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Exam (elaborations)

HESI PN COMPREHENSIVE PREDICTOR EXAM.docx

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HESI PN COMPREHENSIVE PREDICTOR EXAM
1. The nurse is caring for a patient to ease modifiable factors that
contribute to pain. Which areas did the nurse focus on with this patient?
a. Age and gender

b. Anxiety and fear
c. Culture and ethnicity
d. Previous pain experiences and cognitive abilities


ANS: B
Some examples of modifiable contributors to pain are anxiety and fear. The
nurse can take measures to ease the patient’s anxiety and fear related to
pain. Age, gender, culture, ethnicity, cognitive abilities, and previous pain
experience are all nonmodifiable factors that the nurse can help the patient
to understand, but the nurse cannot alter them.
2. The nurse is evaluating the effectiveness of guided imagery for
pain management as used for a patient who has second- and third-
degree burns and needs extensive dressing changes. Which finding best
indicates the effectiveness of guided imagery?
a. The patient’s facial expressions are stoic during the procedure.
The patient rates pain during the dressing change as a 6 on a scale of 0
b. to 10.
The patient’s need for analgesic medication decreases during the
c. dressing changes.
The patient asks for pain medication during the dressing changes only
d. once throughout the procedure.
ANS: C
If the patient needs less pain medication during dressing changes, then guided
imagery is helping to manage the patient’s pain. The purpose of guided
imagery is to allow the patient to alter the perception of pain. Guided imagery
works in conjunction with analgesic medications, potentiating their effects. A
rating of 6 on a 0 to 10 scale indicates that the patient is having moderate pain 204
and shows that this patient is not experiencing pain relief at this time. A

, person who is stoic is not showing feelings, which makes it difficult to know
whether or not the patient is experiencing pain. Having to ask for pain
medication during the dressing changes indicates the guided imagery is not
effective.
19.A nurse is providing medication education to a patient who just started
taking ibuprofen. Which information will the nurse include in the teaching
session?
Ibuprofen helps to depress the central nervous system to decrease pain
a. perception.
b. Ibuprofen reduces anxiety, which will help you cope with your pain.
c. Ibuprofen binds with opiate receptors to reduce your pain.
d. Ibuprofen inhibits the production of prostaglandins.

ANS: D
NSAIDs like ibuprofen likely work by inhibiting the synthesis of
prostaglandins to inhibit cellular responses to inflammation. Ibuprofen does
not depress the central nervous system, nor does it enhance coping with pain.
Opioids bind with opiate receptors to modify perceptions of pain.
20.The nurse has brought a patient the scheduled pain medication. The
patient asks the nurse to wait to give pain medication until the time for the
dressing change, which is 2 hours away. Which response by the nurse is
most therapeutic?
“This medication will still be providing you relief at the time of your
a. dressing change.”
“OK, swallow this pain pill, and I will return in a minute to change
b. your dressing.”
“Would you like medication to be given for dressing changes in
c. addition to your regularly scheduled medication?”
“Your medication is scheduled for this time, and I can’t adjust the time
d. for you. I’m sorry, but you must take your pill right now.”
ANS: C
Additional doses of medication can be given to patients in certain
circumstances, as with an extensive dressing change, when the health care
provider is notified that more medication is needed. It is the nurse’s
responsibility to communicate with the provider and with the patient about a
pain-control plan that works for both. By asking to hold off on the dose, the
204
patient is indicating that the dressing changes are extremely painful. The
regularly scheduled dose might not be as effective for the patient 2 hours later

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