LaCharity chapter 2 exam questions for
management exam 1
The patient describes a burning sensation in the leg. The health care provider tells the nurse
that a medication will be prescribed for neuropathic pain secondary to chemotherapy. The nurse
is most likely to question the prescription of which drug?
1. Imipramine 2. Carbamazepine 3. Gabapentin 4. Morphine - ANS4. Morphine is usually not
prescribed for neuro- pathic pain because pain relief response is poor. Other medications, some
antidepressants (e.g., imipramine) and some anticonvulsants (e.g., carbamazepine and
gabapentin), provide better relief. Focus: Prioritization.
A patient who has cancer will need ongoing treatment for pain. Which brochure is the nurse
most likely to prepare that addresses questions related to the first-line treatment of cancer pain?
1. "An Illustrated Guide to the Analgesic Ladder" 2. "Common Questions About Radiation
Therapy" 3. "How to Make Preparations for Your Cancer
Surgery" 4. "How Nerve Blocks Can Help to Manage Cancer
Pain" - ANS1. Analgesic drugs are the first-line treatment for cancer pain management. If pain is
not controlled by medication, other options are available, including radiation, surgery, and nerve
blocks. Focus: Prioritization.
Which nurse is demonstrating the first step in manag- ing cancer pain by using the ABCDE (ask,
believe, choose, deliver, and empower) clinical approach to pain management as recommended
by the Agency for Healthcare Research and Quality?
1. Nurse J asks if the time of the prescribed dose of medication can be changed.
2. Nurse K asks the patient to describe pain and uses a numerical pain scale.
3.Nurse L asks the patient to participate and to con- tribute in pain management.
4.Nurse M asks about pain management options that are appropriate for the patient. - ANS2.
Asking the patient to describe the pain is the first step. The ABCDE step-by-step clinical
approach includes ask, believe, choose, deliver, and empower (or enable). Focus: Prioritizatio
The nurse assesses the patient and determines that the patient is having frequent breakthrough
cancer pain. Which member of the health care team is the nurse most likely to contact first?
1. Physical therapist to reevaluate physical therapy routines
2. Health care provider to review medication, dosage, and frequency
3. Unlicensed assistive personnel to provide more assistance with activities of daily living
4. Psychiatric clinical nurse specialist to evaluate psychogenic pain - ANS2. Breakthrough pain
is defined as rapid onset, short duration, and moderate to severe; a temporary exacerbation
related to poorly controlled around-the- clock dosing of background pain. Frequent break-
through pain suggests that the around-the-clock dos- ing needs reevaluation, so the nurse
would contact the health care provider and advocate for a change of med- ication or dose or
frequency. Focus: Prioritization.
, The night shift nurse tells the oncoming dayshift nurse that the cancer patient is on
around-the-clock dosing of morphine but that the patient might be having end-of-dose pain.
Which question is the most impor- tant to ask the night shift nurse?
1. "How many times did you have to give a bolus dose of morphine?"
2. "Did the patient tell you that the pain was greater than a 5/10?"
3. "Did you notify the health care provider (HCP), and were changes prescribed?"
4. "Did you try any nonpharmaceutical therapies or adjuvant medications? - ANS3. The nurse
might ask any of these questions, but the most important question is whether the HCP was
notified and if any changes were made to address the patient's pain. If the HCP was not called
during the night (which is often the case), then the day shift nurse must assess the patient's
current pain, talk to him or her directly about last night's pain, and gather data about the
frequency of bolus doses and other options that were tried. Data about last night's care should
be avail- able in the patient's record if it is not mentioned in report. Focus: Prioritization.
The nurse is caring for a patient with esophageal can- cer. Which task could be delegated to
unlicensed assis- tive personnel (UAP)?
1. Assisting the patient with oral hygiene
2. Observing the patient's response to feedings
3. Facilitating expression of grief or anxiety
4. Initiating daily weigh - ANS1. Oral hygiene is within the scope of duties of the UAP. It is the
responsibility of the nurse to observe response to treatments and to help the patient deal with
loss or anxiety. The UAP can be directed to weigh the patient but should not be expected to
know when to initiate that measurement. Focus: Delegation.
A 56-year-old patient comes to the walk-in clinic reporting scant rectal bleeding and intermittent
diar- rhea and constipation for the past several months. There is a history of polyps and a family
history of colo- rectal cancer. While the nurse is trying to teach about colonoscopy, the patient
becomes angry and threatens to leave. What is the priority nursing concept to con- sider in
responding to this patient?
1. Elimination
2. Patient education
3. Cellular regulation
4. Anxiety - ANS4. The patient's physical condition is currently stable, but emotional needs are
affecting his or her abil- ity to receive the information required to make an informed decision.
The other concepts are relevant, but if the patient leaves the clinic, the interventions may be
delayed or ignored. Focus: Prioritization.
Which patient is at greatest risk for pancreatic cancer?
