Review Practice Exercise 3

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Practice Exercise 3

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Total Questions : 5

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Question 1:

A nurse is using the Numeric Rating Scale (NRS) to assess a patient's pain. The patient rates their pain as a "10" on a scale of 0 to 10. The nurse understands that this number represents which dimension of the patient's pain?

A. Behavioral dimension. B. Sensory dimension. C. Affective dimension. D. Cognitive dimension.

Answer and Explanation

Choice A:

Behavioral dimension: Involves observable actions like grimacing, guarding, or restlessness, which are not measured by the NRS.

Choice B:

Sensory dimension: Relates to the physiological detection and description of pain, including its intensity, timing, and location. The NRS score is a direct representation of perceived pain severity.Rationale for incorrect answers:

Choice C:

Affective dimension: Refers to emotional responses to pain, such as fear, anxiety, or depression, rather than numerical intensity.

Choice D:

Cognitive dimension: Concerns beliefs, attitudes, and expectations about pain, which are not directly quantified by a numeric score.

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Question 2:

B. According to the World Health Organization (WHO) pain ladder, which of the following statements are correct regarding the management of cancer pain? Select all that apply

A. The first step is to use non-opioid analgesics, such as NSAIDs, for mild pain. B. Weak opioids, like codeine, are added to the non-opioids for moderate pain. C. Strong opioids, such as morphine or fentanyl, are used alone for severe pain. D. Adjuvants, like antidepressants or anticonvulsants, can be used at any step of the ladder. E. The goal is to move down the ladder to the lowest possible level of analgesic.

Answer and Explanation

Choice A:

The first step is to use non-opioid analgesics, such as NSAIDs, for mild pain: Non-opioids are the foundation for managing early-stage or mild cancer pain. They are often combined with adjuvants as needed.

Choice B:

Weak opioids, like codeine, are added to the non-opioids for moderate pain: This combination enhances analgesia while maintaining non-opioid benefits. It represents step two of the ladder.

Choice C:

Strong opioids, such as morphine or fentanyl, are used alone for severe pain: Strong opioids are typically combined with non-opioids and adjuvants for optimal pain relief, not used alone.

Choice D:

Adjuvants, like antidepressants or anticonvulsants, can be used at any step of the ladder: These agents target specific pain mechanisms and can complement opioids or non-opioids at any stage.Rationale for incorrect answers:

Choice E:

The goal is to move down the ladder to the lowest possible level of analgesic: The aim is consistent pain control and quality of life, not necessarily de-escalation of therapy.

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Question 3:

A patient reports sharp, stabbing pain after an abdominal surgery. What is the most appropriate initial action for the nurse to take?

A. Administer a strong opioid immediately, as the pain is likely severe. B. Document the pain as "acute" and wait one hour to reassess. C. Ask the patient to describe the pain and use a validated pain scale. D. Tell the patient that some pain is expected after surgery.

Answer and Explanation

Choice A:

Administer a strong opioid immediately, as the pain is likely severe: Medication choice should be based on a comprehensive assessment, not assumption. Immediate opioid administration without assessment can lead to inappropriate dosing or missed underlying complications.

Choice B:

Document the pain as "acute" and wait one hour to reassess: Delaying intervention after surgery can prolong suffering and increase stress response; assessment should occur promptly.

Choice C:

Ask the patient to describe the pain and use a validated pain scale: A complete pain assessment includes location, quality, intensity, duration, and aggravating or relieving factors. Using a pain scale provides an objective measure to guide treatment and monitor effectiveness.Rationale for incorrect answers:

Choice D:

Tell the patient that some pain is expected after surgery: While postoperative pain is common, dismissing the report without assessment undermines patient trust and can delay appropriate management.

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Question 4:

The principle of using multimodal analgesia in pain management involves which of the following? Select all that apply

A. Using a combination of different analgesics that work on different pain pathways. B. Administering a single, high-dose opioid to achieve pain relief. C. Combining pharmacological and non-pharmacological interventions. D. Using only non-opioid medications to avoid addiction. E. Providing local anesthetics in conjunction with systemic analgesics.

Answer and Explanation

Choice A:

Using a combination of different analgesics that work on different pain pathways: Targeting multiple mechanisms of pain enhances effectiveness and reduces the required dose of each drug, minimizing side effects.

Choice B:

Administering a single, high-dose opioid to achieve pain relief: This approach increases the risk of side effects and dependence without addressing all pain mechanisms.

Choice C:

Combining pharmacological and non-pharmacological interventions: Physical therapy, relaxation techniques, and cognitive-behavioral strategies can complement medications for more comprehensive pain control.

Choice D:

Using only non-opioid medications to avoid addiction: While minimizing opioids can be beneficial, multimodal analgesia focuses on combining methods, not excluding specific drug classes entirely

Choice E:

Providing local anesthetics in conjunction with systemic analgesics: Regional blocks or local infiltration can reduce the need for high systemic doses and improve targeted pain relief.Rationale for incorrect answers:

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Question 5:

A nurse is teaching a patient about non-pharmacological pain management techniques. Which of the following is the most appropriate example of a non-pharmacological intervention?

A. Applying a heat pack to a sore back. B. Administering a PRN oral opioid. C. Giving a steroid injection to an inflamed joint. D. Increasing the patient's fluid intake

Answer and Explanation

Choice A:

Applying a heat pack to a sore back: Heat therapy relaxes muscles, increases blood flow, and can reduce pain perception. It is a safe, accessible, and effective non-drug approach for many types of musculoskeletal pain.Rationale for incorrect answers:

Choice B:

Administering a PRN oral opioid: This is a pharmacological intervention involving medication, not a non-drug technique.

Choice C:

Giving a steroid injection to an inflamed joint: This involves a pharmacological agent delivered through injection, making it a drug-based treatment.

Choice D:

Increasing the patient's fluid intake: While hydration is important for overall health, it is not a recognized non-pharmacological pain management method.

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Practice Exercise 3

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