c
Chapter 1. Pain
c c
MULTIPLE CHOICE
c c
1.A client tells the nurse that she rarely experiences pain, but when she does, she seeks medical
c c c c c c c c c c c c c c c c
attention. The nurse realizes this client understands that pain is important because it:
c c c c c c c c c c c c c
, 1. is a protective system.
c c c
2. includes the automatic withdrawal reflex.
c c c c
3. creates sensitivity to pain. c c c
4. helps with healing. c c
ANS: 1 c
Pain is a protective system that includes protection from unsafe behaviors by use of reflexes,
c c c c c c c c c c c c c c
memory, and avoidance. Even though the automatic withdrawal reflex is a part of the pain
c c c c c c c c c c c c c c c
response, it does not explain why pain is important. Pain does not create sensitivity to pain. Pain
c c c c c c c c c c c c c c c c c
does not help with healing.
c c c c c
PTS: 1 DIF: Analyze REF: Definitions and Implications of Pain
c c c c c c c c c
2.A client complains that the bed sheets touching his skin are extremely painful. The nurse
c c c c c c c c c c c c c c
realizes this client is experiencing:
c c c c c
1. allodynia.
2. modulation.
3. kinesthesia.
4. proprioception.
ANS: 1 c
Allodynia or hyperalgesia is a state where a slight or nonpainful stimulus is interpreted as very
c c c c c c c c c c c c c c c
painful. Kinesthesia is the awareness of movement. Proprioception is the awareness of body
c c c c c c c c c c c c c
position. Modulation is an influencing factor in the perception of pain.
c c c c c c c c c c c
PTS: 1 DIF: Analyze REF: Peripheral Nervous System
c c c c c c c
3.A client is complaining of severe abdomen pain. The nurse realizes this client is experiencing
c c c c c c c c c c c c c c
which type of pain?
c c c c
1. Neuralgia
2. Pathological
3. Somatic
4. Visceral
ANS: 4 c
Visceral pain is pain arising from the body organs or gastrointestinal tract. Somatic pain is pain
c c c c c c c c c c c c c c c
that originates from the bone, joints, muscles, skin, or connective pain. Neuralgia and
c c c c c c c c c c c c c
,pathological pain are both types of pain that result from injury to a nerve or malfunction of the
c c c c c c c c c c c c c c c c c
neuronal transmission process or due to impaired regulation.
c c c c c c c c
PTS:1DIF:AnalyzeREF:Types of Pain c c
4.A client, diagnosed with acute appendicitis, is experiencing abdominal pain. The best way for
c c c c c c c c c c c c c
the nurse to describe this clients pain would be:
c c c c c c c c c
1. chronic.
2. neuropathic.
3. referred.
4. acute.
ANS: 4 c
Acute pain onset is sudden and of short duration. Chronic pain is a sudden or slow onset of mild
c c c c c c c c c c c c c c c c c c
to severe pain that lasts longer than 6 months. Referred pain is the result of the transfer of
c c c c c c c c c c c c c c c c c c
visceral pain sensations to a body surface at a distance from the actual origin. Neuropathic pain
c c c c c c c c c c c c c c c c
is paroxysmal pain that occurs along the branches of a nerve.
c c c c c c c c c c c
PTS:1DIF:ApplyREF:Types of Pain c c
5.A client is observed holding a pillow over the abdominal region with both knees flexed in a
c c c c c c c c c c c c c c c c
side-lying position. Vital signs assessment reveals an elevated blood pressure and heart rate.
c c c c c c c c c c c c c
Which of the following should the nurse say to this client?
c c c c c c c c c c c
1. Can I get you anything? c c c c
2. Would you like something for pain? c c c c c
3. You look comfortable. c c
4. Your blood pressure is up. c c c c
ANS: 2 c
Sympathetic responses to pain include elevated blood pressure and heart rate. And since the
c c c c c c c c c c c c c
client is hugging a pillow over the abdominal region with both knees flexed in a side-lying
c c c c c c c c c c c c c c c c
position, the best thing for the nurse to say to this client is Would you like something for pain?
c c c c c c c c c c c c c c c c c c c
The other responses are incorrect because they do not acknowledge that the client is experiencing
c c c c c c c c c c c c c c c
pain.
c
PTS: 1 DIF: Apply REF: Assessing the Clinical Manifestations of Pain
c c c c c c c c c c
6.A client experiencing chronic pain asks the nurse why she is not prescribed Demerol like she
c c c c c c c c c c c c c c c
received when she had a total knee replacement. Which of the following should the nurse
c c c c c c c c c c c c c c c
respond to this client?
c c c c
1. You dont need something that strong.
c c c c c
2. That medication does not exist anymore.
c c c c c
3. That medication does not last very long.
c c c c c c
4. It can cause you have high blood pressure.
c c c c c c c
, ANS: 3 c
Meperidine is no longer a major drug for acute or chronic pain due to its short analgesic duration
c c c c c c c c c c c c c c c c c
of 2 to 3 hours and the potential for accumulative toxic effects of its metabolite, normeperidine.
