A client presents to the clinic reporting dull, throbbing left leg pain, rated as 4/10 on a 0–10 pain scale. They have been experiencing this for the past year following a leg fracture in a car collision. The nurse determines that this client is experiencing which type of pain?
Chronic pain
✓
Severe pain
Acute pain
Neuropathic pain
Correct Answer
Chronic pain
The client's pain is considered chronic because it has been going on for more than 3 months.
Question 2
A client who had a cholecystectomy earlier in the day asks the nurse for pain medication for pain rated as 6/ 10 on a 0–10 pain rating scale. When the nurse returns with the pain medication, the client is chatting and laughing with a visitor. Which action should the nurse take?
Assume that the client is not in pain
Challenge the client's pain rating
Determine that the client was not rating their pain correctly
Administer the pain medication
✓
Correct Answer
Administer the pain medication
Pain is a subjective rating, and the nurse should define pain as "whatever the client says it is." Therefore, the nurse should administer the pain medication.
Question 3
A client with no past medical history is prescribed acetaminophen, as needed, for pain related to starting a new workout regimen. They have acetaminophen 500 mg tablets at home. The nurse instructs the client not to exceed how many tablets per day?
8
✓
12
10
6
Correct Answer
8
Eight tablets of 500 mg acetaminophen is 4000 mg, which is the amount of acetaminophen that should not be exceeded in a day.
Question 4
The health care provider has recommended that a client begin taking an anti-inflammatory drug to reduce the pain of osteoarthritis. Which medication does the nurse anticipate the provider will order?
Naltrexone
Tramadol
Ibuprofen
✓
Nalbuphine
Correct Answer
Ibuprofen
Ibuprofen is the only option that is an anti-inflammatory drug.
Question 5
A 75-year-old client reports intermittent pain that ranges from 4 to 10 on a 0–10 scale. The client states that the pain started 5 years ago after they had herpes zoster (shingles). The nurse understands that this pain is classified as which of the following types?
Nociceptive
Visceral
Acute
Neuropathic
✓
Correct Answer
Neuropathic
The affected nerves were damaged by the varicella-zoster virus. Shingles pain, or postherpetic neuralgia, develops in up to 50% of individuals over the age of 65 who contract the disease.
Question 6
The nurse administers morphine intravenously to a postoperative client and returns 20 minutes later to reassess the client. The nurse observes the client taking slow and shallow breaths, and they are unresponsive to verbal and physical stimuli. The nurse activates the rapid response team and prepares to administer which medication?
Tramadol
Naloxone
✓
Methadone
Acetaminophen
Correct Answer
Naloxone
Naloxone works as an opioid receptor antagonist and is the drug of choice to quickly reverse the effects of opioid intoxication, which is indicated here by the client's unresponsiveness and shallow breathing.
Question 7
A nurse in an emergency department is taking a medication history on a new client. The client reports previously experiencing flushing, itching, and low blood pressure after taking an opioid for pain caused by a bone fracture but does not recall the name of the medication. The nurse suspects that the client was most likely taking which opioid?
Morphine
✓
Oxycodone
Methadone
Hydromorphone
Correct Answer
Morphine
This client most likely experienced a reaction to histamine caused by morphine. This adverse reaction is most often seen with morphine and codeine, which is converted into morphine.
Question 8
A client with a history of opioid use disorder is prescribed naltrexone to aid in abstaining from opioid use. Which information will the nurse give the client?
This drug causes a high feeling.
This drug blunts the effects of opioids.
✓
This drug reverses an accidental overdose.
This drug can cause euphoria.
Correct Answer
This drug blunts the effects of opioids.
Naltrexone is an opioid antagonist that can be used orally and intramuscularly to aid clients who are attempting to quit using opioids. While the client is taking naltrexone, any opioids taken will not be able to activate opioid receptors, blunting the effects of opioids and the feelings of euphoria.
Question 9
A client reports that the current dosage of oxycodone they are taking for chronic back pain is no longer relieving the pain. The health care provider increases the dosage of oxycodone, and at a follow-up appointment the client reports that their pain is well controlled again. The nurse explains that the client is experiencing which phenomenon?
Adverse reaction
Tolerance
✓
Allergic reaction
Opioid use disorder
Correct Answer
Tolerance
Tolerance is a natural occurrence in clients receiving chronic opioid agonists. It frequently requires the dosage of the opioid agonist to be increased to achieve adequate pain management.
Question 10
A client recovering from a knee replacement in the postanesthesia care unit develops significant shivering. Which medication does the nurse anticipate will be ordered for this client?
Codeine
Nalbuphine
Meperidine
✓
Aspirin
Correct Answer
Meperidine
Severe shivering with chills (also known as rigors) may occur in clients who received anesthesia. The treatment of choice for this is meperidine. Because of the well-known toxicities of meperidine in older adults and those with poor renal function, it should almost never be used for pain.