analgesic for pain. The nurse assesses that the client has a
Pasero Scale score of 3 and a respiratory rate of 7 shallow breaths/min. The clients oxygen
saturation is 87%. What action should the nurse perform first? - ANSWERS -Attempt to arouse
the client.
An older adult has diabetic neuropathy and often reports unbearable foot pain. About which
medication would the nurse plan to educate the client? - ANSWERS -Duloxetine (Cymbalta)
An emergency department (ED) manager wishes to start offering clients nonpharmacologic pain
control methodologies as an adjunct to medication. Which strategy would be most successful
with this client population? - ANSWERS -listening to music on a headset
An older client who lives alone is being discharged on opioid analgesics. What action by the
nurse is most important? - ANSWERS -request a home safety assessment
A nurse is caring for four clients receiving pain medication. After the hand-off report, which
client should the nurse see first? - ANSWERS -Client with a Pasero Scale score of 4
ANSWERS29
A new nurse reports to the precepting nurse that a client requested pain medication, and when
the nurse brought it, the client was sound asleep. The nurse states the client cannot possibly
sleep with the severe pain the client described. What response by the experienced nurse is
best? - ANSWERS -being able to sleep doesn't mean pain does not exist
The nurse in the surgery clinic is discussing an upcoming surgical procedure with a client. What
information provided by the nurse is most appropriate for the clients long-term outcome? -
ANSWERS -Discuss acceptable pain control after your operation with the surgeon.
A nurse is assessing pain on a confused older client who has difficulty with verbal expression.
What pain assessment tool would the nurse choose for this assessment? - ANSWERS -FACES
Pain Scale-Revised
The nurse is assessing a clients pain and has elicited information on the location, quality,
intensity, effect on functioning, aggravating and relieving factors, and onset and duration. What
question by the nurse would be best to ask the client for completing a comprehensive pain
assessment? - ANSWERS -what pain rating would be acceptable for you?
A nurse is assessing pain in an older adult. What action by the nurse is best? - ANSWERS -Sit
down, ask one question at a time, and allow the client to answer.
The nurse receives a hand-off report. One client is described as a drug seeker who is obsessed
with even tiny changes in physical condition and is on the light constantly asking for more pain
medication. When assessing this clients pain, what statement or question by the nurse is most
appropriate? - ANSWERS -Help me understand how pain is affecting you right now.
,A nurse on the medical-surgical unit has received a hand-off report. Which client should the
nurse see first? - ANSWERS -Client with new-onset abdominal pain, rated as an 8 on a 0-to-10
scale
A nurse uses the Checklist of Nonverbal Pain Indicators to assess pain in a nonverbal client with
advanced dementia. The client scores a zero. What action by the nurse is best? - ANSWERS -
Assess physiologic indicators and vital signs.
A student asks the nurse what is the best way to assess a clients pain. Which response by the
nurse is best? - ANSWERS -clients self report
A student nurse asks why several clients are getting more than one type of pain medication
instead of very high doses of one medication. What response by the registered nurse is best? -
ANSWERS -Pain is so complex it takes different approaches to control it.
A client who had surgery has extreme postoperative pain that is worsened when trying to
participate in physical therapy. What intervention for pain management does the nurse include
in the clients care plan? - ANSWERS -Round-the-clock analgesia with PRN analgesics
A nurse on the postoperative inpatient unit receives a hand-off report on four clients using
patient- controlled analgesia (PCA) pumps. Which client should the nurse see first? - ANSWERS -
Client with a respiratory rate of 8 breaths/min
A registered nurse (RN) and nursing student are caring for a client who is receiving pain
medication via patient-controlled analgesia (PCA). What action by the student requires the RN
to intervene? - ANSWERS -presses the clients button when the patient cannot reach it
A client is put on twice-daily acetaminophen (Tylenol) for osteoarthritis. What finding in the
clients health history would lead the nurse to consult with the provider over the choice of
medication? - ANSWERS -drinking 3-5 beers a day
, A nurse is preparing to give a client ketorolac (Toradol) intravenously for pain. Which
assessment findings would lead the nurse to consult with the provider? - ANSWERS -urine
output of 20ml/2 hours
A hospitalized client uses a transdermal fentanyl (Duragesic) patch for chronic pain. What action
by the nurse is most important for client safety? - ANSWERS -Remove the old patch when
applying the new one.
A hospitalized client has a history of depression for which sertraline (Zoloft) is prescribed. The
client also has a morphine allergy and a history of alcoholism. After surgery, several opioid
analgesics are prescribed. Which one would the nurse choose? - ANSWERS -Hydromorphone
(Dilaudid)
A client has received an opioid analgesic for pain. The nurse assesses that the client has a
Pasero Scale score of 3 and a respiratory rate of 7 shallow breaths/min. The clients oxygen
saturation is 87%. What action should the nurse perform first? - ANSWERS -Attempt to arouse
the client.
An older adult has diabetic neuropathy and often reports unbearable foot pain. About which
medication would the nurse plan to educate the client? - ANSWERS -Duloxetine (Cymbalta)
An emergency department (ED) manager wishes to start offering clients nonpharmacologic pain
control methodologies as an adjunct to medication. Which strategy would be most successful
with this client population? - ANSWERS -listening to music on a headset
An older client who lives alone is being discharged on opioid analgesics. What action by the
nurse is most important? - ANSWERS -request a home safety assessment
A nurse is caring for four clients receiving pain medication. After the hand-off report, which
client should the nurse see first? - ANSWERS -Client with a Pasero Scale score of 4
