Chapter 19 Pain Management, Rest, and Sleep

Chapter 19  Pain Management, Rest, and Sleep

Complete Chapter Questions And Answers
 

Sample Questions

Multiple Choice
Identify the choice that best completes the statement or answers the question.

____ 1. The nurse medicates a patient for a complaint of pain in his right foot. The patient is several days postoperative following an amputation right below the knee. The patient expresses his confusion about why a foot that has been amputated is still causing him intense pain. The nurse explains that the type of pain experienced by the patient is
A.
Cutaneous pain.
B.
Deep somatic pain.
C.
Neuropathic pain.
D.
Soft tissue pain.

____ 2. The nurse explains to a patient with chronic pain that exercise may relieve some of his pain. Based on the gate control theory, exercise
A.
Stimulates the narrow nerve fibers to shut the gate.
B.
Stimulates the narrow nerve fibers to open the gate.
C.
Stimulates the broad nerve fibers to shut the gate.
D.
Stimulates the broad nerve fibers to open the gate

____ 3. A patient who is suffering from terminal cancer asks the nurse how massage decreases his pain. The nurse explains that the theory states that
A.
Massage blocks endorphins that, when released, are effective in inhibiting pain receptors.
B.
Massage stimulates the release of endorphins, which are thought to block the transmission of pain.
C.
Massage assists endorphins in opening the gates and attaching to opiate receptors.
D.
Massage stimulates opiate or pain receptors to release endorphins to essentially change how the brain identifies pain.

____ 4. The nurse is aware that the Asian patient may differ from the Latino patient when in pain. The Asian patient’s culture is of the belief that pain
A.
Is better expressed by moaning than complaining.
B.
Can be verbalized instead of grimacing.
C.
Does not need to be endured and pain medication should be asked for when needed.
D.
Should be suffered in silence, without verbal or and expressive behaviors.

____ 5. A patient who was admitted with severe back pain is watching TV and smiling. The patient received pain medication 4 hours ago and rates his pain at an 8. Knowing his pain medication may be given every 4 to 6 hours, the nurse will
A.
Administer the pain medication.
B.
Tell the patient that if diversion does not work, then he or she will administer pain medication in 2 hours.
C.
Explain the gate control theory and suggest a massage.
D.
Call the physician and ask for an order for a TENS (transcutaneous electrical nerve stimulator) unit.

Chapter 19. Pain Management, Rest, and Sleep
Answer Section

MULTIPLE CHOICE

1. ANS: C

Feedback
A
Cutaneous pain is superficial, or just under the surface, as with a paper cut.
B
Deep somatic pain is bone, ligament, and tendon pain.
C
Phantom limb, or neuropathic pain, feels as though it is coming from the extremity that has been amputated. Chapter Objective: Define key terms related to pain management, rest, and restorative sleep.
D
Soft tissue pain, or visceral pain, is the type of pain that is experienced following surgery, trauma, or metastatic invasion of soft tissue.

PTS: 1 REF: Chapter: 19 | Page: 393 OBJ: Chapter Objective: 19-1
KEY: Content Area: Physiological Adaptation | Integrated Process: Teaching and Learning | Client Need: Physiological Integrity/Physiological Adaptation/Alterations in Body Systems | Cognitive Level: Application

2. ANS: C

Feedback
A
Stimulation of the narrow nerve fibers opens the gate, which allows pain impulses to get through.
B
Stimulation of the narrow nerve fibers opens the gate, which allows pain impulses to get through.
C
Exercise stimulates the broad nerve fibers that shut the gate, which blocks pain impulses and decreases pain. Chapter Objective: Explain the gate control theory.
D
Stimulation of the broad nerve fibers shuts, not opens, the gate.

PTS: 1 REF: Chapter: 19 | Page: 392 OBJ: Chapter Objective: 19-2
KEY: Content Area: Basic Care and Comfort | Integrated Process: Teaching and Learning | Client Need: Physiological Integrity/Basic Care and Comfort/Non-Pharmacological Comfort Interventions | Cognitive Level: Application

3. ANS: B

Feedback
A
Blocking endorphins increases pain.
B
Massage stimulates the release of endorphins that act like morphine and block the transmission of pain to the brain. Chapter Objective: Describe the role that endorphins play in pain perception and relief.
C
Endorphins act by closing the gate.
D
Massage stimulates the release of endorphins, which bind to opiate or pain receptors, but are not produced by the pain receptors.

PTS: 1 REF: Chapter: 19 | Page: 393 OBJ: Chapter Objective: 19-4
KEY: Content Area: Basic Care and Comfort | Integrated Process: Teaching and Learning | Client Need: Physiological Integrity/Basic Care and Comfort/Non-Pharmacological Comfort Interventions | Cognitive Level: Application

4. ANS: D

Feedback
A
Latinos, not Asians, can be comforted by moaning to express pain.
B
Asian patients of the old culture do not verbalize or express pain.
C
Typically, it is the younger generations of Irish and Saudi cultures who will verbalize pain.
D
The Asian culture may feel that pain should be suffered in silence and without behavioral expressions of pain. Chapter Objective: Outline the factors that affect pain and pain perception.

PTS: 1 REF: Chapter: 19 | Page: 394 OBJ: Chapter Objective: 19-6
KEY: Content Area: Psychosocial Integrity | Integrated Process: Nursing Process/Assessment | Client Need: Psychosocial Integrity/Cultural Awareness | Cognitive Level: Application

5. ANS: A

Feedback
A
Only the patient knows whether he has pain and how severe it is; it is the nurse’s responsibility to provide pain relief, not to determine whether the patient truly has pain. Chapter Objective: Correlate acknowledgment and acceptance of pain to treatment of pain.
B
Pain rated at 8 on a scale of 10 should receive pain medication if it is within the time frame allowed.
C
When pain is at an 8, massage could help relieve pain, but it will also require pain medication.
D
While it might be a good idea to add other types of pain control, when pain is rated at an 8, pain medication should be administered.

PTS: 1 REF: Chapter: 19 | Page: 396 OBJ: Chapter Objective: 19-8
KEY: Content Area: Pharmacological Therapies | Integrated Process: Nursing Process/Implementation | Client Need: Physiological Integrity/Pharmacological Therapies/Medication Administration | Cognitive Level: Application