A patient with second-degree burns has been receiving hydromorphone through patient-controlled analgesia (PCA) for a week. The patient wakes up frequently during the night complaining of pain. What action by the nurse is most appropriate?
a. Administer a dose of morphine every 1 to 2 hours from the PCA machine while the patient is sleeping.
b. Consult with the health care provider about using a different treatment protocol to control the patient's pain.
c. Request that the health care provider order a bolus dose of morphine to be given when the patient awakens with pain.
d. Teach the patient to push the button every 10 minutes for an hour before going to sleep, even if the pain is minimal.
Question 2The nurse assesses that a patient receiving epidural morphine has not voided for over 10 hours. What action should the nurse take initially?
a. Monitor for withdrawal symptoms.
b. Place an indwelling urinary catheter.
c. Ask if the patient feels the need to void.
d. Document this allergic reaction in the patient's chart.
Question 3The nurse teaches a student nurse about the action of ibuprofen. Which statement, if made by the student, indicates that teaching was effective?
a. The drug decreases pain impulses in the spinal cord.
b. The drug decreases sensitivity of the brain to painful stimuli.
c. The drug decreases production of pain-sensitizing chemicals.
d. The drug decreases the modulating effect of descending nerves.
Question 4A nurse assesses a patient with chronic cancer pain who is receiving imipramine (Tofranil) in addition to long-acting morphine. Which statement, if made by the patient, indicates to the nurse that the patient is receiving adequate pain control?
a. I'm not anxious at all.
b. I sleep 8 hours every night.
c. I feel much less depressed since I've been taking the Tofranil.
d. The pain is manageable and I can accomplish my desired activities.
Question 5A patient who uses a fentanyl (Duragesic) patch for chronic cancer pain suddenly complains of rapid onset pain at a level 9 (0 to 10 scale) and requests something for pain that will work now.
How will the nurse document the type of pain reported by this patient?
a. Somatic pain
b. Referred pain
c. Neuropathic pain
d. Breakthrough pain
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