A client who has had a right-sided below-the-knee amputation is complaining of constant pain in his right ankle. The nurse documents that the client is experiencing what type of pain?
Intractable
Radiating
Phantom
Referred
The Correct Answer is C
A. Intractable pain refers to pain that is severe and persistent, difficult to control or manage despite treatment. It may be constant or intermittent but is generally not specific to a body part that has been amputated. Intractable pain is not typically used to describe pain specifically related to a phantom limb or residual limb pain after amputation.
B. Radiating pain is pain that spreads from its origin to another location in the body. It often follows the path of a nerve and can be associated with nerve compression or irritation. While radiating pain can occur in various conditions, it does not specifically describe the type of pain experienced in an amputated limb.
C. Phantom pain is perceived pain that feels like it is coming from a part of the body that has been amputated. It is a common phenomenon after limb amputation where the brain continues to receive pain signals from nerves that originally innervated the missing limb. Phantom pain is the correct term for the pain experienced by a client with a below-the-knee amputation who complains of pain in the right ankle. It is described as constant pain in the missing limb or part.
D. Referred pain is pain perceived at a location other than the site of the painful stimulus or origin. It occurs because of shared neural pathways between different areas of the body. Referred pain is not typically used to describe pain specifically related to amputation or phantom limb pain.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. The pulmonic valve is best auscultated at the second intercostal space (ICS) on the left sternal border. This is where the area corresponding to the pulmonic valve is most accurately heard due to the anatomical positioning of the heart.
B. This area does not correspond to any valvular area.
C. This location corresponds to the aortic valve, not the pulmonic valve. The aortic valve is best auscultated at the second ICS, right sternal border.
D. This location corresponds to the tricuspid valve, not the pulmonic valve. The tricuspid valve is best auscultated at the fourth or fifth ICS along the left sternal border.
Correct Answer is ["16"]
Explanation
Total Volume (ml) / Rate (ml/hr) = Time (hr).
For a client receiving 2 liters of IV fluid at a rate of 125 ml/hr,
Convert liters to milliliters (since 1 liter = 1000 ml, therefore 2 liters = 2000 ml). Then, divide the total volume by the rate: 2000 ml / 125 ml/hr = 16 hours.
So, the nurse should expect the IV fluids to last for 16 hours.
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