Practice Exercises for the NCLEX Exam –
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4th Edition
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TEST BANK
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Linda A. LaCharity
Candice K. Kumagai
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Barbara Bartz
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Comprehensive Test Bank for Instructors and
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Students
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© Linda A. LaCharity, Candice K. Kumagai & Barbara Bartz
All rights reserved. Reproduction or distribution without permission is prohibited.
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©STUDYSTREAM
, Prioritization Delegation and Assignment 4th Edition LaCharity Test Bank
Chapter 1. Pain
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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:
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1. is a protective system.
2. includes the automatic withdrawal reflex.
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3. creates sensitivity to pain.
4. helps with healing.
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SOLUTION: 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
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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 REFERENCE: Definitions and Implications of Pain
2.A client complains that the bed sheets touching his skin are extremely painful. The nurse
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realizes this client is experiencing:
1. allodynia.
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2. modulation.
3. kinesthesia.
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4. proprioception.
SOLUTION: 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.
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PTS: 1 DIF: Analyze REFERENCE: Peripheral Nervous System
3.A client is complaining of severe abdomen pain. The nurse realizes this client is experiencing
which type of pain?
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1. Neuralgia
2. Pathological
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3. Somatic
4. Visceral
SOLUTION: 4
Visceral pain is pain arising from the body organs or gastrointestinal tract. Somatic pain is pain
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that originates from the bone, joints, muscles, skin, or connective pain. Neuralgia and
, 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: Analyze REFERENCE:Types of Pain
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4.A client, diagnosed with acute appendicitis, is experiencing abdominal pain. The best way for
the nurse to describe this clients pain would be:
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1. chronic.
2. neuropathic.
3. referred.
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4. acute.
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SOLUTION: 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
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is paroxysmal pain that occurs along the branches of a nerve.
PTS:1DIF:Apply REFERENCE: 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.
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Which of the following should the nurse say to this client?
1. Can I get you anything?
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2. Would you like something for pain?
3. You look comfortable.
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4. Your blood pressure is up.
SOLUTION: 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?
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The other responses are incorrect because they do not acknowledge that the client is experiencing
pain.
PTS: 1 DIF: Apply REFERENCE: Assessing the Clinical Manifestations of Pain
6.A client experiencing chronic pain asks the nurse why she is not prescribed Demerol like she
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received when she had a total knee replacement. Which of the following should the nurse
respond to this client?
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1. You dont need something that strong.
2. That medication does not exist anymore.
3. That medication does not last very long.
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4. It can cause you have high blood pressure.
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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.
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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:ApplyREFERENCE:Opioid Analgesics
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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:
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1. Amitriptyline.
2. Baclofen.
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3. Gabapentin.
4. Diazepam.
SOLUTION: 1
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Amitriptyline is an antidepressant. Gabapentin is an anticonvulsant. Baclofen is a muscle
relaxant. Diazepam is a benzodiazepine.
PTS: 1 DIF: Analyze REFERENCE: Adjuvant Medications
8. A client receiving around-the-clock medication for terminal cancer experiences additional pain
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when performing activities of daily living. The nurse realizes this client is experiencing:
1. breakthrough pain.
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2. intractable pain.
3. psychosomatic pain.
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4. acute pain.
SOLUTION: 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
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a psychological origin. The client is diagnosed with terminal cancer. Acute pain has a sudden
onset and resolves within 6 months.
PTS:1DIF:AnalyzeREFERENCE:Breakthrough Pain
9. A client recovering from surgery tells the nurse that she is nauseated and is experiencing an
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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.
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