Exam 5 Ch5

20問 • 3年前

問題一覧

1. A new nurse asks the precepting nurse “What is the best way to assess a client’s pain?” Which response by the nurse is best?

c. Client’s self-report

2. A new nurse reports to the nurse preceptor that a client requested pain medication, and when the nurse brought it, the client was sound asleep. The nurse states the client cannot possibly sleep with the severe pain the client described. Which response by the experienced nurse is best?

a. “Being able to sleep doesn’t mean pain doesn’t exist.”

3. The nurse in the outpatient surgery clinic is discussing an upcoming surgical procedure with a client. Which information provided by the nurse is most appropriate for the client’s long-term outcome?

b. “Discuss acceptable pain control after your operation with the surgeon.”

4. A nurse is assessing pain on a confused older client who has difficulty with verbal expression. Which pain assessment tool would the nurse choose for this assessment?

c. FACES Pain Scale-Revised

5. The nurse is assessing a client’s pain and has elicited information on the location, quality, intensity, effect on functioning, aggravating and relieving factors, and onset and duration. Which question by the nurse would be best to ask the client for completing a comprehensive pain assessment?

d. “What pain rating would be acceptable to you?”

6. A nurse is assessing pain in an older adult. Which action by the nurse is best?

d. Sit down, ask one question at a time, and allow the client to answer.

7. The nurse receives a hand-off report. One client is described as a drug seeker who is obsessed with even tiny changes in physical condition and is “on the light constantly” asking for more pain medication. When assessing this client’s pain, which statement or question by the nurse is most appropriate?

a. “Help me understand how pain is affecting you right now.”

8. A nurse on the medical-surgical unit has received a hand-off report. Which client would the nurse see first?

b. Client with new-onset abdominal pain, rated as an 8 on a 0-10 scale.

9. A nurse uses the Checklist of Nonverbal Pain Indicators to assess pain in a nonverbal client with advanced dementia but no other medical history except well-controlled hypertension and high cholesterol. The client scores a zero. Which action by the nurse is best?

a. Assess physiologic indicators and vital signs.

10. A nurse asks why several clients are getting more than one type of pain medication instead of very high doses of one medication. Which response by the charge nurse is best?

d. “Pain is so complex it takes different approaches to control it.”

11. A client who had surgery has extreme postoperative pain that is worsened when trying to participate in physical therapy. Which intervention for pain management does the nurse include in the client’s care plan?

d. Round-the-clock analgesia with PRN analgesics

12. A nurse on the postoperative inpatient unit receives hand-off report on four clients using patient-controlled analgesia (PCA) pumps. Which client would the nurse see first?

d. Client with a respiratory rate of 8 breaths/min.

13. A registered nurse is caring for a client who is receiving pain medication via patient-controlled analgesia (PCA). Which action by the nurse indicates the need for further education on pain control with PCA?

c. Presses the button when the client cannot reach it.

14. A client is put on twice-daily acetaminophen for osteoarthritis. Which finding in the client’s health history would lead the nurse to consult with the primary health care provider over the choice of medication?

b. Drinking 3 to 5 beers a day

15. A nurse is preparing to give a client ketorolac intravenously for pain. Which assessment findings would lead the nurse to consult with the primary health care provider?

d. Urine output of 20 mL/2 hr

16. A hospitalized client has a history of depression for which sertraline is prescribed. The client also has a morphine allergy and a history of alcoholism. After surgery, several opioid analgesics are prescribed. Which one would the nurse choose?

b. Hydromorphone

17. A client has received an opioid analgesic for pain. The nurse assesses that the client has a Pasero Scale score of 3 and a respiratory rate of 7 shallow breaths/min. The client’s oxygen saturation is 87%. Which action would the nurse perform first?

b. Attempt to arouse the client.

18. An older adult has diabetic neuropathy and often reports unbearable foot pain. About which medication would the nurse plan to educate the client?

b. Duloxetine

19. A nurse is caring for four clients receiving pain medication. After the hand-off report, which client would the nurse see first?

c. Client with a Pasero Scale score of 4

20. A nurse is caring for a client who received intraspinal analgesia. Which action by the nurse is most important to ensure client safety?

b. Instruct the client to report any unrelieved pain.

NUR 170 exam 4

V Farris · 50問 · 2年前

NUR 170 exam 4