Fresno City College BIO 102 Medical-Surgical Nursing Critical Thinking in Client Care, CHAPTER 9

Medical-Surgical Nursing Critical Thinking in Client Care, 4th Edition Priscilla LeMon

CHAPTER 9

CHAPTER 9

1. Discharge teaching is being done by the nurse for a client who had a myocardial infarction. The client asks why the pain he experienced prior to the event was felt primarily in his left arm. The nurse’s best response would be:

a. “Cardiac pain is generally unexplainable.”

b. “Were you doing some physical activity with your arm just prior to the event?”

c. “What you are describing relates to psychogenic pain.”

d. “Pain in the arm related to cardiac tissue damage is a type of referred pain.”

2. A nursing student is teaching her peers about pain. Which teaching point supports the idea that each person’s pain response should be assessed individually in each situation?

a. “Everyone has the same pain threshold.”

b. “Everyone has a unique tolerance to pain.”

c. “Everyone perceives painful stimuli at the same intensity.”

d. “Most people have the same the pain response to surgery.”

3. Which response by the nurse would be most appropriate to the client comment “I know I won’t feel as much pain with this knee surgery as I did with the other one when I was 20 years younger”?

a. “You are most likely correct.”

b. “It should not be quite as bad with the newer technology.”

c. “You need to consider that you are getting older, and might experience more pain.”

d. “Your pain response might be the same, since one’s pain sensitivity does not decrease with age.”

4. Each client’s response to pain may be influenced by multiple factors. Select all that apply:

a. Age

b. Past experience with pain

c. Cultural influences

d. Knowledge

5. A client has returned to the unit following surgery. The nurse knows that which intervention will provide the most pain relief for the client?

a. Offer pain relief before the client complains of pain.

b. Wait until the client can describe the pain specifically.

c. Assess the pain level every four hours around the clock.

d. Allow the client to “sleep off” the anesthesia, and then offer pain medication.

6. During the discharge teaching process, the nurse explains the physician’s order for the client to take Motrin (ibuprofen) at home for any further discomfort. Since this is an NSAID (nonsteroidal anti-inflammatory drug), what other teaching will be done with this client who also has diabetes?

a. NSAIDs can increase the effect of hypoglycemic medications.

b. NSAIDs can decrease the effect of anticoagulant medications.

c. NSAIDs cause minimal gastrointestinal side effects.

d. NSAIDs have no effect on fever.

7. A client is receiving a narcotic for severe acute pain. Which of the following should the nurse encourage the client to consume on a greater level due to the pain medication?

a. Vitamin D

b. Fiber

c. Protein

d. Carbohydrates

8. An extensive spinal surgery was performed on a client five days ago. The client continues to have pain despite around-the-clock dosing of a narcotic. When assessing the client’s pain, the nurse discovers that the client’s pain level is not decreasing significantly between doses. This is an example of which of the following?

a. Pseudoaddiction

b. Psychologic drug dependence

c. Drug tolerance

d. Addiction

9. An elderly woman is complaining of lower leg pain. Which information found in her medical history would be the most likely indicator of this pain?

a. History of cardiovascular disease

b. History of shingles

c. History of smoking for 20 years

d. History of alcoholism

10. Pain in the elderly is subject to many misconceptions. Which of the following are common misconceptions related to aging? Select all that apply.

a. Opioids will cause excessive respiratory depression.

b. Aging decreases a person’s sensitivity to pain.

c. Older adults are likely to become addicted to narcotics if used.

d. Pain is an expected part of the aging process.

11. Pain can be managed by classes of medications. Which class is also used to treat migraine headaches?

a. Antidepressants

b. Local anesthetics

c. Anticonvulsants

d. Narcotics

12. The nurse is planning to administer a pain medication to a client who is two hours postoperative following bowel resection surgery. The client has four standing orders for pain medication. The nurse should administer which medication based on this situation?

a. Select the one that will be given intramuscularly (IM) to work quickly.

b. Select the one that is ordered on a “p.r.n.” basis.

c. Select the one to be administered intravenously by patient demand and under patient control.

d. Select the one to be administered orally.

13. A client is receiving intraspinal analgesia. Nursing care will focus on:

a. Decrease in heart rate.

b. Increase in heart rate.

c. Increase in urine output.

d. Decrease in urine output.