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OVERVIEW:
NSG 3130 Exam 3 review covers comprehensive pain management
fundamentals, including gate-control theory, pain types, quality, intensity
assessment with scales, acute versus chronic physiologic responses, and
therapeutic communication. It emphasizes pharmacologic interventions,
PCA, epidural analgesia, TENS, multimodal analgesia, nonpharmacologic
methods like distraction and massage, special populations, pediatrics,
older adults, cognitively impaired, postoperative, hospice cancer pain,
phantom and deafferentation pain, barriers, and energy conservation
strategies for recovery and effective nursing care planning.
Correct answer highlighted in bold Green + rationales.
1. Which one of the following nursing interventions for a client in pain is based on
the gate-control theory?
A. Giving the client a back massage
B. Changing the client's position in bed
C. Giving the client a pain medication
D. Limiting the number of visitors
Rationale: Gate-control theory states that non-painful tactile stimulation
(massage, pressure, vibration) stimulates large-diameter fibers that close the
spinal gate to painful stimuli from small-diameter fibers.
2. A priority nursing intervention when caring for a client who is receiving an
epidural infusion for pain relief is to:
A. Use aseptic technique
B. Label the port as an epidural catheter
C. Monitor vital signs every 15 minutes
, D. Avoid supplemental doses of sedatives
Rationale: Epidural analgesia can cause hypotension, respiratory depression,
and other hemodynamic changes. Close vital signs monitoring, especially
initially, is priority to detect complications early.
3. The nurse should describe pain that is causing the client a "burning sensation in
the epigastric region" as:
A. Referred
B. Radiating
C. Deep or visceral
D. Superficial or cutaneous
Rationale: Visceral pain arises from internal organs, is diffuse, poorly localized,
and often described as burning, cramping, or deep aching. Epigastric burning is
visceral.
4. Which of the following is most appropriate when the nurse assesses the intensity
of the client's pain?
A. Ask about what precipitates the pain
B. Question the client about the location of the pain
C. Offer the client a pain scale to objectify the information
D. Use open-ended questions to find out about the sensation
Rationale: Pain intensity is subjective but should be objectified using a validated
pain scale (0-10 numeric, faces, visual analog) to track and treat effectively.
5. The nurse on a postoperative care unit is assessing the quality of the client's pain.
In order to obtain this specific information about the pain experience from the
client, the nurse should ask:
A. What does your discomfort feel like?
B. What activities make the pain worse?
C. How much does it hurt on a scale of 0 to 10?
D. How much discomfort are you able to tolerate?
, Rationale: Quality refers to what the pain feels like - sharp, dull, burning,
stabbing, throbbing. Asking what it feels like elicits quality.
6. When a client's husband questions how a patient-controlled analgesia (PCA)
pump works, the nurse explains that the client:
A. Has control over the frequency of the intravenous (IV) analgesia
B. Can choose the dosage of the drug received
C. May request the type of medication received
D. Controls the route for administering the medication
Rationale: PCA allows the client to self-administer preset doses by pressing a
button, thus controlling frequency within lockout intervals and dose limits set by
provider.
7. An older client with mild musculoskeletal pain is being seen by the primary care
provider. The nurse anticipates that treatment of this client's level of discomfort will
include:
A. Fentanyl
B. Diazepam
C. Acetaminophen
D. Meperidine hydrochloride
Rationale: For mild musculoskeletal pain, especially in older adults,
acetaminophen is first-line due to lower risk profile compared to NSAIDs and
opioids. Opioids like fentanyl and meperidine are for moderate-severe pain.
8. Before inserting a Foley catheter, the nurse explains that the client may feel some
discomfort. This is an example of:
A. Distraction
B. Reducing pain perception
C. Anticipatory response
D. Self-care maintenance