Pain Physiology & Types
A patient with a burn reports sharp, localized pain. Which process is occurring?
A Transduction
B Transmission
C Perception
D Modulation
A
Tissue injury activates nociceptors = transduction.
An alert adult rates pain 6/10 after surgery. What should the nurse do first?
A Document score
B Give morphine
C Assess location and quality of pain
D Notify provider
C
Further assessment precedes intervention.
A post-op patient receives acetaminophen and hydrocodone. This represents:
A Titration
B Adjuvant therapy
C Multi-modal pain management
D PCA
C
Combines different mechanisms for better control.
The nurse cares for a 45-year-old Hispanic man with post-op abdominal pain who says, “Pain medicine is for the weak.” What should the nurse do first?
A. Explain the pain scale again
B. Ask, “Can you tell me what pain means to you?”
C. Offer a lower dose opioid
D. Notify provider of refusal
B
Begin with cultural assessment—understand the patient’s belief before intervening.
A nurse believes a patient’s pain report is exaggerated and delays meds. Which ethical principle is violated?
A Autonomy
B Justice
C Veracity
D Fidelity
B Justice
A client receiving chemotherapy reports “tingling and burning” in feet. What type of pain is this?
A Somatic
B Visceral
C Neuropathic
D Referred
C
Chemo → nerve injury = neuropathic pain.
A nonverbal dementia patient shows grimacing and moaning. Which tool is best?
A Numeric
B PAINAD
C FACES
D FLACC
B
PAINAD for advanced dementia.
After morphine IV, RR = 8/min. Which action is priority?
A Reassess in 30 min
B Administer naloxone
C Call provider
D Give oxygen and document
B
RR < 10 = respiratory depression → naloxone.
A Buddhist patient with metastatic cancer requests guided meditation and soft chanting during dressing changes. Which action best demonstrates culturally sensitive care?
A. Ask family to stop chanting during procedures
B. Allow chanting and provide privacy
C. Tell them noise disturbs others
D. Schedule procedures when no visitors are present
B
Respecting rituals promotes comfort and aligns with holistic, person-centered care.
Select all that apply: Which actions demonstrate ethical pain management?
A. Reporting unrelieved pain to the provider
B. Documenting pain honestly
C. Believing the patient’s report of pain
D. Delaying medication to avoid addiction
A, B, C
Ethical pain care involves honesty, advocacy, and belief in the patient’s self-report.
Select all that apply: Which neurotransmitters increase pain sensation?
A Substance P
B Serotonin
C Bradykinin
D Endorphins
A, C
Substance P & bradykinin enhance transmission;
serotonin and endorphins inhibit pain.
A 4-year-old crying after surgery needs pain assessment. Which scale?
A PAINAD
B Numeric
C FLACC
D Wong-Baker FACES
D
Wong-Baker for young verbal children.
Which statement about NSAIDs is NOT correct?
A They reduce inflammation
B They may cause GI bleeding
C They can be given to renal failure patients safely
D They treat mild-moderate pain
C
NSAIDs are contraindicated in renal impairment.
Select all that apply: Which nursing actions reflect effective use of non-pharmacologic pain management?
A. Positioning for comfort
B. Distraction with music
C. Encouraging deep breathing
D. Documenting “no further intervention needed
A, B, C
Evidence-based non-drug methods complement pharmacologic therapy.
A patient with terminal cancer says, “I don’t want to take morphine because I’ll die sooner.” Which response by the nurse best demonstrates compassionate communication?
A. “Morphine will help you die peacefully.”
B. “Tell me more about what worries you about the medicine.”
C. “You should still take it; the doctor prescribed it.” D. “Morphine doesn’t kill patients.”
B
Open-ended, empathetic questions validate fear and invite trust-based dialogue.
A nurse notes ↑ BP and ↑ HR during dressing change although the patient denies pain. What is the best interpretation?
A Pain under-reported
B Medication reaction
C Normal finding
D Fluid overload
A
Autonomic responses indicate unexpressed pain.
Select all that apply: When documenting pain assessment, which elements are required?
A Intensity
B Location
C Patient behaviors
D Nurse opinion
A, B, C
Pain documentation
must include objective and subjective data.
Select all that apply: Teaching for opioid use should include which topics?
A Avoid driving
B Increase fiber and fluids
C Stop immediately if pain is resolved
D Report sedation or respiratory changes
A, B, D
Safety and side-effect management are key.
An elderly Native American woman refuses heat packs for chronic joint pain, saying, “It draws the illness in.” What is the nurse’s best response?
A.Respectfully ask, “What remedies do you prefer for comfort?”
B. Educate her that heat increases circulation
C. Insist heat is harmless
D. Document “patient non-compliant”
A
Cultural humility—invite patient to share beliefs and integrate safe preferences.
Which statement about documentation and legal accountability in pain management is NOT correct?
A. “Document both verbal and nonverbal indicators.” B. “Record the effect of each intervention.”
C. “Pain documentation is optional if pain is chronic.” D. “Chart patient teaching about pain control.”
C
Pain documentation is always required for accountability and continuity of care.
Which statement about pain pathways is NOT correct?
A A-delta fibers carry fast pain
B C-fibers carry slow pain
C Transmission ends at thalamus
D Perception occurs in spinal cord
D
Perception occurs in the cerebral cortex, not the spinal cord.
An asian patient smiles and nods when asked about pain but grimaces when moving. What should the nurse do next?
A Accept the patient’s words
B ask open questions
C Assume no pain
D Request restraints
B
Cultural stoicism requires behavioral observation and gentle probing.
A cancer patient receives morphine around-the-clock with breakthrough doses. This approach is based on:
A Preventing pain before it occurs
B Avoiding tolerance
C Provider convenience
D Limiting addiction risk
A
Could be for comfort care
A nurse prepares to teach progressive muscle relaxation to a Muslim woman wearing a hijab. Which statement shows cultural competence?
A. “We can adapt the exercise so you remain fully covered.”
B. “You’ll need to remove the hijab for deep breathing.”
C. “Let’s skip this since it may offend you.”
D. “I’ll ask your husband for permission.”
A
Modifying interventions respectfully maintains dignity and inclusivity.
The RN delegates pain reassessment 30 minutes after administering morphine to an LPN. Which action by the LPN requires the RN’s immediate intervention?
A. LPN reports the patient’s pain increased from 6 to 9 B. LPN documents “pain improved from 8 to 4” C. LPN does not report that pain remains severe D. LPN records patient vital signs with pain score
C
LPNs can collect and document data, but failure to report unrelieved or worsening pain endangers patient safety and violates both ethical and legal accountability.