Chapter 10: Pain Lewis et al.: Medical-
Surgical Nursing in Canada, 3rd Edition
with 100% correct answers 2025
1. A 45-year-old woman has breast cancer that has spread to her liver and spine. She
has been taking oxycodone (Percodan) and amitriptyline (Elavil) for pain control at
home, but she now has constant severe pain and is hospitalized for pain control and
development of a pain management program. During assessment of the patient, what
information related to her pain is most important for the nurse to obtain initially?
a. The pattern, area, intensity, and nature of her pain
b. Identification of trigger points of pain by palpation of painful areas
c. The schedule and total dosages of the drugs she is currently taking and when
breakthrough pain occurs
d. The presence of a sympathetic response, such as tachycardia, diaphoresis, and a
rise in blood pressure - Correct AnswerANS: A
Pain is a complex experience involving physiological, sensory (i.e., the perception of
pain by the individual that addresses the pain location, intensity, pattern, and quality),
affective, behavioural, and cognitive dimensions; therefore, the nurse needs to assess
the pattern, area, nature, and intensity of the pain immediately.
PTS: 1 DIF: Cognitive Level: Application REF: page 158
OBJ: 5 TOP: Nursing Process: Assessment MSC: CRNE: CH-1
2. The physician plans to titrate narcotic analgesic to provide pain relief for a patient
with surgical pain. What does the nurse's role in include?
a. Monitoring the effects of continuous intravenous (IV) infusion of narcotic analgesics
b. Teaching the patient to try to increase the time between doses of pain medication
c. Assisting the patient to plan the use of a specific total dose of analgesic over a 24-
hour period
d. Determining with the patient the optimal analgesic dosage required for pain relief with
attention to the side effects produced - Correct AnswerANS: D
The goal of titration is to use the smallest dosage of analgesic that provides effective
pain control with the fewest side effects.
PTS: 1 DIF: Cognitive Level: Application REF: page 166
OBJ: 6 TOP: Nursing Process: Implementation MSC: CRNE: CH-52
3. It is determined that a step 3 drug as proposed by the World Health Organization
(WHO) is necessary for a patient whose cancer pain is unrelieved by step 2 drugs.
Which is an appropriate drug and route for this patient?
a. Oral codeine
b. Oral morphine
c. Intramuscular meperidine (Demerol)
d. Intravenous oxymorphone (Numorphan) - Correct AnswerANS: B
, A step 2 drug that would be appropriate is morphine, which is the standard of
comparison for all other opioid analgesics. Sustained-release preparations (e.g., MS
Contin) are also available.
PTS: 1 DIF: Cognitive Level: Application REF: pages 168-169, Table 10-11
OBJ: 7 TOP: Nursing Process: Assessment MSC: CRNE: CH-52
4. Which of the following is true of persistent pain?
a. It occurs within the normal healing time.
b. The course of pain decreases over time.
c. It is accompanied by an increased heart and pulse rate.
d. It is often accompanied by changes in affect and withdrawal from other people. -
Correct AnswerANS: D
A behavioural manifestation of persistent pain is a change in affect and withdrawal from
other people and social interaction.
PTS: 1 DIF: Cognitive Level: Comprehension REF: page 161, Table 10-5
OBJ: 4 TOP: Nursing Process: Assessment MSC: CRNE: CH-7
5. The physician tells a patient to use ibuprofen (Motrin, Advil) to relieve the pain after
treating a laceration on the patient's forearm from a dog bite. The patient tells the nurse
that he does not think ibuprofen will control his pain. The nurse's response is based on
the knowledge that ibuprofen interferes with the pain by decreasing what process?
a. Perception
b. Modulation
c. Transduction
d. Transmission - Correct AnswerANS: C
Therapies directed at altering either the primary afferent nociceptor (PAN) environment
or the sensitivity of the PAN are used to prevent the transduction and initiation of an
action potential. An example is ibuprofen.
PTS: 1 DIF: Cognitive Level: Application REF: pages 166-167, Table 10-9
OBJ: 7 TOP: Nursing Process: Assessment MSC: CRNE: CH-52
6. A postoperative patient who has undergone extensive bowel surgery moves as little
as possible and does not use his incentive spirometer unless specifically reminded. He
rates his pain severity as an 8 on a 10-point scale but tells the nurse that he can "tough
it out." To encourage the patient to use pain medication, what should the nurse explain
about the effects of withholding or delaying analgesics?
a. Very few patients become addicted to opioids when using them for pain control.
b. He should not worry about side effects because these problems usually decrease
over time.
c. Multiple options of medications are available, and if one drug does not relieve his
pain, other drugs may be tried.
