A nurse is caring for a patient experiencing pain related to a musculoskeletal disorder. Which statement about chronic pain is most accurate?

Chronic pain could cause restlessness, pacing, grimacing, and other facial expressions of pain.

Chronic pain is limited and short in duration.

A patient with chronic pain may have physical signs of tissue injury.

Chronic pain may not manifest in a change of vital signs.

Answer and Explanation

The Correct Answer is A

Choice A rationale:

Chronic pain can manifest in various behavioral and physical symptoms, including restlessness, pacing, grimacing, and other facial expressions of pain. These behaviors are often unconscious attempts to cope with or distract from the pain.

They may also reflect the emotional distress that often accompanies chronic pain. Patients may feel frustrated, anxious, or even depressed due to the persistent nature of their pain and its impact on their lives.

It's crucial for nurses to recognize these behavioral signs of pain, as patients may not always readily report their pain verbally. By observing these behaviors, nurses can assess the patient's pain level more accurately and provide appropriate interventions.

Choice B rationale:

Chronic pain is defined as pain that persists for longer than three months, often for much longer. It is not limited and short in duration.

This distinguishes it from acute pain, which is typically associated with an injury or illness and resolves within a few days or weeks.

Choice C rationale:

While some patients with chronic pain may have physical signs of tissue injury, this is not always the case. Chronic pain can also be caused by nerve damage, inflammation, or changes in the central nervous system.

In some cases, the underlying cause of chronic pain may be unknown.

Choice D rationale:

Although chronic pain may not always cause a significant change in vital signs, it can still be a very real and debilitating experience for patients.

Vital signs, such as heart rate, blood pressure, and respiratory rate, are often more sensitive to acute pain.

Nurses should not rely solely on vital signs to assess chronic pain. Instead, they should consider the patient's self-report of pain, behavioral cues, and other factors.

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Correct Answer is A

Explanation

Choice A rationale:

Confidentiality: Patient information stored within the facility's computer system is highly confidential and protected by various laws and regulations, such as HIPAA (Health Insurance Portability and Accountability Act). Sharing a password with anyone, even trusted colleagues, could potentially compromise patient privacy and lead to unauthorized access or breaches of sensitive data. Nurses are ethically and legally obligated to safeguard patient confidentiality and uphold the highest standards of privacy protection.

Accountability: Each nurse is held individually accountable for any actions taken under their unique login credentials. Sharing a password blurs the lines of responsibility and makes it difficult to trace actions back to the specific individual who performed them. This can create accountability issues and impede investigations in cases of errors, misconduct, or security breaches.

Security Best Practices: Password sharing is universally discouraged by cybersecurity experts as it significantly weakens system security. Strong passwords, kept confidential and changed regularly, are essential for protecting sensitive information from unauthorized access, malware, and potential cyberattacks.

Facility Policies: Most healthcare facilities have strict policies prohibiting password sharing to maintain compliance with regulations and safeguard patient privacy. Violating these policies could lead to disciplinary action, including termination of employment.

Choice B rationale:

While a nurse manager may have a legitimate need to access patient information in certain situations, sharing a password is not the appropriate method for granting such access. Facilities typically have designated procedures for authorized individuals to obtain temporary or secondary login credentials, ensuring accountability and adherence to security protocols.

Choice C rationale:

Unit clerks, while often responsible for administrative tasks within a unit, do not have a clinical role that necessitates access to patient information through the nurse's password. Sharing a password with a unit clerk could lead to unauthorized access and potential privacy violations.

Choice D rationale:

The facility's information system representative is responsible for maintaining the technical infrastructure of the computer system, but they do not require access to patient information through individual nurse passwords. They have their own authorized means of accessing the system for troubleshooting and maintenance purposes.

A. Irrigate the tubing with sterile normal saline solution at least once every 8 hours. B. Replace the drainage plug after releasing hand pressure on the device. C. Fully recollapse the reservoir after emptying it. D. Empty the reservoir once per day.

Correct Answer is C

Explanation

Choice A rationale:

Irrigating the tubing with sterile normal saline solution is not a routine part of closed-wound drainage system care.

It's usually only done if there's evidence of a blockage or infection, and only under the direction of a healthcare provider. Unnecessary irrigation could introduce bacteria into the system and increase the risk of infection.

It could also disrupt the delicate balance of fluids in the wound and delay healing.

Choice B rationale:

Replacing the drainage plug after releasing hand pressure on the device is not correct. The drainage plug should actually be replaced before releasing hand pressure.

This is to prevent air from entering the system, which could disrupt the vacuum and impair drainage.

Choice D rationale:

Emptying the reservoir once per day is not frequent enough.

The reservoir should be emptied whenever it becomes full, which could be more often than once a day, depending on the amount of drainage.

Allowing the reservoir to become too full could put pressure on the wound and impede healing.

Choice C rationale:

Fully re-collapsing the reservoir after emptying it is essential to maintain the vacuum that promotes drainage. If the reservoir is not fully re-collapsed, the vacuum will be lost, and drainage will slow or stop.

This could lead to fluid accumulation in the wound, which could increase the risk of infection and delay healing.

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A nurse is caring for a patient experiencing pain related to a musculoskeletal disorder. Which statement about chronic pain is most accurate?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

With whom should a nurse share her password for access to the facility’s computer system?

Correct Answer is A

Explanation

A nurse is providing postoperative care for a patient who has a closed-wound drainage system. Which of the following actions should the nurse perform?

Correct Answer is C

Explanation

A nurse is caring for a client who is postoperative and requesting something to drink. The nurse reads the client’s postoperative prescriptions, which include, “Clear liquids, advance diet as tolerated.” What action should the nurse take first?

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What triggers the afferent pathways, resulting in the sensation of pain?

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