Pain Management

Every question here, with the answer

1. A hospitalized patient with severe postoperative pain is using patient-controlled analgesia (PCA). The patient is sleeping, and a family member tells the nurse, “I’ll press the button so the pain doesn’t come back.” What is the nurse’s best response?

   1. Teach that only the patient should press the PCA button.
   2. Turn off the PCA pump until the patient wakes up.
   3. Ask the family member to press the button only when the patient appears uncomfortable.
   4. Allow the family member to press the button if the patient requested it earlier.

   Answer: Teach that only the patient should press the PCA button.

   PCA safety depends on the patient being alert enough to press the button, which helps prevent overmedication, sedation, and respiratory depression. Allowing anyone else to press the button bypasses this safety feature.

2. The nurse is preparing to administer an opioid analgesic. Which actions are consistent with safe opioid analgesic administration? Select all that apply.

   1. Delay pain reassessment unless the patient reports that the medication did not work.
   2. Avoid distractions and disruptions while preparing and administering the medication.
   3. Have a second nurse witness any wasted opioid medication and document the wasted amount.
   4. Monitor for adverse effects after medication administration.
   5. Verify the patient’s information before medication administration.

   Answer: Avoid distractions and disruptions while preparing and administering the medication., Have a second nurse witness any wasted opioid medication and document the wasted amount., Monitor for adverse effects after medication administration., Verify the patient’s information before medication administration.

   Safe opioid administration includes reducing distractions, verifying patient information, documenting witnessed waste, and monitoring for adverse effects. Pain reassessment should not be skipped; the section states to perform a comprehensive pain assessment after administration to assess effectiveness.

3. A patient receiving an opioid analgesic becomes difficult to keep awake and shows signs of respiratory depression. What is the nurse’s priority action based on the section?

   1. Teach that nausea usually improves after a few days.
   2. Offer guided imagery before taking further action.
   3. Encourage increased physical activity to prevent constipation.
   4. Closely monitor the patient and administer naloxone if needed.

   Answer: Closely monitor the patient and administer naloxone if needed.

   Respiratory depression is identified as one of the most serious potential opioid side effects. The nurse must closely monitor the patient and give naloxone to reverse opioid effects if needed.

4. The nurse is teaching a patient who is starting opioid therapy about preventing constipation. Which teaching points match the section? Select all that apply.

   1. Use a bowel management program that may include stool softeners.
   2. Avoid all nonpharmacological pain interventions while taking opioids.
   3. Include physical activity as allowed with pain or postsurgical restrictions.
   4. Eat a well-balanced diet.
   5. Increase fluids as appropriate.

   Answer: Use a bowel management program that may include stool softeners., Include physical activity as allowed with pain or postsurgical restrictions., Eat a well-balanced diet., Increase fluids as appropriate.

   Opioids can slow peristalsis and cause hard stools, so constipation prevention should include stool softeners, fluids, diet, and allowed activity. Nonpharmacological interventions are not avoided; effective pain management commonly combines pharmacological and nonpharmacological approaches.

5. A patient reports chronic pain and asks for nonmedication strategies that can be used at home. Which option is most appropriate for the nurse to include?

   1. Avoid environmental changes because lighting, sounds, and temperature do not affect pain.
   2. Guided imagery, because it can be incorporated into daily life once the patient is familiar with the practice.
   3. Biofeedback as a one-time intervention because results are expected immediately.
   4. Massage without caution, even if the patient has a skin rash or infection.

   Answer: Guided imagery, because it can be incorporated into daily life once the patient is familiar with the practice.

   Guided imagery is described as easy to incorporate into daily life after patients learn it and is especially helpful for chronic pain. The other options contradict the section: massage requires caution with rash or infection, biofeedback often needs multiple sessions, and environmental changes can reduce pain.

6. A nurse is screening patients before recommending massage as a nonpharmacological pain intervention. Which patient findings require caution with massage? Select all that apply.

   1. Skin rash
   2. Infection
   3. Pregnancy
   4. Certain cardiovascular diseases
   5. Tight muscles

   Answer: Skin rash, Infection, Pregnancy, Certain cardiovascular diseases

   The section states patients should be cautious with massage if they have a skin rash, infection, certain cardiovascular diseases, or are pregnant. Tight muscles are not listed as a caution; massage is described as helping loosen tight muscles.