Exam (elaborations)

NUR 482 PDM Quiz #1 Exam Questions And Answers

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Course
NURS 482

Institution
St. Xavier University

Which postoperative client is manifesting the most serious negative effect of inadequate pain management? 1. Demonstrates continuous use of call bell related to unsatisfied needs and discomfort 2. Develops venous thromboembolism related to immobility caused by pain and discomfort 3. Refuses to...

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NUR 482 PDM Quiz #1 Exam Questions
And Answers

Which postoperative client is manifesting the most serious negative effect of inadequate pain
management?
1. Demonstrates continuous use of call bell related to unsatisfied needs and discomfort
2. Develops venous thromboembolism related to immobility caused by pain and discomfort
3. Refuses to participate in physical therapy because of fear of pain caused by exercises
4. Feels depressed about loss of function and hopeless about getting relief from pain - ANS
2

A client with chronic pain reports to the charge nurse that the other nurses have not been
responding to requests for pain medication. What is the charge nurse's initial action?
1. Check the medication administration records for the past several days
2. Ask the nurse educator to provide in-service training about pain management
3. Perform a complete pain assessment on the client and take a pain history
4. Have a conference with the staff nurses to assess their care of this client - ANS 4

The home health nurse is interviewing an older client with a history of mild heart failure and
rheumatoid arthritis. The client reports "feeling pretty good, except for the pain and stiffness in
my joints when I first get out of bed". Which member of the health care team would be the most
appropriate to aid in the client's report of pain?
1. Health care provider to review the dosage and frequency of pain medication
2. Physical therapist for evaluation of function and possible exercise therapy
3. Social worker to locate community resources for complementary therapy
4. Unlicensed assistive personnel to help client with a warm shower in the morning - ANS
4

Family members are encouraging the client to "tough out the pain" rather than risk drug
addiction to opioids. The client is stoically abiding. The nurse recognizes that the sociocultural
dimension of pain is the current priority for the client. What question will the nurse ask?
1. Where is the pain located, and does it radiate to other parts of your body?
2. How would you describe the pain, and how is it affecting you?
3. What do you believe about pain medication and drug addiction?
4. How is the pain affecting your activity level and your ability to function? - ANS 3

,A client with diabetic neuropathy reports a burning, electrical type pain in the lower extremities
that is worse at night and not responding to non steroidal anti-inflammatory drugs. Which
medication will the nurse advocate for first?
1. Gabapentin
2. Corticosteroids
3. Hydromorphone
4. Lorazepam - ANS 1

Which client is most likely to receive opioids for extended periods of time?
1. A client with fibromyalgia
2. A client with phantom limb pain in the leg
3. A client with progressive pancreatic cancer
4. A client with trigeminal neuralgia - ANS 3

The nurse is caring for a postoperative client who reports pain. Based on the recent
evidence-based guidelines, which approach would be best?
1. Multimodal strategies
2. Standing orders by protocol
3. Intravenous patient-controlled analgesia (PCA)
4. Opioid dosage based on valid numerical value - ANS 1

The charge nurse is reviewing the records of clients who were assigned to a newly graduated
RN. The RN has correctly documented dose and time of medication, but there is no
documentation regarding non pharmaceutical measures. What action should the charge nurse
take first?
1. Make a note in the nurse's file and continue to observe clinical performance
2. Refer the new nurse to the in-service education department
3. Quiz the nurse about knowledge of pain management and pharmacology
4. Give praise for documenting dose and time and discuss documentation deficits - ANS 4

Which client must be assigned to an experienced RN? Select all the apply.
1. Client who was in an automobile crash and sustained multiple injuries
2. Client with chronic back pain related to a workplace injury
3. Client who has returned from surgery and has a chest tube in place
4. Client with abdominal cramps related to food poisoning
5. Client with a severe headache of unknown origin
6. Client with chest pain who has a history of arteriosclerosis - ANS 1, 3, 5, 6

In the application of the principles of pain treatment, what is the first consideration?
1. Treatment is based on client goals
2. A multidisciplinary approach is needed
3. Client's perception of pain must be accepted
4. Drug side effects must be prevented and managed - ANS 3

, The nurse is considering seeking clarification for several prescriptions of pain medication. Which
client circumstance is the priority concern?
1. A 35-year-old opioid-naive adult will receive a basal dose of morphine via IV
patient-controlled analgesia (PCA)
2. A 65-year-old adult will be discharged with a prescription for nonsteroidal anti-inflammatory
drugs (NSAIDS)
3. A 25-year-old adult is prescribed as needed intramuscular (IM) analgesic for pain
4. A 45-year-old adult is taking oral fluids and foods has orders for IV morphine - ANS 1

Which client has the most immediate need for IV access to deliver immediate analgesia with
rapid titration?
1. Client who has sharp chest pain that increases with cough and shortness of breath
2. Client who reports excruciating lower back pain with hematuria
3. Client who is have an acute myocardial infarction with severe chest pain
4. Client who is having a severe migraine with an elevated blood pressure - ANS 3

When an analgesic is titrated to manage pain, what is the priority goal?
1. Titrate to the smallest dose that provides relief with the fewest side effects
2. Titrate upward until the client is pain free or acceptable level is reached
3. Titrate downward to prevent toxicity, overdose, and adverse effects
4. Titrate to a dosage that is adequate to meet the client's subjective needs - ANS 1

The health care provider prescribes 7 mg morphine IV as needed (PRN). The nursing student
prepares the medication and shows the syringe to the nursing instructor. What should the
nursing instructor do first?
Graphic: Morphine 10 mg/ml; syringe is filled to 7 ml
1. Tell the student to review the provider's prescription before administering medication
2. Waste the medication and tell the student that remediation is required for serious error
3. Ask the student to demonstrate the calculations and steps required to prepare the dose
4. Accompany the student to the client's room and observe as the medication is administered -
ANS 3

A client received as needed (PRN) morphine, lorazepam, and cyclobenzaprine. The unlicensed
assistive personnel (UAP) reports that the client has a respiratory rate of 10 breaths/min. What
is the priority action?
1. Call the health care provider to obtain an order for naloxone.
2. Assess the client's responsiveness and respiratory status
3. Obtain a bag-valve mask and deliver breaths at 20 breaths/min
4. Double-check the prescription to see which drugs were ordered - ANS 2

What client is at greatest risk for respiratory depression while receiving opioids for analgesia?
1. Older adult client with chronic pain related to joint immobility
2. Client with heroin addiction and back pain
3. Young female client with advanced multiple myeloma

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