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Chapter 07: Care of Patients with Pain
deWit: Medical-Surgical Nursing: Concepts & Practice, 3rd Edition
MULTIPLE CHOICE
1. In order to provide the optimum nursing care, it is important for the nurse to know that the standard of pain and
pain control is best determined by which person?
a. Physician
b. Nurse
c. Patient’s family
d. Patient
ANS: D
Only the patient knows when pain occurs and what remedy relieves it.
PTS: 1 DIF: Cognitive Level: Knowledge REF: 127
OBJ: 1 (theory) TOP: Pain Theory KEY: Nursing Process Step: Implementation
MSC: NCLEX: Physiological Integrity: Basic Care and Comfort
2. The nurse clarifies the basics of the gate theory of pain control. Which information should the nurse include?
a. Pain is perceived as opening a “gate” to pain symptoms.
b. The “gate” can be closed to pain by the use of nonpainful stimuli.
c. The “gate” swings back and forth, first allowing pain, then blocking it.
d. The patient can be trained to close the “gate” to pain.
ANS: B
The sensorineural “gate” can be closed by applying a number of nonpharmacologic stimuli so that the pain is not perceived.
PTS: 1 DIF: Cognitive Level: Comprehension REF: 124
OBJ: 1 (theory) TOP: Gate Theory KEY: Nursing Process Step: Implementation
MSC: NCLEX: Physiological Integrity: Basic Care and Comfort
3. When giving care to a 30-year-old Hispanic male, which action can most likely be attributed to the patient’s
cultural beliefs about pain?
a. The patient maintains a stoic affect about pain.
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b. The patient prefers a pill to an injection.
c. The patient ignores somatic interventions such as heat and massage.
d. The patient confesses to pain but refuses pain medication.
ANS: A
Hispanic males are frequently stoic regarding pain. They prefer injections to pills but may elect to use prayer, heat, or herbal
remedies for pain relief.
PTS: 1 DIF: Cognitive Level: Application REF: 131, Cultural Considerations
OBJ: 4 (theory) TOP: Cultural Considerations
KEY: Nursing Process Step: Planning
MSC: NCLEX: Physiological Integrity: Basic Care and Comfort
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4. The nurse is caring for a patient who is having constant nociceptor pain. Which intervention best addresses the
patient’spain during the perception phase of pain?
a. Administer nonsteroidal anti-inflammatory drugs (NSAIDs) for moderate pain.
b. Ask the physician if an opioid could be ordered to treat the patient’s pain when severe.
c. Engage the patient in conversation regarding his family, hobbies, and plans following discharge from the facility.
d. Determine if the patient typically takes a neurotransmitter uptake blocker medication for pain control.
ANS: C
Nonpharmacologic interventions such as distraction and guided imagery are effective for pain relief during the perception phase.
NSAIDs are most effective during the transduction phase of pain, opioids are most effective during the transmission phase, and
drugs that block neurotransmitter uptake work best during the modulation phase.
PTS: 1 DIF: Cognitive Level: Application REF: 125
OBJ: 3 (theory) TOP: Pain Perception
KEY: Nursing Process Step: Implementation
MSC: NCLEX: Physiological Integrity: Basic Care and Comfort
5. The patient is experiencing phantom pain following the amputation of her foot. Which type of pain is most
associatedwith phantom pain?
a. Nociceptive
b. Mild
c. Uncontrollable
d. Neuropathic
ANS: D
Neuropathic pain is associated with a dysfunction of the nervous system that involves an abnormality in the processing of
sensations such as phantom pain. Nociceptive pain is associated with pain stimuli from either somatic (body tissue) or visceral
(organs) structures. Mild and uncontrollable refer to severity rather than classifications of pain.
PTS: 1 DIF: Cognitive Level: Comprehension REF: 126, Table 7-1
OBJ: 1 (theory) TOP: Neuropathic Pain
KEY: Nursing Process Step: Implementation
MSC: NCLEX: Physiological Integrity: Basic Care and Comfort
6. The nurse explains that the pain threshold and pain tolerance are different. Which statement about the pain
threshold is true?
a. Pain threshold is the point at which pain is perceived.
b. Pain threshold is the point at which the person responds to pain.
c. Pain threshold is the point at which pharmacologic intervention is required.
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d. Pain threshold is the point at which signs such as grimacing or groaning are observed.
ANS: A
The pain threshold is the point at which the pain is perceived.
PTS: 1 DIF: Cognitive Level: Knowledge REF: 127
OBJ: 1 (theory) TOP: Pain Threshold
KEY: Nursing Process Step: Implementation
MSC: NCLEX: Physiological Integrity: Basic Care and Comfort
7. The patient who had abdominal surgery this morning refuses the opioid pain medication for fear of addiction.
Howshould the nurse respond?
a. “Opioids are addictive, whereas nonsteroidal anti-inflammatory drugs (NSAIDs) are not.”
b. “Addiction is mainly a matter of attitude.”
c. “Fewer than 3% of people become addicted to drugs used for pain relief.”
d. “Although addiction does occur, it is quickly reversed.”
ANS: C
Pain from abdominal surgery is acute pain. This patient is not experiencing chronic pain that will require ongoing pain
medication, and addiction occurs in fewer than 3% of people who take pain medication. Any medication can be addictive.
Addiction is often not merely a matter of attitude. Finally, addictions typically require long-term therapy.
