A client in an outpatient pain management clinic reports that their leg pain began 1 year ago after an injury that affected the spinal nerves. The pain has an intense sharp quality "like an electric shock". The client rates the pain level 9 on (0-10) scale after taking opioids & non-steroidal anti-inflammatory agents and receiving acupuncture. What are appropriate descriptors of the pain for the nurse to document? (SELECT ALL THAT APPLY)

chronic

visceral

intractable

neuropathic

cutaneous

Answer and Explanation

Correct Answer : A,C,D

A. Chronic:

Chronic pain is characterized by pain that persists beyond the expected time for tissue healing, typically lasting for more than 3 to 6 months.

In this scenario, the client's pain has been present for 1 year, indicating a prolonged duration consistent with chronic pain.

Documenting the pain as chronic provides important information about the nature and duration of the client's pain experience.

C. Intractable:

Intractable pain refers to pain that is difficult to manage or control despite various treatment modalities.

The client's report of intense, sharp pain persisting at a high level (rated 9 out of 10) despite opioid analgesics, non-steroidal anti-inflammatory drugs (NSAIDs), and acupuncture suggests that the pain is intractable.

Documenting the pain as intractable highlights the challenges associated with managing the client's pain and the need for additional interventions or referral to specialized pain management services.

D. Neuropathic:

Neuropathic pain arises from damage or dysfunction of the nervous system and is often described as sharp, shooting, burning, or like an electric shock.

The client's description of their leg pain as "an intense sharp quality 'like an electric shock'" is consistent with neuropathic pain.

Documenting the pain as neuropathic helps identify the underlying pathophysiology of the pain and guides appropriate treatment strategies targeting neuropathic pain mechanisms.

B. Visceral:

Visceral pain originates from internal organs and is typically described as deep, dull, or cramping.

While the pain in this scenario is associated with spinal nerve injury, which can involve visceral pain pathways, the client's description of the pain as sharp and electric shock-like is more indicative of neuropathic pain rather than visceral pain.

Therefore, visceral pain may not be an appropriate descriptor for the client's pain experience in this case.

E. Cutaneous:

Cutaneous pain arises from the skin or subcutaneous tissues and is often described as superficial, sharp, or burning.

While the client's leg pain may involve cutaneous innervation, the description provided ("like an electric shock") suggests involvement of deeper structures and neuropathic pain mechanisms rather than purely cutaneous pain.

Therefore, cutaneous pain may not fully capture the nature of the client's pain experience in this scenario.

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Correct Answer is A

Explanation

A. Trash can accidentally left in path to bathroom: This option accurately documents the environmental factor that contributed to the client's fall. It provides relevant information about the incident, highlighting the presence of a hazard (the trash can) in the path to the bathroom, which led to the fall. Documenting such environmental factors is essential for identifying safety issues and implementing preventive measures.

B. States, "I think I only bruised my left knee": While documenting the client's statement about the extent of their injury is important for assessing and addressing their physical condition, it does not directly address the environmental factor that contributed to the fall. This information may be included in the assessment section of the chart but may not fully capture the circumstances surrounding the fall.

C. Noncompliant with use of call bell: This statement implies a judgment about the client's behavior rather than documenting the circumstances of the fall. While noncompliance with safety measures such as using the call bell may contribute to falls, it is important to focus on objective observations and environmental factors that directly contributed to the incident.

D. Seems angry and upset: Documenting the client's emotional state is relevant for understanding their response to the fall and providing appropriate psychosocial support. However, it does not directly address the cause of the fall or provide information about the environmental factor (the trash can) that contributed to the incident.

A. Jugular vein distention B. Skin turgor, tenting at clavicular area C. Elevated hematocrit D. Oral mucous membranes dry and sticky

Correct Answer is ["B","C","D"]

Explanation

A. Jugular vein distention: Jugular vein distention is not typically associated with deficient fluid volume (dehydration). Instead, it is often seen in conditions of fluid overload, such as heart failure or volume overload. Therefore, this finding is not accurate for deficient fluid volume.

B. Skin turgor, tenting at clavicular area: Skin turgor refers to the skin's ability to return to its normal position after being pinched or pulled. In cases of deficient fluid volume (dehydration), skin turgor is decreased, leading to delayed return of the skin to its normal state. Tenting at the clavicular area is a specific sign of decreased skin turgor and is indicative of dehydration.

C. Elevated hematocrit: Deficient fluid volume (dehydration) leads to hemoconcentration, where there is a relative increase in the proportion of red blood cells to plasma volume. As a result, the hematocrit level, which represents the percentage of red blood cells in the total blood volume, increases. An elevated hematocrit is a laboratory finding commonly associated with deficient fluid volume.

D. Oral mucous membranes dry and sticky: Dehydration can lead to decreased saliva production and dryness of the oral mucous membranes. Dry and sticky oral mucous membranes are common clinical signs of deficient fluid volume (dehydration) and indicate inadequate fluid intake or loss.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is caring for a client who trips and falls over a trash can left in the path to the bathroom. Which is part of an appropriate charting entry?

Correct Answer is A

Explanation

The nurse assesses a client with a history of deficient fluid volume. What are the most accurate findings for this fluid volume status? (SELECT ALL THAT APPLY)

Correct Answer is ["B","C","D"]

Explanation

The nurse makes an error while documenting in the client's chart. The nurse should:

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Which word should the nurse use when describing to a client how a soapsuds enema affects the intestine?

The nurse collects a urine sample from a newly admitted client. The color of the urine is slightly pink. The first nursing action would be to:

What meal option should a nurse choose for a client with fluid volume excess who has been placed on a low-sodium diet?

The nurse caring for a client diagnosed with dehydration recognizes that which of the following are appropriate nursing interventions? (SELECT ALL THAT APPLY)

The nurse teaches the client that fiber provides the bulk in the stools to allow for easier defecation. The nurse recognizes that teaching is effective when the client's menu choices include more: