Chapter 1. Pain MUL cf cf cf
TIPLE CHOICE cf
1.A client tells the nurse that she rarely experiences pain, but when she does, she seeks medical atten
cf cf cf cf cf cf cf cf cf cf cf cf cf cf cf cf cf
tion. The nurse realizes this client understands that pain is important because it:
cf cf cf cf cf cf cf cf cf cf cf cf
1. is a protective system.
cf cf cf
2. includes the automatic withdrawal reflex. cf cf cf cf
3. creates sensitivity to pain. cf cf cf
4. helps with healing. cf cf
ANS: 1 cf
Pain is a protective system that includes protection from unsafe behaviors by use of reflexes, m
cf cf cf cf cf cf cf cf cf cf cf cf cf cf cf
emory, and avoidance. Even though the automatic withdrawal reflex is a part of the pain respon
cf cf cf cf cf cf cf cf cf cf cf cf cf cf cf
se, it does not explain why pain is important. Pain does not create sensitivity to pain. Pain does
cf cf cf cf cf cf cf cf cf cf cf cf cf cf cf cf cf cf
not help with healing.
cf cf cf
PTS: 1 DIF: Analyze REF: Definitions and Implications of Pain
cf cf cf cf cf cf cf cf cf
2.A client complains that the bed sheets touching his skin are extremely painful. The nurse realiz
cf cf cf cf cf cf cf cf cf cf cf cf cf cf cf
es this client is experiencing:
cf cf cf cf
1. allodynia.
2. modulation.
3. kinesthesia.
4. proprioception.
ANS: 1 cf
Allodynia or hyperalgesia is a state where a slight or nonpainful stimulus is interpreted as very p
cf cf cf cf cf cf cf cf cf cf cf cf cf cf cf cf
ainful. Kinesthesia is the awareness of movement. Proprioception is the awareness of body posi
cf cf cf cf cf cf cf cf cf cf cf cf cf
tion. Modulation is an influencing factor in the perception of pain.
cf cf cf cf cf cf cf cf cf cf
PTS: 1 DIF: Analyze REF: Peripheral Nervous System
cf cf cf cf cf cf cf
3.A client is complaining of severe abdomen pain. The nurse realizes this client is experiencing whic
cf cf cf cf cf cf cf cf cf cf cf cf cf cf cf
h type of pain?
cf cf cf
1. Neuralgia
2. Pathological
3. Somatic
4. Visceral
ANS: 4 cf
Visceral pain is pain arising from the body organs or gastrointestinal tract. Somatic pain is pain t
cf cf cf cf cf cf cf cf cf cf cf cf cf cf cf cf
hat originates from the bone, joints, muscles, skin, or connective pain. Neuralgia and
cf cf cf cf cf cf cf cf cf cf cf cf
,pathological pain are both types of pain that result from injury to a nerve or malfunction of the neuro
cf cf cf cf cf cf cf cf cf cf cf cf cf cf cf cf cf cf
nal transmission process or due to impaired regulation.
cf cf cf cf cf cf cf
PTS:1DIF:AnalyzeREF:Types of Pain cf cf
4.A client, diagnosed with acute appendicitis, is experiencing abdominal pain. The best way for t
cf cf cf cf cf cf cf cf cf cf cf cf cf cf
he nurse to describe this clients pain would be:
cf cf cf cf cf cf cf cf
1. chronic.
2. neuropathic.
3. referred.
4. acute.
ANS: 4 cf
Acute pain onset is sudden and of short duration. Chronic pain is a sudden or slow onset of mild
cf cf cf cf cf cf cf cf cf cf cf cf cf cf cf cf cf cf cf
to severe pain that lasts longer than 6 months. Referred pain is the result of the transfer of visce
cf cf cf cf cf cf cf cf cf cf cf cf cf cf cf cf cf cf
ral pain sensations to a body surface at a distance from the actual origin. Neuropathic pain is pa
cf cf cf cf cf cf cf cf cf cf cf cf cf cf cf cf cf
roxysmal pain that occurs along the branches of a nerve.
cf cf cf cf cf cf cf cf c f
PTS:1DIF:ApplyREF:Types of Pain cf cf
5.A client is observed holding a pillow over the abdominal region with both knees flexed in a
cf cf cf cf cf cf cf cf cf cf cf cf cf cf cf cf c
side-
f
lying position. Vital signs assessment reveals an elevated blood pressure and heart rate. Whi
cf cf cf cf cf cf cf cf cf cf cf cf cf
ch of the following should the nurse say to this client?
