NUR 303 Exam 3 Questions With Complete Solutions
0-10 numeric rating scale correct answers adults and children
(>9yrs)
all patient care settings who are able to use numbers to rate the
intensity of pain
Abrasion correct answers Friction; rubbing or scraping
epidermal layers of skin; top layer of skin abraded
Adult nonverbal pain scale (NVPS) correct answers Adults who
are sedated and non-responsive
Basic pain assessing methods correct answers acute - high BP,
pulse, and RR
Chronic - no VS change
•Patient self-report (OLD CAARTS)
•Identify pathologic conditions or procedures that may be
causing pain; consider physiologic measures (increased blood
pressure and pulse)
•Report of family member, other person close to the patient or
caregiver familiar with the person
•Nonverbal behaviors: restlessness, grimacing, crying, clenching
fists, protecting the painful area
•Physiologic measures: increased blood pressure and pulse
,•Attempt an analgesic trial and monitor the results
Behavioral pain scale correct answers Useful with intubated,
critically ill patients; measurement of bodily indicators of pain;
and tolerance of intubation.
Cane correct answers •Hold in cane in stronger hand opposite of
side that needs support and use the stronger side to put weight
on it and drag the weaker foot forward
•Wear nonskid shoes or nonskid socks/slippers
•single ended are used for patients needing minimal support
•Single with straight handles for patients with hand weakness
•3-4 pronged canes for those with poor balance
Checklist of nonverbal indicators correct answers Adults
Unable to validate the presence of or quantify the severity of
pain using numeric or wong baker faces scale
Cold therapy correct answers Discontinue: every 5-10 minutes
assess for redness, pallor, numbness, cyanosis, increased BP,
shivering, and goosebumps, and blisters
-Once comfort is verbalized
-verbalized increased rest and sleep
-Demonstrate evidence of wound healing
-Decrease in muscle spasms, inflammation, and edema
-Verbalize and demonstrate the safe cold application
, Comfort behavior scale correct answers Infants, children, adults
who are unable to use the numeric rating scale or Wong-Baker
FACES pain rating scale
Conscious sedation correct answers a state of anesthesia in
which the patient is conscious but is rendered free of fear and
anxiety
independent airway management
For short term procedures
Contusion correct answers Blunt instrument, overlying skin
remains intact, with injury to underlying soft tissue; possible
resultant bruising and/or hematoma
Cries instrument correct answers Neonates (0-6 months) pain
assessment
Critical Care Pain Observation Tool (CPOT) correct answers
Adults who are sedated and nonresponsive
Crutches correct answers to avoid using one leg or to strengthen
one or both legs
Support of body weight should come to hands and arms, not
axillary
-Forearm crutches: long term support for ambulation
-Axillary crutches: support for patients with temporary
restrictions
0-10 numeric rating scale correct answers adults and children
(>9yrs)
all patient care settings who are able to use numbers to rate the
intensity of pain
Abrasion correct answers Friction; rubbing or scraping
epidermal layers of skin; top layer of skin abraded
Adult nonverbal pain scale (NVPS) correct answers Adults who
are sedated and non-responsive
Basic pain assessing methods correct answers acute - high BP,
pulse, and RR
Chronic - no VS change
•Patient self-report (OLD CAARTS)
•Identify pathologic conditions or procedures that may be
causing pain; consider physiologic measures (increased blood
pressure and pulse)
•Report of family member, other person close to the patient or
caregiver familiar with the person
•Nonverbal behaviors: restlessness, grimacing, crying, clenching
fists, protecting the painful area
•Physiologic measures: increased blood pressure and pulse
,•Attempt an analgesic trial and monitor the results
Behavioral pain scale correct answers Useful with intubated,
critically ill patients; measurement of bodily indicators of pain;
and tolerance of intubation.
Cane correct answers •Hold in cane in stronger hand opposite of
side that needs support and use the stronger side to put weight
on it and drag the weaker foot forward
•Wear nonskid shoes or nonskid socks/slippers
•single ended are used for patients needing minimal support
•Single with straight handles for patients with hand weakness
•3-4 pronged canes for those with poor balance
Checklist of nonverbal indicators correct answers Adults
Unable to validate the presence of or quantify the severity of
pain using numeric or wong baker faces scale
Cold therapy correct answers Discontinue: every 5-10 minutes
assess for redness, pallor, numbness, cyanosis, increased BP,
shivering, and goosebumps, and blisters
-Once comfort is verbalized
-verbalized increased rest and sleep
-Demonstrate evidence of wound healing
-Decrease in muscle spasms, inflammation, and edema
-Verbalize and demonstrate the safe cold application
, Comfort behavior scale correct answers Infants, children, adults
who are unable to use the numeric rating scale or Wong-Baker
FACES pain rating scale
Conscious sedation correct answers a state of anesthesia in
which the patient is conscious but is rendered free of fear and
anxiety
independent airway management
For short term procedures
Contusion correct answers Blunt instrument, overlying skin
remains intact, with injury to underlying soft tissue; possible
resultant bruising and/or hematoma
Cries instrument correct answers Neonates (0-6 months) pain
assessment
Critical Care Pain Observation Tool (CPOT) correct answers
Adults who are sedated and nonresponsive
Crutches correct answers to avoid using one leg or to strengthen
one or both legs
Support of body weight should come to hands and arms, not
axillary
-Forearm crutches: long term support for ambulation
-Axillary crutches: support for patients with temporary
restrictions
