Factors Affecting Pain

Every question here, with the answer

1. An older adult admitted with a urinary tract infection is confused and denies pain. The nurse observes the patient rubbing their lower back and struggling to transfer from the wheelchair to the bed. Which action best reflects the nurse’s understanding of factors affecting pain?

   1. Perform further pain assessment because confusion may interfere with pain perception and expression.
   2. Delay pain assessment until the patient can correctly state where they are.
   3. Assume the distress is caused only by fear about hospitalization.
   4. Accept the patient’s denial of pain and document that no pain is present.

   Answer: Perform further pain assessment because confusion may interfere with pain perception and expression.

   Older adults with confusion may not recognize or communicate pain accurately, so observed behaviors must be included in the assessment. The denial of pain should not be the only cue when physical signs suggest pain may be present.

2. A nurse is assessing pain in patients at different developmental levels. Which findings are consistent with how pain may be expressed? Select all that apply.

   1. An infant may express distress through crying because they cannot verbalize pain.
   2. A toddler may show pain through crying, anger, physical resistance, or withdrawal.
   3. A school-aged child is never able to respond to explanations of pain.
   4. Pain in an older adult may present atypically with confusion and agitation.
   5. An adult who is developmentally delayed may express pain similarly to a child.

   Answer: An infant may express distress through crying because they cannot verbalize pain., A toddler may show pain through crying, anger, physical resistance, or withdrawal., Pain in an older adult may present atypically with confusion and agitation., An adult who is developmentally delayed may express pain similarly to a child.

   Developmental level affects how patients perceive and express pain, and it may not match chronological age. Infants, toddlers, developmentally delayed adults, and older adults may all show pain in ways other than clear verbal reporting.

3. A patient with chronic pain says, “There is no hope. Nothing will ever help this pain,” and has a history of depression. Which concern should the nurse prioritize based on factors affecting pain?

   1. The patient should avoid discussing pain because focusing on it always worsens symptoms.
   2. The patient may be at increased risk for suicide if negative emotions persist with chronic pain.
   3. The patient’s pain is most likely exaggerated because mood does not affect pain.
   4. The patient’s pain perception is unrelated to past emotional history.

   Answer: The patient may be at increased risk for suicide if negative emotions persist with chronic pain.

   The section links persistent negative emotions during chronic pain with increased suicide risk, especially when chronic debilitating pain occurs with a history of depression. Mood is a factor that can affect pain perception, so the nurse should take these cues seriously.

4. A nurse is providing teaching to a patient with chronic back pain who wants to make lifestyle changes. Which statements should the nurse include? Select all that apply.

   1. Alcohol may be used by some patients to self-medicate, but its pain-relieving properties are short-lived.
   2. Prolonged inactivity can lead to chronic pain and more adverse effects.
   3. Healthy lifestyle choices such as exercise, healthy foods, and sunlight can help decrease pain.
   4. A sedentary lifestyle can put a person at increased risk for pain.
   5. Avoiding pain makes it better and prevents negative outcomes.

   Answer: Alcohol may be used by some patients to self-medicate, but its pain-relieving properties are short-lived., Prolonged inactivity can lead to chronic pain and more adverse effects., Healthy lifestyle choices such as exercise, healthy foods, and sunlight can help decrease pain., A sedentary lifestyle can put a person at increased risk for pain.

   The section describes healthy lifestyle choices as helpful for decreasing pain and preventing complications, while substance use and sedentary behavior can worsen risk. Avoidance is not recommended because avoiding pain does not make it better and can lead to negative outcomes.

5. A patient has chronic pain related to injuries from a past traumatic event and reports anxiety when discussing the injury. Which nursing response best aligns with the section’s discussion of trauma and pain?

   1. Reassure the patient that childhood or past trauma is not related to chronic pain later in life.
   2. Explain that chronic pain cannot be connected to trauma once the injury has healed.
   3. Tell the patient to focus only on physical symptoms because emotional factors do not affect pain.
   4. Encourage mental health resources because treating trauma may provide pain relief.

   Answer: Encourage mental health resources because treating trauma may provide pain relief.

   The section explains that pain and trauma are often interconnected and that PTSD or traumatic experiences can contribute to chronic pain. It also states that therapy and mental health resources can help patients deal with trauma and residual effects.