PTS: 1 DIF: Cognitive Level: Application REF: 134, Table 7-4
OBJ: 5 (theory) TOP: False Perception About Pain
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Chapter 07: Care of Patients with Pain
deWit: Medical-Surgical Nursing: Concepts & Practice, 3rd Edition
MULTIPLE CHOICE
1. In order to provide the optimum nursing care, it is important for the nurse to know that the standard of pain and
pain control is best determined by which person?
a. Physician
b. Nurse
c. Patient’s family
d. Patient
ANS: D
Only the patient knows when pain occurs and what remedy relieves it.
PTS: 1 DIF: Cognitive Level: Knowledge REF: 127
OBJ: 1 (theory) TOP: Pain Theory KEY: Nursing Process Step: Implementation
MSC: NCLEX: Physiological Integrity: Basic Care and Comfort
2. The nurse clarifies the basics of the gate theory of pain control. Which information should the nurse include?
a. Pain is perceived as opening a “gate” to pain symptoms.
b. The “gate” can be closed to pain by the use of nonpainful stimuli.
c. The “gate” swings back and forth, first allowing pain, then blocking it.
d. The patient can be trained to close the “gate” to pain.
ANS: B
The sensorineural “gate” can be closed by applying a number of nonpharmacologic stimuli so that the pain is not perceived.
PTS: 1 DIF: Cognitive Level: Comprehension REF: 124
OBJ: 1 (theory) TOP: Gate Theory KEY: Nursing Process Step: Implementation
MSC: NCLEX: Physiological Integrity: Basic Care and Comfort
3. When giving care to a 30-year-old Hispanic male, which action can most likely be attributed to the patient’s
cultural beliefs about pain?
a. The patient maintains a stoic affect about pain.
P a g e 1 | 735
,2
b. The patient prefers a pill to an injection.
c. The patient ignores somatic interventions such as heat and massage.
d. The patient confesses to pain but refuses pain medication.
ANS: A
Hispanic males are frequently stoic regarding pain. They prefer injections to pills but may elect to use prayer, heat, or herbal
remedies for pain relief.
PTS: 1 DIF: Cognitive Level: Application REF: 131, Cultural Considerations
OBJ: 4 (theory) TOP: Cultural Considerations
KEY: Nursing Process Step: Planning
MSC: NCLEX: Physiological Integrity: Basic Care and Comfort
P a g e 2 | 735
,3
4. The nurse is caring for a patient who is having constant nociceptor pain. Which intervention best addresses the
patient’spain during the perception phase of pain?
a. Administer nonsteroidal anti-inflammatory drugs (NSAIDs) for moderate pain.
b. Ask the physician if an opioid could be ordered to treat the patient’s pain when severe.
c. Engage the patient in conversation regarding his family, hobbies, and plans following discharge from the facility.
d. Determine if the patient typically takes a neurotransmitter uptake blocker medication for pain control.
ANS: C
Nonpharmacologic interventions such as distraction and guided imagery are effective for pain relief during the perception phase.
NSAIDs are most effective during the transduction phase of pain, opioids are most effective during the transmission phase, and
drugs that block neurotransmitter uptake work best during the modulation phase.
PTS: 1 DIF: Cognitive Level: Application REF: 125
OBJ: 3 (theory) TOP: Pain Perception
KEY: Nursing Process Step: Implementation
MSC: NCLEX: Physiological Integrity: Basic Care and Comfort
5. The patient is experiencing phantom pain following the amputation of her foot. Which type of pain is most
associatedwith phantom pain?
a. Nociceptive
b. Mild
c. Uncontrollable
d. Neuropathic
ANS: D
Neuropathic pain is associated with a dysfunction of the nervous system that involves an abnormality in the processing of
sensations such as phantom pain. Nociceptive pain is associated with pain stimuli from either somatic (body tissue) or visceral
(organs) structures. Mild and uncontrollable refer to severity rather than classifications of pain.
PTS: 1 DIF: Cognitive Level: Comprehension REF: 126, Table 7-1
OBJ: 1 (theory) TOP: Neuropathic Pain
KEY: Nursing Process Step: Implementation
MSC: NCLEX: Physiological Integrity: Basic Care and Comfort
6. The nurse explains that the pain threshold and pain tolerance are different. Which statement about the pain
threshold is true?
a. Pain threshold is the point at which pain is perceived.
b. Pain threshold is the point at which the person responds to pain.
c. Pain threshold is the point at which pharmacologic intervention is required.
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d. Pain threshold is the point at which signs such as grimacing or groaning are observed.
ANS: A
The pain threshold is the point at which the pain is perceived.
PTS: 1 DIF: Cognitive Level: Knowledge REF: 127
OBJ: 1 (theory) TOP: Pain Threshold
KEY: Nursing Process Step: Implementation
MSC: NCLEX: Physiological Integrity: Basic Care and Comfort
7. The patient who had abdominal surgery this morning refuses the opioid pain medication for fear of addiction.
Howshould the nurse respond?
a. “Opioids are addictive, whereas nonsteroidal anti-inflammatory drugs (NSAIDs) are not.”
b. “Addiction is mainly a matter of attitude.”
c. “Fewer than 3% of people become addicted to drugs used for pain relief.”
d. “Although addiction does occur, it is quickly reversed.”
ANS: C
Pain from abdominal surgery is acute pain. This patient is not experiencing chronic pain that will require ongoing pain
medication, and addiction occurs in fewer than 3% of people who take pain medication. Any medication can be addictive.
Addiction is often not merely a matter of attitude. Finally, addictions typically require long-term therapy.
PTS: 1 DIF: Cognitive Level: Application REF: 134, Table 7-4
OBJ: 5 (theory) TOP: False Perception About Pain
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