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TEST BANK FOR ATI MED SURG PROCTORED EXAM

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MULTIPLE CHOICE 1. Which question asked by the nurse will give the most information about the patient’s metastatic bone cancer pain? a. “How long have you had this pain?” b. “How would you describe your pain?” c. “How much medication do you take for the pain?” d. “How many times a day do you take medication for the pain?” ANS: B 2. A patient who uses a fentanyl (Duragesic) patch for chronic cancer pain suddenly complains of rapid onset pain at a level 9 (0 to 10 scale) and requests “something for pain that will work now.” How will the nurse document the type of pain reported by this patient? a. Somatic pain b. Referred pain c. Neuropathic pain d. Breakthrough pain ANS: D 3. The nurse teaches a student nurse about the action of ibuprofen. Which statement, if made by the student, indicates that teaching was effective? a. “The drug decreases pain impulses in the spinal cord.” b. “The drug decreases sensitivity of the brain to painful stimuli.” c. “The drug decreases production of painsensitizing chemicals.” d. “The drug decreases the modulating effect of descending nerves.” ANS: C 4. A nurse assesses a patient with chronic cancer pain who is receiving imipramine (Tofranil) in addition to long-acting morphine. Which statement, if made by the patient, indicates to the nurse that the patient is receiving adequate pain control? ATI MED SURG PROCTORED EXAM TEST BANK a. “I’m not anxious at all.” b. “I sleep 8 hours every night.” c. “I feel much less depressed since I’ve been taking the Tofranil.” d. “The pain is manageable and I can accomplish my desired activities. ANS: D 5. A patient with chronic back pain has learned to control the pain with the use of imagery and hypnosis. The patient’s spouse asks the nurse how these techniques work. Which response by the nurse is best? a. “The strategies work by affecting the perception of pain.” b. “These techniques block the pain pathways of the nerves.” c. “Both strategies prevent transmission of painful stimuli to the brain.” d. “The therapies slow the release of chemicals in the spinal cord that cause pain.” ANS: A 6. A patient who is receiving sustained-release morphine sulfate (MS Contin) every 12 hours for chronic pain experiences level 9 (0 to 10 scale) breakthrough pain and anxiety. Which action by the nurse is best? a. Provide amitriptyline (Elavil) 10 mg orally. b. Administer lorazepam (Ativan) 1 mg orally. c. Offer ibuprofen (Motrin) 400 to 800 mg orally. d. Give immediate-release morphine 30 mg orally. ANS: D 7. A patient with chronic neck pain is seen in the pain clinic for follow-up. In order to evaluate whether the pain management is effective, which question is best for the nurse to ask? ATI MED SURG PROCTORED EXAM TEST BANK a. “Can you describe the quality of your pain?” ATI MED SURG PROCTORED EXAM TEST BANK b. “Has there been a change in the pain location?” c. “How would you rate your pain on a 0 to 10 scale?” d. “Does the pain keep you from doing things you enjoy?” ANS: D 8. A patient with second-degree burns has been receiving hydromorphone through patientcontrolled analgesia (PCA) for a week. The patient wakes up frequently during the night complaining of pain. What action by the nurse is most appropriate? a. Administer a dose of morphine every 1 to 2 hours from the PCA machine while the patient is sleeping. b. Consult with the health care provider about using a different treatment protocol to control the patient’s pain. c. Request that the health care provider order a bolus dose of morphine to be given when the patient awakens with pain. d. Teach the patient to push the button every 10 minutes for an hour before going to sleep, even if the pain is minimal. ANS: B 9. The nurse assesses that a patient receiving epidural morphine has not voided for over 10 hours. What action should the nurse take initially? a. Monitor for withdrawal symptoms. b. Place an indwelling urinary catheter. c. Ask if the patient feels the need to void. d. Document this allergic reaction in the patient’s chart. ANS: C 10. When visiting a hospice patient, the nurse assesses that the patient has a respiratory rate of 11 breaths/minute and complains of severe pain. Which action is best for the nurse to take? ATI MED SURG PROCTORED EXAM TEST BANK a. Inform the patient that increasing the morphine will cause the