HESI RN COMPREHENSIVE EXIT EXAM
.A nurse is teaching a patient about patient-controlled analgesia (PCA).
Which statement made by the patient indicates to the nurse that teaching is
effective?
a. “I will only need to be on this pain medication.”
b. “I feel less anxiety about the possibility of overdosing.”
c. “I can receive the pain medication as frequently as I need to.”
d. “I need the nurse to notify me when it is time for another dose.”
ANS: B
A PCA is a device that allows the patient to determine the level of pain relief
delivered, reducing the risk of overdose. The PCA infusion pumps are designed to
deliver a specific dose that is programmed to be available at specific time intervals
(usually in the range of 8 to 15 minutes) when the patient activates the delivery
button. A limit on the number of doses per hour or 4-hour interval may also be set.
This can help decrease a patient’s anxiety related to possible overdose. Its use also
often eases anxiety because the patient is not reliant on the nurse for pain relief.
Other medications, such as oral analgesics, can be given in addition to the PCA
machine. One benefit of PCA is that the patient does not need to rely on the nurse
to administer pain medication; the patient determines when to take the medication.
10.A nurse is caring for a patient who is experiencing pain following abdominal
surgery. Which information is important for the nurse to share with the patient when
providing patient education about effective pain management?
“To prevent overdose, you need to wait to ask for pain medication
a. until you begin to experience pain.”
“You should take your medication after you walk to make sure you do
b. not fall while you are walking.”
“We should work together to create a schedule to provide regular
c. dosing of medication.”
“When you experience severe pain, you will need to take oral pain
d. medications.”
, ANS: C
One way to maximize pain relief while potentially decreasing opioid use is to
administer analgesics around the clock (ATC) rather than on a prn basis.
This approach ensures a more constant therapeutic blood level of an
analgesic.
Working with the patient to design a schedule allows the patient to be a full
partner in the care provided. The nurse should not wait until pain is
experienced because it takes medications 10-30 minutes to begin to relieve
pain. The nurse administers pain medications before painful activities, such as
walking, and administers intravenous medications when a patient is having
severe pain.
11.A nurse is caring for a patient who recently had spinal surgery. The nurse
knows that patients usually experience acute pain following this type of
surgery. The patient refuses to get up and walk and is not moving around in
the
bed. However, the patient is stoic and denies experiencing pain at this time. What
most likely explains this patient’s behavior?
a. The surgery successfully cured the patient’s pain.
The patient’s culture is possibly influencing the patient’s experience of
b. pain.
The primary health care provider did not prescribe the correct amount
c. of medication.
The nurse is allowing personal beliefs about pain to influence pain
d. management at this time.
ANS: B
A patient’s culture or beliefs about pain often influence the patient’s expression
of pain. In this case, the patient has just had surgery, and the nurse knows that
this surgical procedure usually causes patients to experience pain. It is
important at this time for the nurse to examine cultural and ethnic factors that
are possibly affecting the patient’s lack of expression of pain at this time.
Even if surgery corrects neurological factors that create chronic pain, surgery
causes pain in the acute period. The patient has not taken any pain medication
so this is an unrealistic assumption; most pain medications have standard
dosages. The nurse is not allowing personal beliefs to influence pain
management because the nurse is attempting to determine the reason why the
patient is not verbalizing the experience of pain.
12.A nurse is providing discharge teaching for a patient with a fractured humerus.
The patient is going home with hydrocodone. Which important
patient education does the nurse provide?
2
a. “You need to drink plenty of fluids and eat a diet high in fiber.”
.A nurse is teaching a patient about patient-controlled analgesia (PCA).
Which statement made by the patient indicates to the nurse that teaching is
effective?
a. “I will only need to be on this pain medication.”
b. “I feel less anxiety about the possibility of overdosing.”
c. “I can receive the pain medication as frequently as I need to.”
d. “I need the nurse to notify me when it is time for another dose.”
ANS: B
A PCA is a device that allows the patient to determine the level of pain relief
delivered, reducing the risk of overdose. The PCA infusion pumps are designed to
deliver a specific dose that is programmed to be available at specific time intervals
(usually in the range of 8 to 15 minutes) when the patient activates the delivery
button. A limit on the number of doses per hour or 4-hour interval may also be set.
This can help decrease a patient’s anxiety related to possible overdose. Its use also
often eases anxiety because the patient is not reliant on the nurse for pain relief.
Other medications, such as oral analgesics, can be given in addition to the PCA
machine. One benefit of PCA is that the patient does not need to rely on the nurse
to administer pain medication; the patient determines when to take the medication.
10.A nurse is caring for a patient who is experiencing pain following abdominal
surgery. Which information is important for the nurse to share with the patient when
providing patient education about effective pain management?
“To prevent overdose, you need to wait to ask for pain medication
a. until you begin to experience pain.”
“You should take your medication after you walk to make sure you do
b. not fall while you are walking.”
“We should work together to create a schedule to provide regular
c. dosing of medication.”
“When you experience severe pain, you will need to take oral pain
d. medications.”
, ANS: C
One way to maximize pain relief while potentially decreasing opioid use is to
administer analgesics around the clock (ATC) rather than on a prn basis.
This approach ensures a more constant therapeutic blood level of an
analgesic.
Working with the patient to design a schedule allows the patient to be a full
partner in the care provided. The nurse should not wait until pain is
experienced because it takes medications 10-30 minutes to begin to relieve
pain. The nurse administers pain medications before painful activities, such as
walking, and administers intravenous medications when a patient is having
severe pain.
11.A nurse is caring for a patient who recently had spinal surgery. The nurse
knows that patients usually experience acute pain following this type of
surgery. The patient refuses to get up and walk and is not moving around in
the
bed. However, the patient is stoic and denies experiencing pain at this time. What
most likely explains this patient’s behavior?
a. The surgery successfully cured the patient’s pain.
The patient’s culture is possibly influencing the patient’s experience of
b. pain.
The primary health care provider did not prescribe the correct amount
c. of medication.
The nurse is allowing personal beliefs about pain to influence pain
d. management at this time.
ANS: B
A patient’s culture or beliefs about pain often influence the patient’s expression
of pain. In this case, the patient has just had surgery, and the nurse knows that
this surgical procedure usually causes patients to experience pain. It is
important at this time for the nurse to examine cultural and ethnic factors that
are possibly affecting the patient’s lack of expression of pain at this time.
Even if surgery corrects neurological factors that create chronic pain, surgery
causes pain in the acute period. The patient has not taken any pain medication
so this is an unrealistic assumption; most pain medications have standard
dosages. The nurse is not allowing personal beliefs to influence pain
management because the nurse is attempting to determine the reason why the
patient is not verbalizing the experience of pain.
12.A nurse is providing discharge teaching for a patient with a fractured humerus.
The patient is going home with hydrocodone. Which important
patient education does the nurse provide?
2
a. “You need to drink plenty of fluids and eat a diet high in fiber.”
