NRSG 2220-Exam 1 (Mod 1-5) exam |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
with correct answers |||\\\ |||\\\
General Survey: - correct answer✔✔-Provides clues to overall health
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
-Begins the moment of contact |||\\\ |||\\\ |||\\\ |||\\\
-First impressions|||\\\
-Challenges your observational skills |||\\\ |||\\\ |||\\\
-Usually includes vital signs, height and weight. We are focusing on skillful observations
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
What do you look for in skilled observation (general survey)? - correct answer✔✔-Signs of
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
distress
-Stature/Build
-Dressing/Grooming
-Posture/Gait/Coordination
-Eye contact
|||\\\
-Level of consciousness, mood
|||\\\ |||\\\ |||\\\
- Speech patterns
|||\\\ |||\\\
-Vision or hearing problems |||\\\ |||\\\ |||\\\
-Nutritional state |||\\\
-Significant others accompanying patient |||\\\ |||\\\ |||\\\
Healthy hair= |||\\\
(general survey) - correct answer✔✔Healthy protein stores in body
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
Pain is a subjective or objective experience? - correct answer✔✔Subjective
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
,-highly individual |||\\\
-ethnocultural considerations |||\\\
Expression of pain does not = - correct answer✔✔degree of pain |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
5th vital sign? - correct answer✔✔Pain
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
How do you care for the patient in pain? - correct answer✔✔-Important to believe the pain is
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
real
-Your goal is to reduce/eliminate pain and manage pain so that patient can resume normal
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
lifestyle
Best indicator of pain? - correct answer✔✔Patient reporting their pain to you
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
Standards to treat/manage pain as put in place by the Joint Commission - correct
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
answer✔✔These standards uphold the idea that the patient has the right to have their pain |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
managed effectively. |||\\\
One important standard is to determine a pain rating goal with your patient.
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
Their plan of care is set on mutually set goals
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
Characteristics of Pain - correct answer✔✔COLD ERA |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
COLD ERA - correct answer✔✔C:haracter of the compaint
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
O:nset of the symptom |||\\\ |||\\\ |||\\\
L:ocation of the complaint |||\\\ |||\\\ |||\\\
D:uration of the problem |||\\\ |||\\\ |||\\\
,E:xacerbated by what? |||\\\ |||\\\
R:elieved by what? |||\\\ |||\\\
A:ssociated symptoms problem |||\\\ |||\\\
OLD CARTS - correct answer✔✔O:nset
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\
L:ocation
D:uration
C:haracter
A:ggravating factors/associated factors |||\\\ |||\\\
R:elieving factors |||\\\
T:emporal factors |||\\\
S:everity
Duration of pain (3) - correct answer✔✔Acute
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
-rapid onset, varies with intensity, protective in nature
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
Chronic
-can be intermittent or persistent, long-standing pain and it interferes with ability to function
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
Acute on chronic
|||\\\ |||\\\
-someone who has chronic pain and then has acute exacerbation of pain on top of chronic pain
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
Remission of pain - correct answer✔✔No symptoms of pain at the time
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
Exacerbation - correct answer✔✔Symptoms may reappear and get worse |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
Source of Pain (3) - correct answer✔✔Cutaneous/Superficial:
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
, -Pain at skin level, tend to be painful because of all nerve endings
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
Somatic: |||\\\
-Pain that comes from tendons, ligaments, bones, vessels, pain tends to be more diffuse, hard
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
to pinpoint|||\\\
Visceral:
-pain originates from organs, poorly localized
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\
Etiology of Pain - correct answer✔✔-Referred Pain: Pain perceived in an area distant from
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
where pain is actually originating. (MI, pain in arm not in heart)
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
-Neuropathic Pain: Injury or peripheral or central nerves (crushed vertebrae in neck may result |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
in pain in hands or wherever those nerves innervate)
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
-Intractable Pain: Pain that is resistant to interventions, regardless of what we do we cannot |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
get to goal pain |||\\\ |||\\\ |||\\\
-Phantom Pain: Pain in a limb that is no longer there, common in amputation patients, sensory |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
information is still in brain even though no limb |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
-Psychogenic Pain: no physical cause, may be pain from significant mental event |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
How do patients respond to pain? (3) - correct answer✔✔-Voluntary Behavioral Responses:
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
Moving away from painful stimuli (pull away from you), grimacing/moaning, restless, trying to
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
guard the painful area |||\\\ |||\\\ |||\\\
-Involuntary Physiological Responses: sympathetic responses (BP, pulse, RR increase, pupils |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
dilate, muscles tense, sweating) If pain is sustained for long amounts of time the
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
parasympathetic will kick in and you'll see opposite |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
-Psychological Responses: Patient might withdraw, anxious, fearful, anorexia, tired and |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
depressed, hopeless |||\\\
What tools do I use to assess pain? (4) - correct answer✔✔-Wong Baker: Faces Pain Rating
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
Scale: Helpful with children, older adults, those who can't read or have language barrier (based
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
on smiley faces) Also has multiple different languages. Also includes how much pain interferes
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