respiratory drive to fail. ATI MED SURG PROCTORED EXAM TEST BANK b. Tell the patient that additional morphine can be administered when the respirations are 12. c. Titrate the prescribed morphine dose upward until the patient indicates adequate pain relief. d. Administer a nonopioid analgesic, such as a nonsteroidal antiinflammatory drug (NSAID), to improve patient pain control. ANS: C 11. The nurse is completing the medication reconciliation form for a patient admitted with chronic cancer pain. Which medication is of most concern to the nurse? a. Amitriptyline (Elavil) 50 mg at bedtime b. Ibuprofen (Advil) 800 mg 3 times daily c. Oxycodone (OxyContin) 80 mg twice daily d. Meperidine (Demerol) 25 mg every 4 hours ANS: D 12. The nurse reviews the medication administration record in order to choose the most appropriate pain medication for a patient with cancer who describes the pain as “deep, aching and at a level 8 on a 0 to 10 scale”. Which medication should the nurse administer? a. Fentanyl (Duragesic) patch b. Ketorolac (Toradol) tablets c. Hydromorphone (Dilaudid) IV d. Acetaminophen (Tylenol) suppository ANS: C 13. The nurse is caring for a patient who has diabetes and complains of chronic burning leg pain even when taking oxycodone (OxyContin) twice daily. When reviewing the orders, which prescribed medication is the best choice for the nurse to administer as an adjuvant to decrease the patient’s pain? a. Aspirin (Ecotrin) b. Celecoxib (Celebrex) c. Amitriptyline (Elavil) ATI MED SURG PROCTORED EXAM TEST BANK d. Acetaminophen (Tylenol) ATI MED SURG PROCTORED EXAM TEST BANK ANS: C 14. A patient who uses a fentanyl (Duragesic) patch for chronic abdominal pain caused by ovarian cancer asks the nurse to administer the prescribed hydrocodone (Vicodin) tablets, but the patient is asleep when the nurse returns with the medication. Which action is best for the nurse to take? a. Wake the patient and administer the hydrocodone. b. Wait until the patient wakes up and reassess the pain. c. Suggest the use of nondrug therapies for pain relief instead of additional opioids. d. Consult with the health care provider about changing the fentanyl (Duragesic) dose. ANS: A 15. The following medications are prescribed by the health care provider for a middle-aged patient who uses long-acting morphine (MS Contin) for chronic back pain, but still has ongoing pain. Which medication should the nurse question? a. Morphine (Roxanol) b. Pentazocine (Talwin) c. Celecoxib (Celebrex) d. Dexamethasone (Decadron) ANS: B 16. The nurse is caring for a 1-day postoperative patient who is receiving morphine through patientcontrolled analgesia (PCA). What action by the nurse is a priority? a. Check the respiratory rate. b. Assess for nausea after eating. c. Inspect the abdomen and auscultate bowel sounds. d. Evaluate the sacral and heel areas for signs of redness. ANS: A 17. A patient who has fibromyalgia tells the nurse, “I feel depressed because I ache too much to play golf.” The patient says the pain is usually at a level 7 (0 to 10 scale). Which patient goal has the highest priority when the nurse is developing the treatment plan? ATI MED SURG PROCTORED EXAM TEST BANK a. The patient will exhibit fewer signs of ATI MED SURG PROCTORED EXAM TEST BANK depression. b. The patient will say that the aching has decreased. c. The patient will state that pain is at a level 2 of 10. d. The patient will be able to play 1 to 2 rounds of golf. ANS: D 18. A patient who has just started taking sustained-release morphine sulfate (MS Contin) for chronic arthritic joint pain following a traumatic injury complains of nausea and abdominal fullness. Which action should the nurse take initially? a. Administer the ordered antiemetic medication. b. Tell the patient that the nausea will subside in about a week. c. Order the patient a clear liquid diet until the nausea decreases. d. Consult with the health care provider about using a different opioid. ANS: A 19. A patient with terminal cancer–related pain and a history of opioid abuse complains of breakthrough pain 2 hours before the next dose of sustained-release morphine sulfate (MS Contin) is due. Which action should the nurse take first? a. Use distraction by talking about things the patient enjoys. b. Administer the prescribed PRN immediate-acting morphine. c. Suggest the use of alternative therapies such as heat or cold. d. Consult with the doctor about increasing the MS Contin dose. ANS: B

