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Chapter 10 Chronic pain and its treatment
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Chapter 10 Chronic pain and its treatment
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Chapter 10 Chronic pain and its treatmentMULTIPLE CHOICE
1. The nurse is completing an assessment on a nonverbal adult patient. Which type of
pain scale assessment tool is the most accurate to use?
a. TPPPS
b. FLACC
c. POCIS
d. MOPS
ANS: B
The Face, Legs, Activity, Cry, Consolability (FLACC) scale would be used to assess
pain in the nonverbal patient. The Toddler Preschooler Postoperative Pain Scale
(TPPPS), Pain Observation Scale for Young Children (POCIS), and Modified
Objective Pain Scale (MOPS) would not be appropriate for this patient.
2. Which action will the nurse take when a patient receiving morphine sulfate via
percutaneous coronary angioplasty (PCA) has a shallow, irregular respiratory rate of 6
breaths/min?
a. Elevate the patients head of bed to facilitate lung expansion.
b. Increase the patients primary intravenous (IV) flow rate.
c. Complete the FLACC scale.
d. Notify the health care provider and prepare to administer naloxone (Narcan).
ANS: D
The patient is exhibiting signs of respiratory depression. Administration of the
antidote naloxone would be the most appropriate nursing intervention. Lung
expansion or increasing the primary IV infusion rate would not relieve respiratory
depression. Assessing the patients pain at this point is a lesser priority than treating
the respiratory depression.
,3. Which patient assessment would indicate to the nurse that salicylate toxicity is
occurring?
a. Gastrointestinal (GI) bleeding
b. Increased bleeding times
c. Tinnitus
d. Occasional nausea
ANS: C
, Symptoms of salicylism include ringing in the ears (tinnitus), impaired hearing,
dimming of vision, sweating, fever, lethargy, dizziness, mental confusion, nausea, and
vomiting. Although salicylates may cause GI bleeding over time, it is not a symptom
associated with toxicity. Increased bleeding time is an effect associated with the
treatment of clots. Occasional nausea is a common adverse effect of treatment with
salicylates; it is not a sign of toxicity.
4. What is the advantage of taking a nonsteroidal anti inflammatory drug (NSAID)
that is a COX 2 inhibitor?
a. The medication is cheaper than aspirin.
b. There are fewer GI adverse effects.
c. They are more effective than COX 1 inhibitors.
d. They have no known adverse effects.
ANS: B
COX 2 inhibitor NSAIDs have fewer GI adverse effects than salicylates or COX 1
inhibitors. Aspirin is one of the least expensive analgesics available. The anti
inflammatory actions of NSAIDs are caused by COX 2 inhibition; the unwanted
adverse effects are caused by inhibition of COX 1. All these medications have adverse
effects.
]
5. An 86 year old patient who was admitted with GI bleeding as a result of salicylate
therapy is being discharged. As the nurse reviews the discharge medication list, the
patient states that she doesnt understand why Tylenol doesnt work as well as the
aspirin she had been taking. What would be the nurses best response?
a. Tylenol and aspirin are chemically the same drug.
b. Tylenol is appropriate for only minor pain.
c. Tylenol does not help with inflammatory discomfort.
d. A therapeutic blood level must be established with Tylenol.
ANS: C
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