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Fundamentals Test 3: 17, 30, 32 Chapter 17: Administering Medications 1.A registered nurse for more than 15 years was concerned when she learned that her hospital was going to let unlicensed nursing... assistants start IVs on patients. The nurse knew this was in violation of the scope of nursing practice in her state. Which of the following organizations defines the scope of nursings professional functions and responsibilities? a. The US Food and Drug Administration (FDA) b. The MedWatch program c. Employee assistance programs (EAP) d. State Nurse Practice Acts 2.A 34 year old has been on morphine for 6 months after back surgery and has gone to multiple health care providers to obtain prescriptions. Which term best describes this situation? a. Medication dependence b. Medication abuse c. Medication misuse d. Medication underuse 3.A patient calls to say that he is unable to pay for the medication from a specific manufacturer that was prescribed. The health care provider gives another name for the medication and suggests the patient look for this name instead. The new name was probably which of the following? a. Generic b. Trade c. Chemical d. Proprietary 4.A patient is unable to swallow pain medication following oral surgery. What would be the appropriate form of the medication to use to administer the drug using the rectal route? a. Tablet b. Elixir c. Capsule d. Suppository 5.A 12-year-old patient has undergone knee surgery. She has an order for pain medication, which can be given by several different routes. Which of the following routes of administration will provide the fastest pain relief? a. Transcutaneous b. Intravenous c. Oral d. Rectal 6. The nurse is preparing oral medications for a patient. In preparing these medications the nurse is aware of which of the following? a. Acidic medications are absorbed slowly by the gastric mucosa. b. Alkaline medications are absorbed rapidly by the gastric mucosa. c. Solutions and suspensions are more difficult to absorb than capsules. d. Alkaline medications are absorbed in the small intestine. 7.A nurse is caring for a patient with kidney disease. The nurse needs to make more focused assessments when administering medications to this patient because the patient may experience problems with the process of: a. excretion. b. absorption. c. distribution. d. metabolism. 8. The nurse is preparing to give an intramuscular (IM) injection of pain medication. The nurse prepares this medication knowing which of the following? a. Intramuscular (IM) medications are absorbed faster than subcutaneous medications. b. Medication absorption is faster with subcutaneous medications. c. Blood supply to the subcutaneous tissue is richer than to muscle. d. Muscle tissue has a less developed vascular system than subcutaneous tissue. 9.A nurse is working with the pharmacist to determine when a patients medications should be given. Several medications are due to be given in the morning. What is the most important reason to appropriately schedule the patients medications? a. Some medications are absorbed more quickly on an empty stomach. b. All medications are hindered by the presence of gastric contents. c. If given at the same time, all medications will be absorbed at the same rate. d. The nurse must schedule medications to fit the pharmacys schedule. 10.A patient is hospitalized with a central nervous system infection that needs to be treated with water-soluble antibiotics. The medications will be instilled into the subarachnoid space via an epidural catheter. Why is this the best route of administration for this patient? a. Intravenous water-soluble antibiotics cannot pass through the blood-brain barrier. b. Only water-soluble medications can pass into the brain and cerebrospinal fluid. c. Older patients better tolerate lipid soluble medications than younger patients. d. Lipid soluble medications are safer for patients who are pregnant. 11. Which of the following patients is most at risk for theophylline toxicity due to decreased biotransformation ability? a. A 45-year-old man with renal insufficiency b. A 59-year-old man with chronic obstructive airway disease c. A 53-year-old woman who smokes and has asthma d. A 49-year-old woman with chronic obstructive airway disease and hepatitis 12. Which of the following patients is most at risk for digoxin toxicity resulting from impaired excretion? a. A 56-year-old man with coronary artery disease b. A 24-year-old woman with cystic fibrosis c. A 53-year-old woman with renal disease d. A 57-year-old man with a hemorrhagic stroke 13.A woman has been prescribed a daily iron supplement by her health care provider. She recently became constipated, most likely related to the iron supplement. Which of the following best describes this response? a. Therapeutic effect c. Side effect d. Toxicity 14.A postoperative patient is receiving morphine sulfate from a patient-controlled analgesia device. On assessment, the nurse notes that the patients respirations are depressed. The nurse realizes the effect of morphine sulfate infusion can be labeled as which of the following? a. Toxic b. Allergic c. Therapeutic d. Idiosyncratic 15.A patient states that aspirin upsets her stomach. This is known as a(n): a. allergic response. b. toxic effect. c. idiosyncratic reaction. d. side effect. 16.A postoperative patient is undergoing antibiotic therapy. She has never had any problems taking medications in the past. When the nurse hung the second dose of IV antibiotics, the patient suddenly developed shortness of breath and had difficulty breathing. The nurse recognized this was most likely a(n): a. idiosyncratic reaction. b. toxic effect. c. side effect. d. anaphylactic reaction. 