c c c c c c c c c c c c c c c c
The best response for the nurse to make to the client would be that medication does not last very
c c c c c c c c c c c c c c c c c c c
long. The other responses are inaccurate.
c c c c c c
PTS:1DIF:ApplyREF:Opioid Analgesics c
7.A client is informed that a tricyclic antidepressant medication is going to help control his
c c c c c c c c c c c c c c
chronic pain. The nurse would expect the physician to prescribe:
c c c c c c c c c c
1. Amitriptyline.
2. Baclofen.
3. Gabapentin.
4. Diazepam.
ANS: 1 c
Amitriptyline is an antidepressant. Gabapentin is an anticonvulsant. Baclofen is a muscle
c c c c c c c c c c c
relaxant. Diazepam is a benzodiazepine.
c c c c c
PTS: 1 DIF: Analyze REF: Adjuvant Medications
c c c c c c
8.A client receiving around-the-clock medication for terminal cancer experiences additional pain
c c c c c c c c c c
when performing activities of daily living. The nurse realizes this client is experiencing:
c c c c c c c c c c c c c
1. breakthrough pain. c
2. intractable pain. c
3. psychosomatic pain. c
4. acute pain. c
ANS: 1 c
Breakthrough pain is commonly seen in the advanced stages of cancer. It is spontaneous,
c c c c c c c c c c c c c
unpredictable, and can be initiated by certain activities such as during activities of daily living.
c c c c c c c c c c c c c c c
Intractable pain is resistant to some or all forms of therapy. Psychosomatic pain is that which has
c c c c c c c c c c c c c c c c c
a psychological origin. The client is diagnosed with terminal cancer. Acute pain has a sudden
c c c c c c c c c c c c c c c
onset and resolves within 6 months.
c c c c c c
PTS:1DIF:AnalyzeREF:Breakthrough Pain c
9.A client recovering from surgery tells the nurse that she is nauseated and is experiencing an
c c c c c c c c c c c c c c c
increase in pain. Which of the following does this clients symptoms suggest to the nurse?
c c c c c c c c c c c c c c c
1 The client is becoming dependent upon the pain medication.
c c c c c c c c
.
2 The clients pain threshold is lower when experiencing nausea.
c c c c c c c c
.
3 The client is experiencing withdrawal symptoms from pain medication.
c c c c c c c c
.
Chapter 1. Pain
c c
MULTIPLE CHOICE
c c
1.A client tells the nurse that she rarely experiences pain, but when she does, she seeks medical
c c c c c c c c c c c c c c c c
attention. The nurse realizes this client understands that pain is important because it:
c c c c c c c c c c c c c
, 1. is a protective system.
c c c
2. includes the automatic withdrawal reflex.
c c c c
3. creates sensitivity to pain. c c c
4. helps with healing. c c
ANS: 1 c
Pain is a protective system that includes protection from unsafe behaviors by use of reflexes,
c c c c c c c c c c c c c c
memory, and avoidance. Even though the automatic withdrawal reflex is a part of the pain
c c c c c c c c c c c c c c c
response, it does not explain why pain is important. Pain does not create sensitivity to pain. Pain
c c c c c c c c c c c c c c c c c
does not help with healing.
c c c c c
PTS: 1 DIF: Analyze REF: Definitions and Implications of Pain
c c c c c c c c c
2.A client complains that the bed sheets touching his skin are extremely painful. The nurse
c c c c c c c c c c c c c c
realizes this client is experiencing:
c c c c c
1. allodynia.
2. modulation.
3. kinesthesia.
4. proprioception.
ANS: 1 c
Allodynia or hyperalgesia is a state where a slight or nonpainful stimulus is interpreted as very
c c c c c c c c c c c c c c c
painful. Kinesthesia is the awareness of movement. Proprioception is the awareness of body
c c c c c c c c c c c c c
position. Modulation is an influencing factor in the perception of pain.
c c c c c c c c c c c
PTS: 1 DIF: Analyze REF: Peripheral Nervous System
c c c c c c c
3.A client is complaining of severe abdomen pain. The nurse realizes this client is experiencing
c c c c c c c c c c c c c c
which type of pain?
c c c c
1. Neuralgia
2. Pathological
3. Somatic
4. Visceral
ANS: 4 c
Visceral pain is pain arising from the body organs or gastrointestinal tract. Somatic pain is pain
c c c c c c c c c c c c c c c
that originates from the bone, joints, muscles, skin, or connective pain. Neuralgia and
c c c c c c c c c c c c c
,pathological pain are both types of pain that result from injury to a nerve or malfunction of the
c c c c c c c c c c c c c c c c c
neuronal transmission process or due to impaired regulation.
c c c c c c c c
PTS:1DIF:AnalyzeREF:Types of Pain c c
4.A client, diagnosed with acute appendicitis, is experiencing abdominal pain. The best way for
c c c c c c c c c c c c c
the nurse to describe this clients pain would be:
c c c c c c c c c
1. chronic.