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ATI MED SURG PROCTORED EXAM TEST BANK




MULTIPLE CHOICE

1. Which question asked by the nurse will give the most information about the patient’s metastatic
bone cancer pain?
a. “How long have you had this pain?”
b. “How would you describe your pain?”
c. “How much medication do you take for
the pain?”
d. “How many times a day do you take
medication for the pain?”
ANS: B

2. A patient who uses a fentanyl (Duragesic) patch for chronic cancer pain suddenly complains of
rapid onset pain at a level 9 (0 to 10 scale) and requests “something for pain that will work now.”
How will the nurse document the type of pain reported by this patient?
a. Somatic pain
b. Referred pain
c. Neuropathic pain
d. Breakthrough pain
ANS: D

3. The nurse teaches a student nurse about the action of ibuprofen. Which statement, if made by the
student, indicates that teaching was effective?
a. “The drug decreases pain impulses in the
spinal cord.”
b. “The drug decreases sensitivity of the
brain to painful stimuli.”
c. “The drug decreases production of pain-
sensitizing chemicals.”
d. “The drug decreases the modulating effect
of descending nerves.”
ANS: C

4. A nurse assesses a patient with chronic cancer pain who is receiving imipramine (Tofranil) in
addition to long-acting morphine. Which statement, if made by the patient, indicates to the nurse
that the patient is receiving adequate pain control?

,ATI MED SURG PROCTORED EXAM TEST BANK



a. “I’m not anxious at all.”
b. “I sleep 8 hours every night.”
c. “I feel much less depressed since I’ve
been taking the Tofranil.”
d. “The pain is manageable and I can
accomplish my desired activities.
ANS: D

5. A patient with chronic back pain has learned to control the pain with the use of imagery and
hypnosis. The patient’s spouse asks the nurse how these techniques work. Which response by the
nurse is best?
a. “The strategies work by affecting the
perception of pain.”
b. “These techniques block the pain
pathways of the nerves.”
c. “Both strategies prevent transmission of
painful stimuli to the brain.”
d. “The therapies slow the release of
chemicals in the spinal cord that cause
pain.”
ANS: A

6. A patient who is receiving sustained-release morphine sulfate (MS Contin) every 12 hours for
chronic pain experiences level 9 (0 to 10 scale) breakthrough pain and anxiety. Which action by
the nurse is best?
a. Provide amitriptyline (Elavil) 10 mg
orally.
b. Administer lorazepam (Ativan) 1 mg
orally.
c. Offer ibuprofen (Motrin) 400 to 800 mg
orally.
d. Give immediate-release morphine 30 mg
orally.
ANS: D

7. A patient with chronic neck pain is seen in the pain clinic for follow-up. In order to evaluate
whether the pain management is effective, which question is best for the nurse to ask?

,ATI MED SURG PROCTORED EXAM TEST BANK



a. “Can you describe the quality of your
pain?”

, ATI MED SURG PROCTORED EXAM TEST BANK



b. “Has there been a change in the pain
location?”
c. “How would you rate your pain on a 0 to
10 scale?”
d. “Does the pain keep you from doing
things you enjoy?”
ANS: D

8. A patient with second-degree burns has been receiving hydromorphone through patient-
controlled analgesia (PCA) for a week. The patient wakes up frequently during the night
complaining of pain. What action by the nurse is most appropriate?
a. Administer a dose of morphine every 1 to
2 hours from the PCA machine while the
patient is sleeping.
b. Consult with the health care provider
about using a different treatment protocol
to control the patient’s pain.
c. Request that the health care provider order
a bolus dose of morphine to be given
when the patient awakens with pain.
d. Teach the patient to push the button every
10 minutes for an hour before going to
sleep, even if the pain is minimal.
ANS: B

9. The nurse assesses that a patient receiving epidural morphine has not voided for over 10 hours.
What action should the nurse take initially?
a. Monitor for withdrawal symptoms.
b. Place an indwelling urinary catheter.
c. Ask if the patient feels the need to void.
d. Document this allergic reaction in the
patient’s chart.
ANS: C

10. When visiting a hospice patient, the nurse assesses that the patient has a respiratory rate of 11
breaths/minute and complains of severe pain. Which action is best for the nurse to take?

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