A patient with a deep partial thickness burn has been receiving hydromorphone through patient-controlled analgesia (PCA) for 1 week. The nurse caring for the patient during the previous shift reports that the patient wakes up frequently during the night reporting pain. What action by the nurse is appropriate?

Teach the patient to push the button every 10 minutes for an hour before going to sleep, even if the pain is minimal.

Request that the health care provider order a bolus dose of morphine to be given when the patient awakens with pain.

Consult with the health care provider about using a different treatment protocol to control the patient's pain.

Administer a dose of morphine every 1 to 2 hours from the PCA machine while the patient is sleeping.

Answer and Explanation

The Correct Answer is C

C. This option is appropriate as the current treatment protocol is not effectively managing the patient's pain. The nurse can collaborate with the healthcare provider to reassess the patient's pain management needs and explore alternative strategies or adjustments to the PCA regimen.

A. This approach may lead to overmedication and increase the risk of adverse effects such as respiratory depression or sedation.

B. Requesting a bolus dose when the patient awakens with pain could be a part of the solution, but it should be carefully evaluated within the context of the overall pain management plan.

D. Administering scheduled doses of morphine from the PCA machine without the patient's input or based solely on time intervals is not recommended.

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Correct Answer is B

Explanation

B. Amitriptyline is a tricyclic antidepressant that is often used in low doses to treat neuropathic pain, including diabetic neuropathy. It can help relieve burning, shooting, or stabbing pain often associated with this condition.

A. Naproxen is a nonsteroidal anti-inflammatory drug (NSAID) commonly used for relieving pain and inflammation associated with conditions like arthritis and musculoskeletal injuries. However, it is not typically used as a first-line treatment for neuropathic pain.

C. Celecoxib is a selective COX-2 inhibitor NSAID primarily used for its anti-inflammatory properties and pain relief in conditions like arthritis. While it may help with inflammation-associated pain, it is not specifically indicated for neuropathic pain.

D. While it may provide some relief, opioids are generally not recommended as first-line treatment for neuropathic pain due to their potential for dependence, tolerance, and other side effects.

A. "You will need to remove all jewelry before the test." B. "You will need to fast for 12 hours before the test." C. "You will need to empty your bladder before the test." D. "You will need to lie flat for 4 hours following the test."

Correct Answer is A

Explanation

A. Metal objects, including jewelry, can interfere with the DXA scan and affect the quality of the images. Therefore, it is important for the client to remove all jewelry and metal objects before the test to ensure accurate results.

B. Fasting is not typically required for a dual-energy x-ray absorptiometry (DXA) scan. DXA scans are non- invasive and do not involve the administration of any substances that would necessitate fasting.

C. This instruction is not specifically required for a DXA scan. However, it is generally a good practice for clients to empty their bladder before any imaging test to ensure comfort during the procedure.

D. This instruction is not accurate for a DXA scan. DXA scans are typically quick procedures that do not require the client to lie flat for an extended period afterward. Clients can resume their normal activities immediately following the scan without any restrictions.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is caring for a patient who has diabetes and reports chronic, burning leg pain even when taking oxycodone (OxyContin) twice daily. Which prescribed medication is the best choice for the nurse to administer as an adjuvant to decrease the patient's pain?

Correct Answer is B

Explanation

A nurse is teaching a client who is scheduled for dual-energy x-ray absorptiometry (DXA) to screen for osteoporosis. Which of the following instructions should the nurse include in the teaching?

Correct Answer is A

Explanation

A patient is admitted to the postanesthesia care unit (PACU) with a blood pressure (BP) 122/72 mm Hg. Thirty minutes after admission, the BP is 114/62, with a pulse of 74 and warm, dry skin. Which action by the nurse is most appropriate?

A nurse is developing a plan of care for a client who has a fracture to achieve the outcome of functional healing. To assist in meeting this goal, which of the following nursing interventions is the highest priority?

A nurse is caring for a client who has an unrepaired femur fracture of the midshaft. Which of the following techniques should the nurse use when performing an assessment of the client's neurovascular status?

An unconscious patient who was transferred from surgery to the postanesthesia care unit (PACU) 15 minutes ago has an oxygen saturation of 89%. Which action should the nurse take first?

A nurse in a one-day surgery center is providing discharge teaching for a client who is postoperative following a partial meniscectomy. Which of the following instructions should the nurse include?

A nurse is caring for a client who is 1-day postoperative following total hip arthroplasty. It is 0830 and the client is schedule for physical therapy (PT) at 0900. Which of the following interventions should the nurse take?

A nurse is assessing a client following the application of a leg cast for the treatment of a fracture. If the cast is too tight, which of the following findings should the nurse expect to observe first?

A nurse is teaching a client about risk factors for osteoarthritis. Which of the following factors should the nurse include in the teaching? (Select all that apply.)