Principles of Management Mcq

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					                                     Practice Quiz Answers

                                               Unit 8

Question 1

The nurse consults with the primary physician of a client who is experiencing continuous, severe
pain. In planning for the client’s treatment, the nurse is aware of the principles of pain
management and that it is appropriate to expect treatment to include:


A) Focusing on intramuscular administration of analgesics
B) Waiting for pain to become more intens e before administering opioids
C) Administering opioid with nonopioid analgesics for severe pain experiences
D) Administering large dos es of opioids initially to clients who have not taken the medications
previously.

Correct Answer: C

Explanation: To treat a client who is experiencing continuous severe pain, the nurse should
expect the client to receive opioid and nonopioid analgesics for severe pain experiences.
A. Intramuscular administration of analgesics is not expected because the injection itself is
painful, and inconsistent erratic absorption of the drug may occur.
B. The nurse should administer opioids be fore the client’s pain becomes intense. It is easier to
maintain pain control than it is to get intense pain under control.
D. Large doses of opioids are not given initially to clients who have not taken the medications
before as it may cause respiratory depression. The expectation is to begin with lower doses and
titrate upward.

Question 2

When assessing the intensity of the pain, the nurse should:

A) Ask about what precipitates the pain
B) Question the client about the location of the pain
C) Offer the client a pain scale to objectify the information
D) Use open-ended questions to find out about the sensation

Correct Answer: C

Explanation: Descriptive scales are a more objective means of measuring pain intensity.
A. Asking the client what precipitat es the pain does not assess intensity, but rather is an
assessment of the pain pattern.
B. Asking the client about the location of pain does not assess the intensity of the client’s pain.
D. To determine the quality of the client’s pain, the nurse may ask open-ended questions to find
out about the sensation experienced.
Question 3

The client tells the nurs e about a burning sensation in the epigastric area. The nurse should
describe this type of pain as:

A) Referred
B) Radiating
C) Deep visceral
D) Superficial or cutaneous

Correct Answer: C

Explanation: Deep or visceral pain is diffuse and may radiate in several directions. Visceral pain
may be described as a burning sensation.
A. Referred pain is felt in a part of the body separate from the sourc e of pain, such as with a
myocardial infarction, in which pain may be referred to the jaw, left arm, and left shoulder.
B. Radiating pain feels as though it travels down or along a body part, such as low back pain that
is accompanied by pain radiating down the leg from sciatic nerve irritation.
D. Superficial or cutaneous pain is of short duration and is localized, as in a small cut.

Question 4

The nurse tells the client that the urinary catheter insertion may feel uncomfortable. This is most
accurately an ex ample of:

A) Distraction
B) Reducing pain perception
C) Anticipatory teaching
D) Self-care maintenance

Correct Answer: C

Explanation: considers the client’s condition, aspects of the procedure that may be
uncomfortable, and techniques to avoid causing pain. The nurse who tells the client that the
urinary catheter insertion may feel unc omfortable is an example of anticipatory res ponse.
A. This is not an example of using distraction. Distraction directs a client’s attention to something
else and thus can reduce the awareness of pain and even increase toleranc e.
B. Reducing pain perception means to remove stimuli that are uncomfortable or to prevent stimuli
that are painful, such as changing wet linens, or preventing constipation with fluids, diet, and
exercise.
D. This is not an example of self-care maintenance. Self-care maintenance implies that the client
is able to carry out necessary activities to care for himself or herself. This may include pain
management measures.

Question 5

Nurs es working with clients in pain need to recognize and avoid common misconceptions and
myths about pain. In regards to the pain experience, whic h of the following is correct?