d. Unrelieved pain can be harmful because it impairs respiratory and gastrointestinal
function and can impair his recovery from surgery. - Correct AnswerANS: D
Surgical Nursing in Canada, 3rd Edition
with 100% correct answers 2025
1. A 45-year-old woman has breast cancer that has spread to her liver and spine. She
has been taking oxycodone (Percodan) and amitriptyline (Elavil) for pain control at
home, but she now has constant severe pain and is hospitalized for pain control and
development of a pain management program. During assessment of the patient, what
information related to her pain is most important for the nurse to obtain initially?
a. The pattern, area, intensity, and nature of her pain
b. Identification of trigger points of pain by palpation of painful areas
c. The schedule and total dosages of the drugs she is currently taking and when
breakthrough pain occurs
d. The presence of a sympathetic response, such as tachycardia, diaphoresis, and a
rise in blood pressure - Correct AnswerANS: A
Pain is a complex experience involving physiological, sensory (i.e., the perception of
pain by the individual that addresses the pain location, intensity, pattern, and quality),
affective, behavioural, and cognitive dimensions; therefore, the nurse needs to assess
the pattern, area, nature, and intensity of the pain immediately.
PTS: 1 DIF: Cognitive Level: Application REF: page 158
OBJ: 5 TOP: Nursing Process: Assessment MSC: CRNE: CH-1
2. The physician plans to titrate narcotic analgesic to provide pain relief for a patient
with surgical pain. What does the nurse's role in include?
a. Monitoring the effects of continuous intravenous (IV) infusion of narcotic analgesics
b. Teaching the patient to try to increase the time between doses of pain medication
c. Assisting the patient to plan the use of a specific total dose of analgesic over a 24-
hour period
d. Determining with the patient the optimal analgesic dosage required for pain relief with
attention to the side effects produced - Correct AnswerANS: D
The goal of titration is to use the smallest dosage of analgesic that provides effective
pain control with the fewest side effects.
PTS: 1 DIF: Cognitive Level: Application REF: page 166
OBJ: 6 TOP: Nursing Process: Implementation MSC: CRNE: CH-52
3. It is determined that a step 3 drug as proposed by the World Health Organization
(WHO) is necessary for a patient whose cancer pain is unrelieved by step 2 drugs.
Which is an appropriate drug and route for this patient?
a. Oral codeine
b. Oral morphine
c. Intramuscular meperidine (Demerol)
d. Intravenous oxymorphone (Numorphan) - Correct AnswerANS: B
, A step 2 drug that would be appropriate is morphine, which is the standard of
comparison for all other opioid analgesics. Sustained-release preparations (e.g., MS
Contin) are also available.
PTS: 1 DIF: Cognitive Level: Application REF: pages 168-169, Table 10-11
OBJ: 7 TOP: Nursing Process: Assessment MSC: CRNE: CH-52
4. Which of the following is true of persistent pain?
a. It occurs within the normal healing time.
b. The course of pain decreases over time.
c. It is accompanied by an increased heart and pulse rate.
d. It is often accompanied by changes in affect and withdrawal from other people. -
Correct AnswerANS: D
A behavioural manifestation of persistent pain is a change in affect and withdrawal from
other people and social interaction.
PTS: 1 DIF: Cognitive Level: Comprehension REF: page 161, Table 10-5
OBJ: 4 TOP: Nursing Process: Assessment MSC: CRNE: CH-7
5. The physician tells a patient to use ibuprofen (Motrin, Advil) to relieve the pain after
treating a laceration on the patient's forearm from a dog bite. The patient tells the nurse
that he does not think ibuprofen will control his pain. The nurse's response is based on
the knowledge that ibuprofen interferes with the pain by decreasing what process?
a. Perception
b. Modulation
c. Transduction
d. Transmission - Correct AnswerANS: C
Therapies directed at altering either the primary afferent nociceptor (PAN) environment
or the sensitivity of the PAN are used to prevent the transduction and initiation of an
action potential. An example is ibuprofen.
PTS: 1 DIF: Cognitive Level: Application REF: pages 166-167, Table 10-9
OBJ: 7 TOP: Nursing Process: Assessment MSC: CRNE: CH-52
6. A postoperative patient who has undergone extensive bowel surgery moves as little
as possible and does not use his incentive spirometer unless specifically reminded. He
rates his pain severity as an 8 on a 10-point scale but tells the nurse that he can "tough
it out." To encourage the patient to use pain medication, what should the nurse explain
about the effects of withholding or delaying analgesics?
a. Very few patients become addicted to opioids when using them for pain control.
b. He should not worry about side effects because these problems usually decrease
over time.
c. Multiple options of medications are available, and if one drug does not relieve his
pain, other drugs may be tried.
d. Unrelieved pain can be harmful because it impairs respiratory and gastrointestinal
function and can impair his recovery from surgery. - Correct AnswerANS: D
