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Chapter 4 Question 1 A patient complains of a dull, aching sensation in the lower back after long periods of sitting. The nurse anticipates the administration of medication to suppress pain impulse transmission in which fibers to treat the patient’s complaint? 1. A delta fibers 2. C fibers 3. Myelinated fibers 4. Enkephalins Question 2 A patient has received a pain medication that blocks pain signals from the spinal cord. The nurse anticipates the effects of this medication will result in which level of pain? 1. 0 on a scale from 0–10 2. 8 on a scale from 0–10 3. 5 on a scale from 0–10 4. 2 on a scale from 0–10 Question 3 The intensive care nurse plans to test nociception in the patient with a closed-head injury. Which nursing action is indicated? 1. Move an object across the patient’s visual field. 2. Place a container of ground coffee close to the patient’s nostrils. 3. Ask the patient to squeeze and release the nurse’s hand. 4. Press the patient’s nail bed. Question 4 The nurse observes the patient during a major abdominal dressing change. Which facets of pain can be observed by the nurse during this procedure? 1. Expressing behaviors 2. Pain 3. Nociception 4. Suffering Question 5 1. “This patient’s vital signs reflect a sympathetic nervous system response to pain.” 2. “Since the vital signs are normal; the patient is not experiencing pain.” 3. “This patient needs further assessment to determine if pain is present.” 4. “Since the patient is mechanically ventilated, pain is unlikely.” Question 6 A patient tells the nurse that his back has not “bothered” him for months but now that he’s in the intensive care unit, his back is “killing” him. The nurse considers which cause of this pain when designing interventions? 1. Lack of mobility due to hospitalization 2. Worsening of the disease process that caused the hospital admission 3. An undiagnosed injury to the back 4. Tolerance to pain medication Question 7 While giving an end-of-shift report, the exiting nurse describes treatment for a patient’s complaint of arm pain. The nurse receiving the report should question the validity of which statement? 1. “The patient is resting quietly in bed.” 2. “The patient’s blood pressure is normal so the pain is gone.” 3. “I administered 800 mg of ibuprofen.” 4. “I also applied a hot pack to the arm at the patient’s request.” Question 8 A trauma patient has just been sedated, intubated, and placed on mechanical ventilation. The nurse documents the patient’s pain level as 9 on the 1–10 scale. How should this action be interpreted? 1. The patient should receive the highest dose of analgesic medication ordered. 2. The nurse has inappropriately scaled the patient’s pain. 3. The nurse should wait until the patient has adapted to the mechanical ventilator before scaling the level of pain. 4. Pain will decrease now that the patient does not have to work to breathe. Question 9 The nurse prepares to administer a nonsteroidal anti-inflammatory drug to the patient with postoperative knee pain. The nurse should consider which pharmacological properties of NSAIDs? 1. NSAIDs inhibit the manufacture of bradykinins. 2. NSAIDs bind with opioid receptors throughout the nervous system. 3. NSAIDs exert peripheral effects. 4. NSAIDs inhibit the formation of prostaglandins. 5. NSAIDS exert CNS effects.   Question 10 A semi-conscious patient with pancreatic cancer requires pain management. After multiple attempts, the oncology nurses are unable to establish venous access. What is the best alternative route for pain medication administration until venous access can be obtained? 1. Rectal suppository 2. Injection in deltoid muscle 3. Subcutaneous injection in abdominal tissue 4. Oral liquid