Prioritization, Delegation, and Assignment: Practice Exercises for
the NCLEX Examination
LINDA A. LACHARITY, CANDICE K. KUMAGAI, BARBARA BARTZ
4th Edition
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Prioritization Delegation and Assignment 4th Edition LaCharity Test Bank
Chapter 1. Pain
MULTIPLE CHOICE
1.A client tells the nurse that she rarely experiences pain, but when she does, she
seeks medical attention. The nurse realizes this client understands that pain is
important because it:
1. is a protective system.
2. includes the automatic withdrawal reflex.
3. creates sensitivity to pain.
4. helps with healing.
ANS: 1
Pain is a protective system that includes protection from unsafe behaviors by use of
reflexes, memory, and avoidance. Even though the automatic withdrawal reflex is a
part of the pain response, it does not explain why pain is important. Pain does not
create sensitivity to pain. Pain does not help with healing.
PTS: 1 DIF: Analyze REF: Definitions and Implications of Pain
2.A client complains that the bed sheets touching his skin are extremely painful. The
nurse realizes this client is experiencing:
1. allodynia.
2. modulation.
3. kinesthesia.
4. proprioception.
ANS: 1
Allodynia or hyperalgesia is a state where a slight or nonpainful stimulus is
interpreted as very painful. Kinesthesia is the awareness of movement.
Proprioception is the awareness of body position. Modulation is an influencing factor
in the perception of pain.
PTS: 1 DIF: Analyze REF: Peripheral Nervous System
3.A client is complaining of severe abdomen pain. The nurse realizes this client is
experiencing which type of pain?
1. Neuralgia
2. Pathological
3. Somatic
4. Visceral
ANS: 4
Visceral pain is pain arising from the body organs or gastrointestinal tract. Somatic
pain is pain that originates from the bone, joints, muscles, skin, or connective pain.
Neuralgia and
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pathological pain are both types of pain that result from injury to a nerve or
malfunction of the neuronal transmission process or due to impaired regulation.
PTS:1DIF:AnalyzeREF:Types of Pain
4.A client, diagnosed with acute appendicitis, is experiencing abdominal pain. The
best way for the nurse to describe this clients pain would be:
1. chronic.
2. neuropathic.
3. referred.
4. acute.
ANS: 4
Acute pain onset is sudden and of short duration. Chronic pain is a sudden or slow
onset of mild to severe pain that lasts longer than 6 months. Referred pain is the
result of the transfer of visceral pain sensations to a body surface at a distance from
the actual origin. Neuropathic pain is paroxysmal pain that occurs along the branches
of a nerve.
PTS:1DIF:ApplyREF:Types of Pain
5.A client is observed holding a pillow over the abdominal region with both knees
flexed in a side-lying position. Vital signs assessment reveals an elevated blood
pressure and heart rate. Which of the following should the nurse say to this
client?
1. Can I get you anything?
2. Would you like something for pain?
3. You look comfortable.
4. Your blood pressure is up.
ANS: 2
Sympathetic responses to pain include elevated blood pressure and heart rate. And
since the client is hugging a pillow over the abdominal region with both knees flexed
in a side-lying position, the best thing for the nurse to say to this client is Would you
like something for pain? The other responses are incorrect because they do not
acknowledge that the client is experiencing pain.
PTS: 1 DIF: Apply REF: Assessing the Clinical Manifestations of Pain
6.A client experiencing chronic pain asks the nurse why she is not prescribed Demerol
like she received when she had a total knee replacement. Which of the following
should the nurse respond to this client?
1. You dont need something that strong.
2. That medication does not exist anymore.
3. That medication does not last very long.
4. It can cause you have high blood pressure.
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ANS: 3
Meperidine is no longer a major drug for acute or chronic pain due to its short
analgesic duration of 2 to 3 hours and the potential for accumulative toxic effects of
its metabolite, normeperidine. The best response for the nurse to make to the client
would be that medication does not last very long. The other responses are
inaccurate.
PTS:1DIF:ApplyREF:Opioid Analgesics
7.A client is informed that a tricyclic antidepressant medication is going to help
control his chronic pain. The nurse would expect the physician to prescribe:
1. Amitriptyline.
2. Baclofen.
3. Gabapentin.
4. Diazepam.
ANS: 1
Amitriptyline is an antidepressant. Gabapentin is an anticonvulsant. Baclofen is a
muscle relaxant. Diazepam is a benzodiazepine.
PTS: 1 DIF: Analyze REF: Adjuvant Medications
8. A client receiving around-the-clock medication for terminal cancer experiences
additional pain when performing activities of daily living. The nurse realizes this
client is experiencing:
1. breakthrough pain.
2. intractable pain.
3. psychosomatic pain.
4. acute pain.
ANS: 1
Breakthrough pain is commonly seen in the advanced stages of cancer. It is
spontaneous, unpredictable, and can be initiated by certain activities such as during
activities of daily living. Intractable pain is resistant to some or all forms of therapy.
Psychosomatic pain is that which has a psychological origin. The client is diagnosed
with terminal cancer. Acute pain has a sudden onset and resolves within 6 months.
PTS:1DIF:AnalyzeREF:Breakthrough Pain
9. A client recovering from surgery tells the nurse that she is nauseated and is
experiencing an increase in pain. Which of the following does this clients
symptoms suggest to the nurse?
1 The client is becoming dependent upon the pain medication.
.
2 The clients pain threshold is lower when experiencing nausea.
.
3 The client is experiencing withdrawal symptoms from pain medication.
.