Chapter 19 Drugs Used for Pain Management

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Chapter 19  Drugs Used for Pain Management

 

 

Complete Chapter Questions And Answers
 

Sample Questions

 

MULTIPLE 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.

DIF: Cognitive Level: Application REF: Page 293 OBJ: 2
TOP: Nursing Process Step: Assessment
MSC: NCLEX Client Needs Category: Physiological Integrity
NOT: CONCEPT(S): Clinical Judgment; Pain

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 patient’s head of bed to facilitate lung expansion.
b.
Increase the patient’s 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 patient’s pain at this point is a lesser priority than treating the respiratory depression.

DIF: Cognitive Level: Application REF: Page 306 OBJ: 3 | 6
TOP: Nursing Process Step: Implementation
MSC: NCLEX Client Needs Category: Physiological Integrity
NOT: CONCEPT(S): Clinical Judgment; Safety; Gas Exchange

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.

DIF: Cognitive Level: Comprehension REF: Page 310 OBJ: 5
TOP: Nursing Process Step: Assessment
MSC: NCLEX Client Needs Category: Physiological Integrity
NOT: CONCEPT(S): Clinical Judgment; Safety

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.

DIF: Cognitive Level: Knowledge REF: Page 314 OBJ: N/A
TOP: Nursing Process Step: Planning
MSC: NCLEX Client Needs Category: Physiological Integrity
NOT: CONCEPT(S): Clinical Judgment; Patient Education; Safety

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 doesn’t understand why Tylenol doesn’t work as well as the aspirin she had been taking. What would be the nurse’s 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
Acetaminophen (Tylenol) is effective as an analgesic or antipyretic. Tylenol does not possess any anti-inflammatory activity and is therefore ineffective in relieving symptoms related to inflammation. Tylenol and aspirin are distinctly different drugs. Tylenol can be useful in the relief of moderate pain. Tylenol can be effective in a single dose, without needing treatment over a period of time.

DIF: Cognitive Level: Application REF: Page 308 OBJ: 4 | 5
TOP: Nursing Process Step: Implementation
MSC: NCLEX Client Needs Category: Health Promotion and Maintenance
NOT: CONCEPT(S): Clinical Judgment; Patient Education; Pain

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