A nurse in a long-term care facility is reinforcing teaching about pain control with a client who has terminal cancer. Which of the following information should the nurse include?

Analgesia should be used around the clock to promote pain control.

Pain patches are applied each morning and removed at bedtime.

We will use intramuscular medications to control your pain.

A medication dose must be decreased if you develop tolerance.

Answer and Explanation

The Correct Answer is A

Choice A reason: Using analgesia around the clock is an appropriate action. The nurse should follow the principle of prevention rather than rescue when managing pain for a client who has terminal cancer. The nurse should administer analgesics on a regular schedule to maintain a steady level of pain relief and prevent breakthrough pain.

Choice B reason: Applying pain patches each morning and removing them at bedtime is not an appropriate action. The nurse should follow the manufacturer's instructions for applying and removing pain patches. Some patches are designed to be worn for 24 hours, while others are worn for 72 hours. Removing the patches too soon can cause inadequate pain control and withdrawal symptoms.

Choice C reason: Using intramuscular medications to control pain is not an appropriate action. The nurse should avoid using intramuscular route for administering analgesics to a client who has terminal cancer. Intramuscular injections are painful, unreliable, and increase the risk of infection and bleeding. The nurse should use oral, transdermal, or subcutaneous routes whenever possible.

Choice D reason: Decreasing a medication dose if the client develops tolerance is not an appropriate action. The nurse should understand that tolerance is a normal physiological response to long-term opioid use and does not indicate addiction or abuse. The nurse should adjust the medication dose according to the client's level of pain and response to treatment.

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Correct Answer is B

Explanation

Choice A: This is incorrect because maintaining the client on bed rest can increase the risk of complications such as pneumonia, thromboembolism, or pressure ulcers. The nurse should encourage early ambulation and frequent position changes to promote healing and prevent complications.

Choice B: This is correct because repositioning the client can help relieve pressure and discomfort from the incision site. The nurse should assist the client to change positions every 2 hours and use pillows or splints to support the incision.

Choice C: This is incorrect because applying a warm, moist compress to the incision area can interfere with wound healing and increase the risk of infection. The nurse should keep the incision site clean and dry and follow the provider's orders for dressing changes.

Choice D: This is incorrect because administering an additional dose of pain medication is not necessary when the client reports a pain level of 2 on a scale of 0 to 10. The nurse should monitor the client's pain level and administer pain medication as prescribed and as needed.

A. Nonpalpable area of redness, less than 5 mm (0.2 in) in diameter B. Palpable area of induration, greater than 10 mm (0.4 in) in diameter C. Area of ecchymosis, greater than 12 mm (0.5 in) in diameter D. Tenderness at the injection site

Correct Answer is B

Explanation

Choice A reason: Nonpalpable area of redness, less than 5 mm (0.2 in) in diameter is a negative result for the tuberculin skin test, which means that the client does not have tuberculosis infection or exposure.

Choice B reason: Palpable area of induration, greater than 10 mm (0.4 in) in diameter is a positive result for the tuberculin skin test, which means that the client has tuberculosis infection or exposure and needs further testing, such as chest x-ray or sputum culture, to confirm the diagnosis and rule out active disease.

Choice C reason: Area of ecchymosis, greater than 12 mm (0.5 in) in diameter is not a relevant finding for the tuberculin skin test, as it indicates bruising or bleeding under the skin that may be caused by trauma or coagulation disorder.

Choice D reason: Tenderness at the injection site is not a relevant finding for the tuberculin skin test, as it indicates inflammation or irritation of the skin that may be caused by needle insertion or allergic reaction.

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A nurse in a long-term care facility is reinforcing teaching about pain control with a client who has terminal cancer. Which of the following information should the nurse include?

Nursing Test Bank

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