1. An older African-American man who smokes
2. A young white obese woman with gallbladder
disease
3. A young African-American man with type1 diabetes
management exam 1
The patient describes a burning sensation in the leg. The health care provider tells the nurse
that a medication will be prescribed for neuropathic pain secondary to chemotherapy. The nurse
is most likely to question the prescription of which drug?
1. Imipramine 2. Carbamazepine 3. Gabapentin 4. Morphine - ANS4. Morphine is usually not
prescribed for neuro- pathic pain because pain relief response is poor. Other medications, some
antidepressants (e.g., imipramine) and some anticonvulsants (e.g., carbamazepine and
gabapentin), provide better relief. Focus: Prioritization.
A patient who has cancer will need ongoing treatment for pain. Which brochure is the nurse
most likely to prepare that addresses questions related to the first-line treatment of cancer pain?
1. "An Illustrated Guide to the Analgesic Ladder" 2. "Common Questions About Radiation
Therapy" 3. "How to Make Preparations for Your Cancer
Surgery" 4. "How Nerve Blocks Can Help to Manage Cancer
Pain" - ANS1. Analgesic drugs are the first-line treatment for cancer pain management. If pain is
not controlled by medication, other options are available, including radiation, surgery, and nerve
blocks. Focus: Prioritization.
Which nurse is demonstrating the first step in manag- ing cancer pain by using the ABCDE (ask,
believe, choose, deliver, and empower) clinical approach to pain management as recommended
by the Agency for Healthcare Research and Quality?
1. Nurse J asks if the time of the prescribed dose of medication can be changed.
2. Nurse K asks the patient to describe pain and uses a numerical pain scale.
3.Nurse L asks the patient to participate and to con- tribute in pain management.
4.Nurse M asks about pain management options that are appropriate for the patient. - ANS2.
Asking the patient to describe the pain is the first step. The ABCDE step-by-step clinical
approach includes ask, believe, choose, deliver, and empower (or enable). Focus: Prioritizatio
The nurse assesses the patient and determines that the patient is having frequent breakthrough
cancer pain. Which member of the health care team is the nurse most likely to contact first?
1. Physical therapist to reevaluate physical therapy routines
2. Health care provider to review medication, dosage, and frequency
3. Unlicensed assistive personnel to provide more assistance with activities of daily living
4. Psychiatric clinical nurse specialist to evaluate psychogenic pain - ANS2. Breakthrough pain
is defined as rapid onset, short duration, and moderate to severe; a temporary exacerbation
related to poorly controlled around-the- clock dosing of background pain. Frequent break-
through pain suggests that the around-the-clock dos- ing needs reevaluation, so the nurse
would contact the health care provider and advocate for a change of med- ication or dose or
frequency. Focus: Prioritization.
, The night shift nurse tells the oncoming dayshift nurse that the cancer patient is on
around-the-clock dosing of morphine but that the patient might be having end-of-dose pain.
Which question is the most impor- tant to ask the night shift nurse?
1. "How many times did you have to give a bolus dose of morphine?"
2. "Did the patient tell you that the pain was greater than a 5/10?"
3. "Did you notify the health care provider (HCP), and were changes prescribed?"
4. "Did you try any nonpharmaceutical therapies or adjuvant medications? - ANS3. The nurse
might ask any of these questions, but the most important question is whether the HCP was
notified and if any changes were made to address the patient's pain. If the HCP was not called
during the night (which is often the case), then the day shift nurse must assess the patient's
current pain, talk to him or her directly about last night's pain, and gather data about the
frequency of bolus doses and other options that were tried. Data about last night's care should
be avail- able in the patient's record if it is not mentioned in report. Focus: Prioritization.
The nurse is caring for a patient with esophageal can- cer. Which task could be delegated to
unlicensed assis- tive personnel (UAP)?
1. Assisting the patient with oral hygiene
2. Observing the patient's response to feedings
3. Facilitating expression of grief or anxiety
4. Initiating daily weigh - ANS1. Oral hygiene is within the scope of duties of the UAP. It is the
responsibility of the nurse to observe response to treatments and to help the patient deal with
loss or anxiety. The UAP can be directed to weigh the patient but should not be expected to
know when to initiate that measurement. Focus: Delegation.
A 56-year-old patient comes to the walk-in clinic reporting scant rectal bleeding and intermittent
diar- rhea and constipation for the past several months. There is a history of polyps and a family
history of colo- rectal cancer. While the nurse is trying to teach about colonoscopy, the patient
becomes angry and threatens to leave. What is the priority nursing concept to con- sider in
responding to this patient?
1. Elimination
2. Patient education
3. Cellular regulation
4. Anxiety - ANS4. The patient's physical condition is currently stable, but emotional needs are
affecting his or her abil- ity to receive the information required to make an informed decision.
The other concepts are relevant, but if the patient leaves the clinic, the interventions may be
delayed or ignored. Focus: Prioritization.
Which patient is at greatest risk for pancreatic cancer?
1. An older African-American man who smokes
2. A young white obese woman with gallbladder
disease
3. A young African-American man with type1 diabetes