cf cf cf cf cf cf cf cf cf cf
1. Can I get you anything? cf cf cf cf
2. Would you like something for pain? cf cf cf cf cf
3. You look comfortable. cf cf
4. Your blood pressure is up. cf cf cf cf
ANS: 2 cf
Sympathetic responses to pain include elevated blood pressure and heart rate. And since the clie
cf cf cf cf cf cf cf cf cf cf cf cf cf cf
nt is hugging a pillow over the abdominal region with both knees flexed in a side-
cf cf cf cf cf cf cf cf cf cf cf cf cf cf cf
lying position, the best thing for the nurse to say to this client is Would you like something for p
cf cf cf cf cf cf cf cf cf cf cf cf cf cf cf cf cf cf cf
ain? The other responses are incorrect because they do not acknowledge that the client is experie
cf cf cf cf cf cf cf cf cf cf cf cf cf cf cf
ncing pain. cf
PTS: 1 DIF: Apply REF: Assessing the Clinical Manifestations of Pain
cf cf cf cf cf cf cf cf cf cf
6.A client experiencing chronic pain asks the nurse why she is not prescribed Demerol like she r
cf cf cf cf cf cf cf cf cf cf cf cf cf cf cf cf
eceived when she had a total knee replacement. Which of the following should the nurse respon
cf cf cf cf cf cf cf cf cf cf cf cf cf cf cf
d to this client?
cf cf cf
1. You dont need something that strong.
cf cf cf cf cf
2. That medication does not exist anymore.
cf cf cf cf cf
3. That medication does not last very long.
cf cf cf cf cf cf
4. It can cause you have high blood pressure.
cf cf cf cf cf cf cf
, ANS: 3 cf
Meperidine is no longer a major drug for acute or chronic pain due to its short analgesic duration
cf cf cf cf cf cf cf cf cf cf cf cf cf cf cf cf cf
of 2 to 3 hours and the potential for accumulative toxic effects of its metabolite, normeperidine
cf cf cf cf cf cf cf cf cf cf cf cf cf cf cf cf
. The best response for the nurse to make to the client would be that medication does not last ve
cf cf cf cf cf cf cf cf cf cf cf cf cf cf cf cf cf cf cf
ry long. The other responses are inaccurate.
cf cf cf cf cf cf
PTS:1DIF:ApplyREF:Opioid Analgesics c f
7.A client is informed that a tricyclic antidepressant medication is going to help control his chro
cf cf cf cf cf cf cf cf cf cf cf cf cf cf cf
nic pain. The nurse would expect the physician to prescribe:
cf cf cf cf cf cf cf cf cf
1. Amitriptyline.
2. Baclofen.
3. Gabapentin.
4. Diazepam.
ANS: 1 cf
Amitriptyline is an antidepressant. Gabapentin is an anticonvulsant. Baclofen is a muscle relaxan
cf cf cf cf cf cf cf cf cf cf cf cf
t. Diazepam is a benzodiazepine.
cf cf cf cf
PTS: 1 DIF: Analyze REF: Adjuvant Medications
cf cf cf cf cf cf
8.A client receiving around-the-
cf cf cf
clock medication for terminal cancer experiences additional pain when performing activities of daily
cf cf cf cf cf cf cf cf cf cf cf cf
living. The nurse realizes this client is experiencing:
cf cf cf cf cf cf cf cf
1. breakthrough pain. cf
2. intractable pain. cf
3. psychosomatic pain. cf
4. acute pain. cf
ANS: 1 cf
Breakthrough pain is commonly seen in the advanced stages of cancer. It is spontaneous, unpre
cf cf cf cf cf cf cf cf cf cf cf cf cf cf
dictable, and can be initiated by certain activities such as during activities of daily living. Intrac
cf cf cf cf cf cf cf cf cf cf cf cf cf cf cf
table pain is resistant to some or all forms of therapy. Psychosomatic pain is that which has a psy
cf cf cf cf cf cf cf cf cf cf cf cf cf cf cf cf cf cf
chological origin. The client is diagnosed with terminal cancer. Acute pain has a sudden onset a
cf cf cf cf cf cf cf cf cf cf cf cf cf cf cf
nd resolves within 6 months.
cf cf cf cf
PTS:1DIF:AnalyzeREF:Breakthrough Pain c f
9.A client recovering from surgery tells the nurse that she is nauseated and is experiencing an increa
cf cf cf cf cf cf cf cf cf cf cf cf cf cf cf cf
se in pain. Which of the following does this clients symptoms suggest to the nurse?
cf cf cf cf cf cf cf cf cf cf cf cf cf cf
1 The client is becoming dependent upon the pain medication.
cf cf cf cf cf cf cf cf
.
2 The clients pain threshold is lower when experiencing nausea.
cf cf cf cf cf cf cf cf
.
3 The client is experiencing withdrawal symptoms from pain medication.
cf cf cf cf cf cf cf cf
.