Health Assessment Focused Exam on Pain Management | Update with complete solutions |Q&A 100+|Verified |already graded A+

Health Assessment Focused Exam on Pain Management | Update with complete solutions |Q&A 100+|Verified |already graded A+ pain definition - ANSWER an unpleasant sensory and emotional experience associated with, or resembling that associated with, actual or potential tissue damage chronic pain - ANSWER usually associated with a specific cause or injury-pain that persists for more than 6 months; can be malignant (cancer-related), or breakthrough pain malignant (cancer-related) pain - ANSWER parallels the pathophysiology created by tumor cells. pain is induced by tissue necrosis ro stretching of an organ by the growing tumor Q: quality/quantity R: region/radiation S: severity scale T: timing using pain assessment tools - ANSWER no matter what tool you use, you want to select a pain assessment tool that is understandable for the patients and is developmentally appropriate for the patinet numeric pain intensity scale - ANSWER rate pain of 0 (no pain) to 10 (unbearable pain) simple descriptive pain intensity scale - ANSWER no pain, mild pain, moderate pain, severe pain, very severe pain, worse possible pain visual analogue scale (VAS) - ANSWER a question that asks for a response by marking a line between the minimum (no pain) or maximum value (pain as bas as it could possibly be) Face Pain Scale-Revised (FPS-R) - ANSWER primarily used in pediatrics because children oftentimes have a hard time describing pain or rating it but they can be familiar with the face and how sad/upset the face looks. they pick the face that mostly describes how they are feeling physiologic responses to pain - ANSWER -Anxiety, fear, hopelessness, sleeplessness, thoughts of suicide -Focus on pain, reports of pain, cries and moans, frowns and facial grimaces -Decrease in cognitive function, mental confusion, altered temperament, high somatization, and dilated pupils -Increased heart rate; peripheral, systemic, and coronary vascular resistance; and blood pressure -Increased respiratory rate and sputum retention, resulting in infection and atelectasis -Decreased gastric and intestinal motility -Decreased urinary output, resulting in urinary retention, fluid overload, depression of all immune responses -Increased antidiuretic hormone, epinephrine, norepinephrine, aldosterone, glucagons, decreased insulin, testosterone -Hyperglycemia, glucose intolerance, insulin resistance, protein catabolism -Muscle spasm resulting in impaired muscle function and immobility, perspiration During an examination of an aging male, the nurse recognizes that normal changes to expect would be: A) enlarged scrotal sac. B) increased pubic hair. C) decreased penis size. D) increased rugae over the scrotum. - ANSWER ANS: C In the aging male the amount of pubic hair decreases, the penis size decreases, and there is a decrease in the rugae over the scrotal sac. The scrotal sac does not enlarge. An older man is concerned about his sexual performance. The nurse knows that in the absence of disease, a withdrawal from sexual activity later in life may be due to: A) side effects of medications. B) decreased libido with aging. C) decreased sperm production. D) decreased pleasure from sexual intercourse. - ANSWER ANS: A In the absence of disease, a withdrawal from sexual activity may be due to side effects of medications such as antihypertensives, antidepressants, or sedatives. The other options are not correct. A newborn baby boy is about to have a circumcision. The nurse knows that indications for circumcision include: A) cultural and religious beliefs. B) prevention of testicular cancer. C) improving the sperm count later in life. D) preventing dysuria - ANSWER ANS: A Indications for circumcision include cultural and religious beliefs, prevention of phimosis and inflammation of the glans penis and foreskin, decreasing the incidence of cancer of the penis, and decreasing the incidence of urinary tract infections in infancy. A 59-year-old patient has been diagnosed with prostatitis and is being seen at the clinic for complaints of burning and pain during urination. He is experiencing: A) dysuria. B) nocturia. C) polyuria. D) hematuria. - ANSWER ANS: A Dysuria or burning with urination is common with acute cystitis, prostatitis, and urethritis. Nocturia is voiding during the night. Polyuria is voiding in excessive quantities. Hematuria is voiding with blood in the urine A 45-year-old mother of two children is seen at the clinic for complaints of "losing my urine when I sneeze." The nurse documents that she is experiencing: A) urinary frequency. B) enuresis. C) stress incontinence. D) urge incontinence. - ANSWER ANS: C Stress incontinence is involuntary urine loss with physical strain, sneezing, or coughing that occurs due to weakness of the pelvic floor. Urinary frequency is urinating more times than usual (more than 5 to 6 times per day). Enuresis is involuntary passage of urine at night after age 5 to 6 years (bed wetting). Urge incontinence is involuntary urine loss from overactive detrusor muscle in the bladder. It contracts, causing an urgent need to void. When the nurse is conducting sexual history from a male adolescent, which statement would be most appropriate to use at the beginning of the interview? A) "Do you use condoms?" B) "You don't masturbate, do you?" C) "Have you had sex in the last 6 months?" D) "Often boys your age have questions about sexual activity." - ANSWER ANS: D Start the interview with a permission statement. This conveys that it is normal and all right to think or feel a certain way. Avoid sounding judgmental. Which of these statements is most appropriate when the nurse is obtaining a genitourinary history from an elderly man? A) "Do you need to get up at night to urinate?" B) "Do you experience nocturnal emissions, or 'wet dreams'?" C) "Do you know how to perform a testicular self-examination?" D) "Has anyone ever touched your genitals when you did not want them to?" - ANSWER ANS: A The elderly male patient should be asked about the presence of nocturia. This may be due to diuretic medication, fluid retention from mild heart failure or varicose veins, or fluid ingestion 3 hours before bedtime, especially coffee and alcohol. The other questions are more appropriate for younger males. When the nurse is performing a genital examination on a male patient, the patient has an erection. The nurse's most appropriate action or response is to: A) ask the patient if he would like someone else to examine him. B) continue with the examination as though nothing has happened. C) stop the examination, leave the room while stating that the examination will resume at a later time. D) reassure the patient that this is a normal response and continue with the examination. - ANSWER ANS: D When the male patient has an erection, the nurse should reassure the patient that this is a normal physiologic response to touch and proceed with the rest of the examination. The other responses are not correct and may be perceived as judgmental. The nurse is examining the glans and knows that which of these is a normal finding for this area? A) The meatus may have a slight discharge when the glans is compressed. B) Hair is without pest inhabitants. C) The skin is wrinkled and without lesions. D) Smegma may be present under the foreskin of an uncircumcised male. - ANSWER ANS: D The glans looks smooth and without lesions and does not have hair. The meatus should not have any discharge when the glans is compressed. Some cheesy smegma may have collected under the foreskin of an uncircumcised male. When performing a genitourinary assessment, the nurse notices that the urethral meatus is positioned ventrally. This finding is: A) called hypospadias. B) the result of phimosis. C) probably due to a stricture. D) often associated with aging. - ANSWER ANS: A Normally the urethral meatus is positioned just about centrally. Hypospadias is the ventral location of the urethral meatus. The position of the meatus does not change with aging. Phimosis is the inability to retract the foreskin. A stricture is a narrow opening of the meatus. The nurse is performing a genital examination on a male patient and notices urethral drainage. When collecting urethral discharge for microscopic examination and culture, the nurse should: A) ask the patient to urinate into a sterile cup. B) ask the patient to obtain a specimen of semen. C) insert a cotton-tipped applicator into the urethra. D) compress the glans between the examiner's thumb and forefinger and collect any discharge. - ANSWER ANS: D