The nurse is caring for older patients in a long-term-care facility. The nurse understands that which factors influence pain management in these patients?
Select all that apply.
1. Increased A fiber transmission increases the potential for addiction in older adults.
2. An increased risk of depression in older adults is related to chronic pain.
3. Less reporting of referred pain may mask myocardial infarction in older adults.
4. Assessment of pain in the cognitively impaired older adult is not possible.
5. Delirium should be evaluated as pain.
Question 2A patient recovering from a broken leg asks why the pain is so sharp. What should the nurse explain about acute pain?
Select all that apply.
1. The pain signal releases catecholamines.
2. The pain signal reduces blood flow to the gut.
3. The pain signal travels along nerve fibers to the spinal cord.
4. The pain signal travels up to the brain portion called the thalamus.
5. The pain signal spreads throughout the cortex, limbic system, and brainstem
Question 3A nurse is teaching pain management to a homebound hospice patient, already being treated with opioids. This patient has been diagnosed with metastatic breast cancer and expresses anxiety about keeping her pain under control.
In which nonpharmacologic complementary methods might the nurse instruct the patient?
Select all that apply.
1. guided imagery
2. progressive muscle relaxation
3. distraction
4. acupuncture
5. regional pain management
Question 4The nurse is preparing to apply a transdermal analgesic patch to a patient. In what order should the nurse administer this medication?
Choice 1. Choose a new site and cleanse and dry an upper torso location.
Choice 2. Clip chest hair and open the medication package.
Choice 3. Keep the patch intact for 72 hours.
Choice 4. Place the patch, making sure all edges are in contact with the skin.
Question 5The nurse is explaining the pain response process to a patient experiencing chronic pain. In which order should the nurse identify the steps in the neural pain pathway?
Choice 1. In the thalamus and cerebral cortex, the pain impulse becomes pain when the sensation reaches conscious levels and is perceived and evaluated by the person experiencing the sensation.
Choice 2. Dorsal horn synapses relay impulses up the spinal cord. Spinal neurons transmit the impulses via axons that cross over to the spinothalamic tract.
Choice 3. The impulses ascend the spinothalamic tracts and pass through the medulla and midbrain to the thalamus.
Choice 4. A noxious stimulus is perceived by cutaneous nociceptors and then transmitted through A-delta (A) and even smaller C nerve fibers to the spinal cord dorsal horn.
Question 6A patient is prescribed a fentanyl patch to administer 100 mcg/hour. The patient uses one patch for 72 hours and then is changed to an intravenous infusion of morphine 8 hours into the second patch.
If the patient had been receiving the morphine intravenously, how many mg of the medication would the patient have received from wearing the patch?
Record your answer rounding to the nearest whole number.
Quick Reply
