NUR 202 FINAL EXAM QUESTIOS & ANSWERS
1. A client experiencing pain from an amputated limb tells the nurse that the pain is
constant and the pain medication is not effective. What would be appropriate for the
nurse to say or do in this situation?
a. Remind the client that the limb is gone and can't be causing pain.
b. Call the healthcare provider to report the ongoing pain.
c. Do nothing. In time the pain will diminish on its own. d. Help the client to a sitting
position and offer magazines. - Answer -Call the healthcare provider to report the
ongoing pain. Pain is whatever the person says it is—existing whenever the person
says it does. It is highly subjective and cannot be shared with others. The best course of
action would be for the nurse to contact the healthcare provider to report the client's
ongoing pain. The other options would not be supportive of the client and the pain
experience.
During a healthcare visit, the nurse learns that a client has had some degree of pain for
years yet has never sought medical intervention for the pain. The nurse realizes that
one explanation for this might be:
a. The client is practicing pain-reducing interventions.
b. The client has a history of substance abuse.
c. The client doesn't really have pain.
d. The client has become accustomed to having pain. - Answer -The client has become
accustomed to having pain. Previous experiences with pain affect the way an individual
responds to pain. This client's history of having pain for years may explain why he/she is
able to live with the pain. There is no provided history of pain-reducing interventions or
substance abuse. Assuming the client doesn't have pain is a judgment on the nurse's
part and a nontherapeutic assessment.
After a hip replacement, a client is unable to tolerate any touching or clothing over the
incision site. The nurse realizes that this client is exhibiting:
a. hyperalgesia
b. pain reaction
c. pain tolerance
d. pain threshold - Answer -hyperalgesia sensitivity to pain. The amount of pain
stimulation a person requires to feel pain is called the pain threshold, or pain reaction.
Pain tolerance is the maximum amount and duration of pain that an individual is willing
to endure.
A client complaining of pain is seen by the nurse. This client smiles and hesitates to
respond when asked about the degree of pain. The nurse realizes this client is
demonstrating the pain behavior consistent with:
a. a toddler
b. a school-age child
c. an adolescent
,d. an older adult - Answer -an adolescent Typical adolescent pain behavior includes
being slow to acknowledge pain, thinking pain may be considered a weakness and not
reporting pain so as to appear brave in front of peers. A toddler often responds with
crying and anger because a toddler perceives the pain as a threat to security. A school-
age child tries to be brave when facing pain. The older adult may withhold complaints of
pain because of fear of the treatment or lifestyle changes that may be involved.
A client asks the nurse for pain medication. The nurse is slow to respond and doesn't
provide the medication for over an hour. This nurse is demonstrating:
a. compassion to the client in pain
b. anger toward the patient in pain
c. poor time management skills
d. denial that the patient is truly in pain - Answer -denial that the patient is truly in pain
Nurses have their own attitudes and expectations about pain and may place a higher
value on silent suffering or self-control in response to pain. Nurses may deny or
downplay the pain they observe in others. The nurse is not demonstrating compassion
or anger. There is no information
in the question that addresses the nurse's time management skills. However, if the
nurse is
unable to administer the pain medication in a timely manner due to the acuity of the
patient assignment, the nurse should ask a colleague for assistance.
A client in the pain clinic appears fatigued. The nurse learns the client has not been
sleeping well. This finding will most likely have which effect on the client's pain?
a. Increased pain
b. Decreased pain
c. Decreased pain perception
d. No effect - Answer -Increased pain When pain interferes with sleep, fatigue and
muscle tension often result and increase the pain. Fatigue also reduces a person's
ability to cope, thereby increasing pain perception. The combination of fatigue and pain
doesn't result in decreased pain or pain perception.
A client returns from physical therapy in excruciating pain and tells the nurse, "Exercise
always
makes the pain worse." The nurse plans to:
a. do nothing. This is part of the healing process.
b. provide pain medication prior to the client's physical therapy sessions
c. provide pain medication immediately after physical therapy
d. provide distraction techniques to reduce the client's perception of pain - Answer -
provide pain medication prior to the client's physical therapy sessionsThis episode
demonstrates a precipitating factor to the onset of pain. The best selection would be to
medicate the client prior to attending physical therapy. During the focused interview
regarding pain, the nurse obtains information regarding the pain. Excruciating pain after
exercise is not an expected part of the healing process. The goal is for the client to be
as comfortable as possible, which will assist in activity during physical therapy, so
, medicating before therapy takes precedence over medicating after therapy. Distraction
techniques are also used to assist with pain, but the premedication is the priority.
