An older aphasic patient has severe osteoarthritis, bilateral contractures of the lower extremities, and a stage IV pressure ulcer. The nurse practitioner prescribes analgesic medi-cations to be administered around-the-clock, with as-needed doses to be ad
to be administered as appropriate. What observation by the nurse would indicate that the pain regimen is effective? Select all that apply.
a. Pa-tient slept throughout the night.
b. Pa-tient winces only when turned and repositioned.
c. Pa-tient slept during dressing change.
d. Pa-tient compliant with attempts to provide AM care.
e. Pa-tient ate 80 of breakfast, 70 of lunch and 100 of dinner
Question 2An older patient who was recently admitted to the subacute setting after having a knee replacement, is very anxious and refuses to get out of bed, stating that it is too painful. Which intervention will the nurse implement?
a. Share with the patient that it's important to get out of bed and that there is pain medication available if it does hurt
b. Use the Hoyer lift to get her out of bed so that the knee will not experience much move-ment and so there will be little pain.
c. Offer pain medication, administer the medication, and wait 20 minutes before getting her out of bed.
d. Allow the patient to remain in bed but share that getting up will be required at least twice a day starting the next morning.
Question 3When educating a client on the use of an adjuvant medication, which statement best demonstrates the nurse's understanding of this therapy?
a. These medications are used instead of opioids to decrease the likelihood of addiction.
b. Ad-juvant medications are prescribed because they seldom cause any significant side effects.
c. These types of medications are used to eliminate the side effects of opioid medications.
d. These drugs are used in combination with analgesics to increase the effect of the analgesics.
Question 4An older adult is currently prescribed both aspirin (81 mg) and ibuprofen daily. What instructions are most important for the nurse to provide to assure the expected outcomes for this client?
a. The medications should be taken together to ensure the effectiveness of both medications
b. Take ibuprofen 30 minutes after the aspirin so as to not interfere with its effectiveness
c. The aspirin will negatively affect the analgesic affect of the ibuprofen
d. The medications should be taken at least 4 hours apart to minimize risk of gastric irritation
Question 5An older client with a history of hypertension and osteoarthritis who has recently fallen and fractured two ribs is prescribed extra strength Tylenol for the pain. What statement by the client requires further evaluation by the nurse?
a. I find that when I drink herbal tea and then take my Tylenol at bedtime, I sleep through the whole night.
b. I heard that meditation may help me deal with the pain without taking all that Tylenol.
c. Two extra strength Tylenol tablets (500 mg/tablet) every 4 hours around-the-clock and my pain is gone.
d. I make sure that I take my Tylenol with breakfast when I first get up.
Question 6An older adult with gastric cancer with bone metastases is being discharged from the hospital after beginning a regimen of opioid analgesics to control the metastatic pain. What should be included in the discharge teaching plan?
a. The development of a plan to prevent constipation
b. Bene-fits of grief counseling
c. In-creasing calories in the diet
d. Pre-venting pressure ulcers
Question 7An older adult is being treated for severe pain resulting from a history of osteoarthritis. In her discharge teaching, which information is most important to the successful management of the pain?
a. check for incompatibilities before taking any new medications
b. ar-range to take a dose of analgesic prior to physical activity
c. to take the analgesic around the clock as prescribed
d. be alert for the signs of overdose toxicity
Question 8An older adult is admitted to the hospital with complications resulting from lung cancer with metastases to bone. A long-acting opioid administered around-the-clock is prescribed. When explaining this intervention to the family, the nurse bases the explan
the explanation on the principle that this technique:
a. Pre-vents the development of an addiction to opioids.
b. Pro-vides more stable therapeutic plasma levels of the drug.
c. Pre-vents many side effects of traditionally administered opioids.
d. Pro-vides relief with lesser amounts of opioids.
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