with daily life |||\\\ |||\\\
with correct answers |||\\\ |||\\\
General Survey: - correct answer✔✔-Provides clues to overall health
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
-Begins the moment of contact |||\\\ |||\\\ |||\\\ |||\\\
-First impressions|||\\\
-Challenges your observational skills |||\\\ |||\\\ |||\\\
-Usually includes vital signs, height and weight. We are focusing on skillful observations
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
What do you look for in skilled observation (general survey)? - correct answer✔✔-Signs of
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
distress
-Stature/Build
-Dressing/Grooming
-Posture/Gait/Coordination
-Eye contact
|||\\\
-Level of consciousness, mood
|||\\\ |||\\\ |||\\\
- Speech patterns
|||\\\ |||\\\
-Vision or hearing problems |||\\\ |||\\\ |||\\\
-Nutritional state |||\\\
-Significant others accompanying patient |||\\\ |||\\\ |||\\\
Healthy hair= |||\\\
(general survey) - correct answer✔✔Healthy protein stores in body
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
Pain is a subjective or objective experience? - correct answer✔✔Subjective
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
,-highly individual |||\\\
-ethnocultural considerations |||\\\
Expression of pain does not = - correct answer✔✔degree of pain |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
5th vital sign? - correct answer✔✔Pain
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
How do you care for the patient in pain? - correct answer✔✔-Important to believe the pain is
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
real
-Your goal is to reduce/eliminate pain and manage pain so that patient can resume normal
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
lifestyle
Best indicator of pain? - correct answer✔✔Patient reporting their pain to you
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
Standards to treat/manage pain as put in place by the Joint Commission - correct
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
answer✔✔These standards uphold the idea that the patient has the right to have their pain |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
managed effectively. |||\\\
One important standard is to determine a pain rating goal with your patient.
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
Their plan of care is set on mutually set goals
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
Characteristics of Pain - correct answer✔✔COLD ERA |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
COLD ERA - correct answer✔✔C:haracter of the compaint
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
O:nset of the symptom |||\\\ |||\\\ |||\\\
L:ocation of the complaint |||\\\ |||\\\ |||\\\
D:uration of the problem |||\\\ |||\\\ |||\\\
,E:xacerbated by what? |||\\\ |||\\\
R:elieved by what? |||\\\ |||\\\
A:ssociated symptoms problem |||\\\ |||\\\
OLD CARTS - correct answer✔✔O:nset
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\
L:ocation
D:uration
C:haracter
A:ggravating factors/associated factors |||\\\ |||\\\
R:elieving factors |||\\\
T:emporal factors |||\\\
S:everity
Duration of pain (3) - correct answer✔✔Acute
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
-rapid onset, varies with intensity, protective in nature
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
Chronic
-can be intermittent or persistent, long-standing pain and it interferes with ability to function
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
Acute on chronic
|||\\\ |||\\\
-someone who has chronic pain and then has acute exacerbation of pain on top of chronic pain
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
Remission of pain - correct answer✔✔No symptoms of pain at the time
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
Exacerbation - correct answer✔✔Symptoms may reappear and get worse |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
Source of Pain (3) - correct answer✔✔Cutaneous/Superficial:
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
, -Pain at skin level, tend to be painful because of all nerve endings
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
Somatic: |||\\\
-Pain that comes from tendons, ligaments, bones, vessels, pain tends to be more diffuse, hard
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
to pinpoint|||\\\
Visceral:
-pain originates from organs, poorly localized
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\
Etiology of Pain - correct answer✔✔-Referred Pain: Pain perceived in an area distant from
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
where pain is actually originating. (MI, pain in arm not in heart)
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
-Neuropathic Pain: Injury or peripheral or central nerves (crushed vertebrae in neck may result |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
in pain in hands or wherever those nerves innervate)
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
-Intractable Pain: Pain that is resistant to interventions, regardless of what we do we cannot |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
get to goal pain |||\\\ |||\\\ |||\\\
-Phantom Pain: Pain in a limb that is no longer there, common in amputation patients, sensory |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
information is still in brain even though no limb |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
-Psychogenic Pain: no physical cause, may be pain from significant mental event |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
How do patients respond to pain? (3) - correct answer✔✔-Voluntary Behavioral Responses:
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
Moving away from painful stimuli (pull away from you), grimacing/moaning, restless, trying to
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
guard the painful area |||\\\ |||\\\ |||\\\
-Involuntary Physiological Responses: sympathetic responses (BP, pulse, RR increase, pupils |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
dilate, muscles tense, sweating) If pain is sustained for long amounts of time the
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
parasympathetic will kick in and you'll see opposite |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
-Psychological Responses: Patient might withdraw, anxious, fearful, anorexia, tired and |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
depressed, hopeless |||\\\
What tools do I use to assess pain? (4) - correct answer✔✔-Wong Baker: Faces Pain Rating
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
Scale: Helpful with children, older adults, those who can't read or have language barrier (based
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
on smiley faces) Also has multiple different languages. Also includes how much pain interferes
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
with daily life |||\\\ |||\\\