To assess the characteristics of a client's pain, the nurse should ask:
a. "Can you point to the painful area?"
b. "Does the pain move or is it in just one spot?"
c. "Using a scale of 0 for no pain and 10 for severe pain, how would you rate your
pain?"
d. "When did the pain start?" - Answer -"Using a scale of 0 for no pain and 10 for
severe pain, how would you rate your pain
Which multidimensional tool should the nurse use in the assessment of a client
experiencing pain?
a. The brief pain inventory
b. The numeric rating scale
c. The body diagram
d. The Oucher scale - Answer -The brief pain inventory The brief pain inventory
provides information on pain and how pain interferes with the person's ability to function.
This tool is considered a multidimensional tool. Unidimensional tools include the
numeric rating scale, body diagram, and Oucher scales.
A client comes into the clinic complaining of severe lower back pain that began after a
round of golf a few days ago. The nurse realizes that this client is experiencing:
a. pain during the transduction phase of the pain process
b. pain during the transmission phase of the pain process
c. pain during the perception phase of the pain process d. pain during the modulation
phase of the pain process - Answer -pain during the transduction phase of the pain
process The receptors that transmit pain sensation are called nociceptors. During the
transduction phase, noxious stimuli, such as a muscle spasm, trigger a release of
biochemical mediators that sensitize nociceptors. The transmission phase of pain
involves transmitting the pain response from the peripheral nerve to the thalamus and
sensory cortex. The perception phase is when the client becomes aware of the pain.
The modulation phase occurs when substances such as endogenous opioids,
serotonin, and norepinephrine are released, which can inhibit painful stimuli.
A client with chronic back pain has been prescribed a tricyclic antidepressant
medication. The nurse realizes that this medication will:
a. do nothing for the client's pain
b. cause the client to sleep through most of the pain
c. act as a placebo for the client's pain
d. increase the modulation phase of the pain cycle - Answer -increase the modulation
phase of the pain cycle Individuals with chronic pain may be prescribed tricyclic
antidepressants to inhibit the reuptake of norepinephrine and serotonin. This action
increases the modulation phase that helps inhibit painful ascending stimuli. A
medication would not be prescribed if it were not thought to be effective. When treating
pain, the primary effect of the medication is not sleep.
1. A client experiencing pain from an amputated limb tells the nurse that the pain is
constant and the pain medication is not effective. What would be appropriate for the
nurse to say or do in this situation?
a. Remind the client that the limb is gone and can't be causing pain.
b. Call the healthcare provider to report the ongoing pain.
c. Do nothing. In time the pain will diminish on its own. d. Help the client to a sitting
position and offer magazines. - Answer -Call the healthcare provider to report the
ongoing pain. Pain is whatever the person says it is—existing whenever the person
says it does. It is highly subjective and cannot be shared with others. The best course of
action would be for the nurse to contact the healthcare provider to report the client's
ongoing pain. The other options would not be supportive of the client and the pain
experience.
During a healthcare visit, the nurse learns that a client has had some degree of pain for
years yet has never sought medical intervention for the pain. The nurse realizes that
one explanation for this might be:
a. The client is practicing pain-reducing interventions.
b. The client has a history of substance abuse.
c. The client doesn't really have pain.
d. The client has become accustomed to having pain. - Answer -The client has become
accustomed to having pain. Previous experiences with pain affect the way an individual
responds to pain. This client's history of having pain for years may explain why he/she is
able to live with the pain. There is no provided history of pain-reducing interventions or
substance abuse. Assuming the client doesn't have pain is a judgment on the nurse's
part and a nontherapeutic assessment.
After a hip replacement, a client is unable to tolerate any touching or clothing over the
incision site. The nurse realizes that this client is exhibiting:
a. hyperalgesia
b. pain reaction
c. pain tolerance
d. pain threshold - Answer -hyperalgesia sensitivity to pain. The amount of pain
stimulation a person requires to feel pain is called the pain threshold, or pain reaction.
Pain tolerance is the maximum amount and duration of pain that an individual is willing
to endure.
A client complaining of pain is seen by the nurse. This client smiles and hesitates to
respond when asked about the degree of pain. The nurse realizes this client is
demonstrating the pain behavior consistent with:
a. a toddler
b. a school-age child
c. an adolescent
,d. an older adult - Answer -an adolescent Typical adolescent pain behavior includes
being slow to acknowledge pain, thinking pain may be considered a weakness and not
reporting pain so as to appear brave in front of peers. A toddler often responds with
crying and anger because a toddler perceives the pain as a threat to security. A school-
age child tries to be brave when facing pain. The older adult may withhold complaints of
pain because of fear of the treatment or lifestyle changes that may be involved.
