Delegation
Analgesia
Opioids
Pain and leadership positions
100
For Client education about nonpharmaceutical alternatives, which topic could you delegate to an experienced LPN/LVN, who will function with your continued support and supervision?
What is Application of heat and cold
100
A client with diabetic neuropathy reports a burning, electrical-type pain in lower extremities, not responding to NSAIDS a. Amitriptyline(Elavil) b. Corticosteroids c. Dilaudid d. Lorazepam(Ativan)
What is answer a.
100
Which client is at greatest risk for resp. depression while receiving opioids for analgesia? a. elderly client with chronic pain; has hip fracture b. client with heroin addiction and backpain c. female client with advanced multiple myeloma d. a child with an arm fracture and CF
What is answer d.
100
After a client reports that nurses are not responding to requests for pain meds, what is the charge nurse's first action? a. check the MAR b. ask for an in-service educational program on the subject c. perform a pain assessment and take a pain hx d. conference with the nurses responsible for pt.
What is answer d.
200
Which client would a RN delegate to a newly graduated nurse? a. crying child who needs pre medication before reduction of a fracture or b. child who is receiving palliative end of life care
What is answer a.
200
Which client has to most immediate need for IV access for stat analgesia with rapid titration? a. sharp chest pain, increased with cough; SOB b. excruciating lower back pain with hematuria c. Acute MI with chest pain d. Severe migraine with elevated BP
What is answer c.
200
Which client si most likely to receive opioids for extended period? a. fibromyalgia b. phantom limb pain c. progressive pancreatic cancer d. trigeminal neurlgia
What is answer c.
200
As the charge nurse, a newly graduated RN has correctly charted dose and time of meds but did not document non pharm. measures. What action do take?
What is praising the nurse for the correct charting, yet discussing the deficits in charting.
300
In the care of clients with pain and discomfort, which task is most appropriate to delegate to the nursing assistant? a. Assisting client w/ prep of a sitz bath b. Monitor client for signs of discomfort during ambulation c. Coach client to deep breathe during painful procedure d. Evaluate relief after applying a cold compress
What is answer a.
300
When analgesic is titrated to manage pain, what is the priority goal? a. smallest dose that provides relief with few side effects b. titrate upward until pain free c. titrate downward to prevent toxicity d. ensure dosage is adequate to meet subjective needs of pt.
What is answer a.
300
A client's opioid therapy is being tapered off, and teh nurse is watchful for signs of withdrawl. What is one of the first signs? a. fever b. nausea c. diaphoresis d. abdominal cramps
What is answer c.
300
(26)A charge nurse, you have a pt's family tell you that "he needs more pain medicine." What is the best response? a. The DR ordered the med q. 4hrs. b. If the med is given too frequently, it could be harmful. c. Please tell him I will be right there to check on him. d. Let's wait 30-40 minutes. If there is no relief, I'll call the DR.
What is answer c.
400
The physician has ordered a placebo for a client with chronic pain. You are a new hire and feel uncomfortable giving the med. What do you do first? a. prepare med and give to DR. b. check policy on placebos c. Follow personal code of ethic and refuse to participate d. Contact the charge nurse for advice
What is answer d.
400
On the first post op day, client with PCA reports inadequate pain control. What do you do first? a. Deliver bolus dose per standing order b. Contact Dr. to increase the dose c. Try nonpharmacologic comfort measures d. Assess the pain for location, quality, and intensity
What is answer d.
400
What is the priority intervention for a client refusing pain meds due to the fear of addiction. The pts. sibling is a drug addict. a. Encourage to express fears and past experience b. Provide accurate info about the use of pain meds c. Explain that addiction is unlikely d. Seek family assistance in resolving this problem
What is answer a.
400
Pain disorder adn depresion have been diagnosed in a client. He reports chronic low back pain and complains,"None of these DRs have done anything to help." Which statement concerns you the most? a. "I twisted my back last night, and now the pain is a lot worse." b. "I'm so sick of the pain, I think I'll just end it." c. "Occasionally I buy pain killers from a guy in my neighborhood." d. "I will sue you and the DR.; you are not doing anything for me."
What is answer b.
500
Which clients could be assigned to LPN under an RN supervision? a. Leg cast, needs neuro and circ. checks, and prn hydrocodone b. preop teaching for PCA pump c. post op toe amputation with diabetic neuropathic pain d. terminal cancer pt, refusing meds e. arthritis, needs scheduled med and heat application (select all that apply):):)
What are answers a,c, & e.
500
What is the best way to schedule medication for a client with constant pain? a. prn at client request b. before painful procedures c. IV bolus after pain assmnt. d. around the clock
What is answer d.
500
In application of the principles of pain treatment, what is the first consideration?
What is believing the client's perception of pain.
500
You are Charge nurse and you have a pt who cant accurately report pain. What is the first action you take? a. Closely assess for nonverbal signs of pain b. Obtain baseline behavioral indicators from family members. c. Look at the MAR and chart to note the time of last dose and pt response. d. Give the max "as needed" dose within the minimum time frame for relief.
What is answer b.
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