A) The client is the best authority on the pain experience.
B) Chronic pain is mostly psychological in nature.
C) Regular use of analgesics leads to drug addition.
D) The amount of tissue damage is accurately reflected in the degree of pain perceived.
Correct Answer: A

Explanation: A client’s self-report of pain is the single most reliable indicator of the existence and
intensity of pain and any related discomfort. Pain is individualistic.
B. A misconception about pain is that chronic pain is psychological.
C. The belief that administering analgesics regularly will lead to drug addiction is a
misconception.
D. A misconception about pain is that the amount of tissue damage is accurately reflected in the
degree of pain perceived.

Question 6

Upon ent ering the room, the nurse discovers that the client is experiencing acute pain. An
expected assessment finding for this client is:

A) Bradycardia
B) Bradypnea
C) Diaphoresis
D) Decreased muscle tension

Correct Answer: C

Explanation: An expected assessment finding of a client experiencing acute pain would be
diaphoresis due to sympathetic nerve stimulation.
A. An expected assessment finding of a client experiencing acute pain would be an inc reased
heart rate, not bradycardia.
B. An expected assessment finding of a client experiencing acute pain would be an inc reased
respiratory rate, not bradypnea.
D. The client experiencing acut e pain will have inc reased muscle tension.

Question 7

The client will be going home on medication administered through a PCA (patient -controlled
analgesia) system. To assist the family members with an understanding of how thi s therapy
works, the nurse explains that the client:

A) Has control over the frequency of the IV analgesia
B) Can choose the dosage of the drug received
C) May request the type of medication received
D) Controls the route for administering the medication

Correct Answer: A

Explanation: With a PCA system, the client controls medication delivery.
B. The P CA system is designed to deliver no more than a specified number of dos es. The client
does not choose the dosage.
C. The physician prescribes the type of medication to be used. The advantage for the client is
that he or she may self-administer opioids with minimal risk of overdose.
D. The client does not control the route for administration. Systemic PCA typically involves IV
drug administration, but can also be given subcutaneously.
Question 8

Which one of the following nursing interventions for a client in pain is based on the gat e-control
theory?

A) Giving the client a back massage
B) Changing the client’s position in bed
C) Giving the client a pain medication
D) Limiting the number of visitors

Correct Answer: A

Explanation: The gate-cont rol theory suggests that cutaneous stimulation activates larger,
faster-transmitting A-beta sensory nerve fibers. This decreases pain transmission through small -
diameter A-delta and C fibers. A back massage is a nursing int ervention based on the gat e-
control theory.
B. Changing the client’s position in bed is not a form of cutaneous stimulation used to relieve
pain.
C. Giving the client a pain medication is a pharmacologic al approach to relieving pain. It is not
based on the gate-control theory.
D. Limiting the number of visitors may provide a quiet environment conducive to relaxation, but it
is not based on the gate-control theory.

Question 9

The nurse on a postoperative care unit is assessing the quality of the client’s pain. To obtain this
specific information about the pain experience from the client, the nurse should ask:

A) “What does your discomfort feel like?”
B) “What activities make the pain worse?”
C) “How much does it hurt on a scale of 1 to 10?”
D) “How much discomfort are you able to tolerat e?”

Correct Answer: A

Explanation: To determine the quality of the client’s pain the nurse might say, “What does your
discomfort feel like?” It is more accurate to have clients describe the pain in their own words
whenever possible.
B. Inquiring about what activities make the pain worse is a type of question directed at
determining the pain pattern.
C. Having the client rate his or her pain on a pain scale is a method of measuring the intensity of
pain.
D. To determine the client’s expectations, the nurse may ask the client, “How much discomfort
are you able to tolerate?”
Question 10

The nurse recognizes opiods are used to control pain at this process of nociception.

A) Trans duction
B) Transmission
C) Modulation
D) Perception

Correct Answer: B.

Explanation: Opiods controls pain during the second process of nociception which is
transmission by blocking the release of neurotransmitters.
A: effective drugs used at this stage of nociception are NSAIDS.
C: effective drugs used at this stage of nociception are antidepressants
D: nonpharmacologic measures are used at this stage of nociception




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