Chapter 08: Pain and Pain Management

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

MULTIPLE CHOICE

 

1. The definition of pain with the most clinical significance is that pain is:

a.	an uncomfortable experience present only in the patient with an intact nervous system.
b.	an unpleasant experience accompanied by crying and tachycardia.
c.	activation of the sympathetic nervous system from an injury.
d.	whatever the patient experiencing it says it is, occurring when that patient says it does.

 

ANS:   D

The definition of pain with the most clinical significance is that pain is whatever the patient experiencing it says it is, and it occurs when that patient says it does.

 

DIF:    Cognitive Level: Knowledge REF:    76

OBJ:    Nursing Process: Assessment TOP:    Pain

MSC:   NCLEX: Physiological Integrity: Physiological Adaptation

 

2. The nerve endings responsible for pain are known as the:

a.	baroreceptors.
b.	nociceptors.
c.	unmyelinated receptors.
d.	thermal receptors.

 

ANS:   B

The nerve endings responsible for pain are the nociceptors.

 

DIF:    Cognitive Level: Knowledge REF:    77

OBJ:    Nursing Process: Assessment TOP:    Pain

MSC:   NCLEX: Physiological Integrity: Physiological Adaptation

 

3. Transdermal fentanyl is not typically used in the critically ill patient because it:

a.	can cause respiratory depression.
b.	produces toxic metabolites.
c.	requires 12 to 16 hours for the onset of action.
d.	is not well absorbed because of the stress response.

 

ANS:   C

The use of transdermal fentanyl is rarely indicated in the critically ill patient. Transdermal fentanyl in critical care is used for the patient who requires extended pain control. Transdermal delivery requires 12 to 16 hours for onset of action and has a duration of 72 hours.

 

DIF:    Cognitive Level: Application REF:    88

OBJ:    Nursing Process: Intervention TOP:    Pain

MSC:   NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

 

4. Using a specific pain intensity scale in the critical care unit:

a.	eliminates the need for the subjectivity of the patient.
b.	allows for one tool for all patient types.
c.	provides consistency of assessment and documentation.
d.	is not necessary, because all pain is treated equally in the CCU.

 

ANS:   C

Many CCUs are using a specific pain intensity scale because a single tool provides consistency of assessment and documentation. A pain intensity scale is useful in the critical care environment. Asking the patient to grade his or her pain on a scale of 0 to 10 is a consistent method and aids the nurse in objectifying the subjective nature of the patient’s pain. However, the patient’s tool preference should be considered.

 

DIF:    Cognitive Level: Evaluation   REF:    81

OBJ:    Nursing Process: Assessment TOP:    Pain

MSC:   NCLEX: Physiological Integrity: Physiological Adaptation

 

5. Mr. K is mechanically ventilated and unable to communicate any aspects of his pain to his nurse. The nurse knows that the best tool for pain assessment for Mr. K is:

a.	FLACC.
b.	Wong-Baker FACES.
c.	BIS.
d.	BPS.

 

ANS:   D

FLACC is a pediatric pain assessment tool. The Wong-Baker FACES tool requires the patient to associate a level of pain to a facial representation. BIS is an objective measure of sedation levels during neuromuscular blockade in the ICU. The BPS was tested exclusively in mechanically ventilated unconscious patients. Its validity was supported with significantly higher BPS scores during nociceptive procedures than during rest or nonnociceptive procedures.

 

DIF:    Cognitive Level: Evaluation   REF:    81

OBJ:    Nursing Process: Assessment TOP:    Pain

MSC:   NCLEX: Physiological Integrity: Physiological Adaptation