Pain NCLEX Practice Questions

Pain NCLEX Practice Questions 1. A patient who has just started taking sustained-release morphine sulfate (MS Contin) for chronic pain complains of nausea and abdominal fullness. The most appropriate initial action by the nurse is to a. consult with the health care provider about using a different opioid. b. administer the ordered metoclopramide (Reglan) 10 mg IV. c. tell the patient that the nausea will subside in about a week. d. order the patient a clear liquid diet until the nausea decreases. 2 .All the following medications are included in the admission orders for an 86-year-old patient with moderate degenerative arthritis in both hips. Which medication will the nurse use as an initial therapy? a. Aspirin (Bayer) 650 mg orally b. Oxycodone (Roxicodone) 5 mg orally c. Acetaminophen (Tylenol) 650 mg orally d. Naproxen (Aleve) 200 mg orally 3.To obtain the most complete assessment data about a patient’s chronic pain pattern, the nurse asks the patient a. “Can you describe where your pain is the worst?” b. “What is the intensity of your pain on a scale of 0 to 10?” c. “Would you describe your pain as aching, throbbing, or sharp?” d. “Can you describe your daily activities in relation to your pain?” 4. Morphine 10 mg IV every 4 to 6 hours prn is ordered for a patient with a pancreatic tumor who has a distant history of opioid abuse. After 3 days of receiving the morphine every 6 hours, the patient tells the nurse that the medication is needed more frequently to control the pain. The best initial action by the nurse is to a. administer the morphine every 4 hours as needed. b. consult with the doctor about initiating an appropriate weaning protocol for the morphine. c. remind the patient that the previous substance abuse increases the risk for addiction. d. use alternative therapies such as heat or cold. 5. A patient receiving prn intermittent IV administration of opiates following gastric surgery watches a favorite television program every morning. The patient does not request pain medication during this time and when questioned denies the need for medication. The nurse’s evaluation of this situation is that a. lying quietly in bed is the best method of controlling the patient’s incisional pain. b. encouraging the patient to watch other television programs will decrease the pain. c. the distraction of the television enables the patient to decrease the perception of pain. d. the patient’s dose of opiates needs to be decreased because her pain is well controlled . 6. The hospice RN obtains the following information about a 72-year-old terminally ill patient with cancer of the colon. The patient takes oxycodone (OxyContin) 100 mg twice daily for level 6 abdomen pain on a 10-point scale. The pain has made it difficult to continue with favorite activities such as playing cards with friends twice a week. The patient’s children are supportive of the patient’s wish to stop chemotherapy but express sadness that the patient does not have long to live. Based on this information, which nursing diagnosis has priority in planning the patient’s care? a. Impaired social interaction related to disabling pain b. Anxiety related to poor patient coping skills c. Disabled family coping related to patient-family conflict d. Risk for aspiration related to opioid use 7. A patient with extensive second-degree burns on the legs and trunk is using patient-controlled analgesia (PCA) with IV morphine to be delivered at 1 mg every 10 minutes to control the pain. Several times during the night, the patient awakens in severe pain, and it takes more than an hour to regain pain relief. The most appropriate action by the nurse is to a. request that the health care provider order a bolus dose of morphine to be given when the patient awakens with pain. b. consult with the patient’s health care provider about adding a continuous morphine infusion to the PCA regimen at night. c. teach the patient to push the button every 10 minutes for an hour before going to sleep even if the pain is minimal. d. administer a dose of morphine every 1 to 2 hours from the PCA machine while the patient is sleeping. 8 . A patient with fibromyalgia experiences chronic pain in certain joints which adjunct therapy will most likely relieve her pain a. Ibuprofen (Motrin) 400-800 mg orally b. Immediate-release morphine 30 mg orally c. Amitriptyline (Elavil) 10 mg orally. d. Lorazepam (Ativan) 1 mg orally 9. The health care provider plans to titrate a patient-controlled opioid infusion (PCA) to provide pain relief for a patient with acute surgical pain who has never received opioids in the past. Which of the following nursing actions regarding opioid administration are appropriate at this time? (Select all that apply.) a. Monitoring for therapeutic and adverse effects of opioid administration b. Teaching about the need to decrease opioid doses by the second postoperative day c. Assessing for signs that the patient is becoming addicted to the opioid d. Educating the patient about how analgesics improve postoperative activity level e. Emphasizing that the risk of opioid side effects increases over time 10. A post op patient is using patient-controlled analgesia (PCA) with IV morphine to be delivered at 1 mg every 10 minutes with a continuous basal rate of 0.5 mg/hr. when doing your initial assessment he is hard to arouse and his respirations are 8 /minute your initial action would be. a. b. c. d. Call a code Reassess in one hour for he may be still under sedation from anesthesia Give naloxone (Narcan) IVP to reverse the side effects of the morphine Turn off the basal rate of the PCA and reassess in 1 hour