2. neuropathic.
3. referred.
4. acute.
ANS: 4 c
Acute pain onset is sudden and of short duration. Chronic pain is a sudden or slow onset of mild
c c c c c c c c c c c c c c c c c c
to severe pain that lasts longer than 6 months. Referred pain is the result of the transfer of
c c c c c c c c c c c c c c c c c c
visceral pain sensations to a body surface at a distance from the actual origin. Neuropathic pain
c c c c c c c c c c c c c c c c
is paroxysmal pain that occurs along the branches of a nerve.
c c c c c c c c c c c
PTS:1DIF:ApplyREF:Types of Pain c c
5.A client is observed holding a pillow over the abdominal region with both knees flexed in a
c c c c c c c c c c c c c c c c
side-lying position. Vital signs assessment reveals an elevated blood pressure and heart rate.
c c c c c c c c c c c c c
Which of the following should the nurse say to this client?
c c c c c c c c c c c
1. Can I get you anything? c c c c
2. Would you like something for pain? c c c c c
3. You look comfortable. c c
4. Your blood pressure is up. c c c c
ANS: 2 c
Sympathetic responses to pain include elevated blood pressure and heart rate. And since the
c c c c c c c c c c c c c
client is hugging a pillow over the abdominal region with both knees flexed in a side-lying
c c c c c c c c c c c c c c c c
position, the best thing for the nurse to say to this client is Would you like something for pain?
c c c c c c c c c c c c c c c c c c c
The other responses are incorrect because they do not acknowledge that the client is experiencing
c c c c c c c c c c c c c c c
pain.
c
PTS: 1 DIF: Apply REF: Assessing the Clinical Manifestations of Pain
c c c c c c c c c c
6.A client experiencing chronic pain asks the nurse why she is not prescribed Demerol like she
c c c c c c c c c c c c c c c
received when she had a total knee replacement. Which of the following should the nurse
c c c c c c c c c c c c c c c
respond to this client?
c c c c
1. You dont need something that strong.
c c c c c
2. That medication does not exist anymore.
c c c c c
3. That medication does not last very long.
c c c c c c
4. It can cause you have high blood pressure.
c c c c c c c
, ANS: 3 c
Meperidine is no longer a major drug for acute or chronic pain due to its short analgesic duration
c c c c c c c c c c c c c c c c c
of 2 to 3 hours and the potential for accumulative toxic effects of its metabolite, normeperidine.
c c c c c c c c c c c c c c c c
The best response for the nurse to make to the client would be that medication does not last very
c c c c c c c c c c c c c c c c c c c
long. The other responses are inaccurate.
c c c c c c
PTS:1DIF:ApplyREF:Opioid Analgesics c
7.A client is informed that a tricyclic antidepressant medication is going to help control his
c c c c c c c c c c c c c c
chronic pain. The nurse would expect the physician to prescribe:
c c c c c c c c c c
1. Amitriptyline.
2. Baclofen.
3. Gabapentin.
4. Diazepam.
ANS: 1 c
Amitriptyline is an antidepressant. Gabapentin is an anticonvulsant. Baclofen is a muscle
c c c c c c c c c c c
relaxant. Diazepam is a benzodiazepine.
c c c c c
PTS: 1 DIF: Analyze REF: Adjuvant Medications
c c c c c c
8.A client receiving around-the-clock medication for terminal cancer experiences additional pain
c c c c c c c c c c
when performing activities of daily living. The nurse realizes this client is experiencing:
c c c c c c c c c c c c c
1. breakthrough pain. c
2. intractable pain. c
3. psychosomatic pain. c
4. acute pain. c
ANS: 1 c
Breakthrough pain is commonly seen in the advanced stages of cancer. It is spontaneous,
c c c c c c c c c c c c c
unpredictable, and can be initiated by certain activities such as during activities of daily living.
c c c c c c c c c c c c c c c
Intractable pain is resistant to some or all forms of therapy. Psychosomatic pain is that which has
c c c c c c c c c c c c c c c c c
a psychological origin. The client is diagnosed with terminal cancer. Acute pain has a sudden
c c c c c c c c c c c c c c c
onset and resolves within 6 months.
c c c c c c
PTS:1DIF:AnalyzeREF:Breakthrough Pain c
9.A client recovering from surgery tells the nurse that she is nauseated and is experiencing an
c c c c c c c c c c c c c c c
increase in pain. Which of the following does this clients symptoms suggest to the nurse?
c c c c c c c c c c c c c c c
1 The client is becoming dependent upon the pain medication.
c c c c c c c c
.
2 The clients pain threshold is lower when experiencing nausea.
c c c c c c c c
.
3 The client is experiencing withdrawal symptoms from pain medication.
c c c c c c c c
.