A client asks the nurse for pain medication. The nurse is slow to respond and doesn't
provide the medication for over an hour. This nurse is demonstrating:
a. compassion to the client in pain
b. anger toward the patient in pain
c. poor time management skills
d. denial that the patient is truly in pain - Answer -denial that the patient is truly in pain
Nurses have their own attitudes and expectations about pain and may place a higher
value on silent suffering or self-control in response to pain. Nurses may deny or
downplay the pain they observe in others. The nurse is not demonstrating compassion
or anger. There is no information
in the question that addresses the nurse's time management skills. However, if the
nurse is
unable to administer the pain medication in a timely manner due to the acuity of the
patient assignment, the nurse should ask a colleague for assistance.
A client in the pain clinic appears fatigued. The nurse learns the client has not been
sleeping well. This finding will most likely have which effect on the client's pain?
a. Increased pain
b. Decreased pain
c. Decreased pain perception
d. No effect - Answer -Increased pain When pain interferes with sleep, fatigue and
muscle tension often result and increase the pain. Fatigue also reduces a person's
ability to cope, thereby increasing pain perception. The combination of fatigue and pain
doesn't result in decreased pain or pain perception.
A client returns from physical therapy in excruciating pain and tells the nurse, "Exercise
always
makes the pain worse." The nurse plans to:
a. do nothing. This is part of the healing process.
b. provide pain medication prior to the client's physical therapy sessions
c. provide pain medication immediately after physical therapy
d. provide distraction techniques to reduce the client's perception of pain - Answer -
provide pain medication prior to the client's physical therapy sessionsThis episode
demonstrates a precipitating factor to the onset of pain. The best selection would be to
medicate the client prior to attending physical therapy. During the focused interview
regarding pain, the nurse obtains information regarding the pain. Excruciating pain after
exercise is not an expected part of the healing process. The goal is for the client to be
as comfortable as possible, which will assist in activity during physical therapy, so
, medicating before therapy takes precedence over medicating after therapy. Distraction
techniques are also used to assist with pain, but the premedication is the priority.
To assess the characteristics of a client's pain, the nurse should ask:
a. "Can you point to the painful area?"
b. "Does the pain move or is it in just one spot?"
c. "Using a scale of 0 for no pain and 10 for severe pain, how would you rate your
pain?"
d. "When did the pain start?" - Answer -"Using a scale of 0 for no pain and 10 for
severe pain, how would you rate your pain
Which multidimensional tool should the nurse use in the assessment of a client
experiencing pain?
a. The brief pain inventory
b. The numeric rating scale
c. The body diagram
d. The Oucher scale - Answer -The brief pain inventory The brief pain inventory
provides information on pain and how pain interferes with the person's ability to function.
This tool is considered a multidimensional tool. Unidimensional tools include the
numeric rating scale, body diagram, and Oucher scales.
A client comes into the clinic complaining of severe lower back pain that began after a
round of golf a few days ago. The nurse realizes that this client is experiencing:
a. pain during the transduction phase of the pain process
b. pain during the transmission phase of the pain process
c. pain during the perception phase of the pain process d. pain during the modulation
phase of the pain process - Answer -pain during the transduction phase of the pain
process The receptors that transmit pain sensation are called nociceptors. During the
transduction phase, noxious stimuli, such as a muscle spasm, trigger a release of
biochemical mediators that sensitize nociceptors. The transmission phase of pain
involves transmitting the pain response from the peripheral nerve to the thalamus and
sensory cortex. The perception phase is when the client becomes aware of the pain.
The modulation phase occurs when substances such as endogenous opioids,
serotonin, and norepinephrine are released, which can inhibit painful stimuli.
A client with chronic back pain has been prescribed a tricyclic antidepressant
medication. The nurse realizes that this medication will:
a. do nothing for the client's pain
b. cause the client to sleep through most of the pain
c. act as a placebo for the client's pain
d. increase the modulation phase of the pain cycle - Answer -increase the modulation
phase of the pain cycle Individuals with chronic pain may be prescribed tricyclic
antidepressants to inhibit the reuptake of norepinephrine and serotonin. This action
increases the modulation phase that helps inhibit painful ascending stimuli. A
medication would not be prescribed if it were not thought to be effective. When treating
pain, the primary effect of the medication is not sleep.