17. The nurse is medicating the patient daily with warfarin (Coumadin). The patient is having blood levels drawn daily to determine the dose needed. The nurse realizes that the goal is to reach which of the following? a. The minimum effect concentration (MEC) in the plasma b. Reach the peak concentration level of the medication c. The level that falls between the MEC and toxic level d. An adequate trough level in the plasma 18.A patient with a respiratory infection asks the nurse why some antibiotics are prescribed to be taken every 12 hours and some have to be taken 4 times a day. What is the nurses best response? a. The time between doses changes because any medications half-life varies so much. b. We need to vary the times to keep the blood values fluctuating. c. We try to give the next dose of medication only after the last dose is gone. d. Regular doses are given based on the half-life to maintain a therapeutic plateau. 19.A patient has an order for a subcutaneous injection of insulin. The nurse will prepare to give this injection into which of the following tissues? a. Into a large muscle b. Into the connective tissue beneath the dermis c. Into a vein using a pump d. Between the epidermis and dermis 20.A patients health care provider wrote a prescription for an antibiotic for an upper respiratory infection. According to safe medication practice standards, the nurse should transcribe the order as which of the following? a. .5 mg b. 5.0 mg c. mg d. 0.5 mg 21.A nurse working in a clinic is teaching a patient how much cough syrup to take. The cough syrup comes in a 250-mL bottle, and the dosage is 10 mL every 4 hours. How many teaspoons should she instruct the patient to take? a. 1 b. 2 c. 3 d. 4 22.A nurse is working in a newborn special care unit that has numerous premature infants. She recently transferred to this unit from an adult intensive care unit. The nurse is very cautious in administering medications because premature newborns are especially vulnerable to medication errors. Why is this true? a. Premature infants excrete urine more quickly than older infants. b. Premature infants metabolize medications more quickly than older children. c. Premature infants require more frequent dosing to achieve desired effects. d. Premature infants have less mature livers and kidneys. 23.A nurse is assigned to care for a pediatric patient. The most common method for calculating pediatric medication dosage is based on the childs: a. age. b. height. c. weight. d. body surface area. 24. The patient is admitted to the cardiac unit. Everyone admitted to the cardiac unit will have an EKG done unless otherwise ordered. This is an example of which type of order? a. PRN b. Standing c. One-time d. STAT 25. The patient is vomiting and complaining of severe chest discomfort. The nurse calls the health care provider in an attempt to obtain which of the following type of order? a. PRN b. Standing c. One-time d. STAT 26. The health care provider orders pain medication to be given to a patient when the patient needs it to control pain. What is this called? a. PRN order b. Standing order c. One-time order d. STAT order 27. Nurses are legally required to document medications administered to patients. The nurse is mandated to document which of the following? a. Medication after administration b. Medication before administration c. Rationale for giving a questionable incorrect dosage d. Concerns about giving the medication 28.A nurse is caring for a patient who is to be discharged with a prescription for eye drops. The nurse knows that the patient understands how to administer eye drops correctly when the patient states that eye drops should be instilled on the: a. sclera. b. cornea. c. conjunctival sac. d. area between the iris and lower eyelid. 29.A patient is to receive two different kinds of insulin. What is the nurses most appropriate action? a. Prepare the regular (clear) insulin first. b. Mix Lantus and Lente insulin in the same syringe. c. Administer the rapid-acting insulin within 30 minutes of a meal. d. Verify insulin dosage with another nurse after administration. 30.A patient is to receive a medication that is irritating to muscle tissue. The most appropriate injection technique involves which of the following? a. Z-track technique of injection b. Subcutaneous technique of injection c. Use of the vastus lateralis in adults d. Use of the deltoid muscle in children less than 12 months old 31. The intended or desired physiological response of a medication is known as a(n) effect. a. adverse b. side c. therapeutic d. toxic 32. Undesired, unintended, and often unpredictable responses to medication are referred to as effects. a. Adverse b. Side c. Therapeutic d. Toxic 33.A(n) effect is a predictable and often unavoidable adverse effect produced at a usual therapeutic dose. a. adverse b. side c. therapeutic d. toxic 34. effect(s) is/are capable of causing injury or death. They often develop after prolonged intake of a medication or when a medication accumulates in the blood because of impaired metabolism or excretion. a. An adverse b. A side c. Therapeutic d. Toxic 35. Unpredictable effects of some medications in which a patient overreacts or underreacts to a medication or has a reaction different from what is expected are known as: a. medication allergies. b. anaphylactic reactions. c. medication interactions. d. idiosyncratic reactions. 36. When a patients immune system causes abnormal reactions to a medication, the patient has a(n): a. medication allergy. b. anaphylactic reaction. c. medication interaction. d. idiosyncratic reaction. 37. Allergic symptoms vary, depending on an individual and the medication; they range from mild to severe. Sudden constriction of bronchiolar muscles, edema of the pharynx and larynx, and severe wheezing and shortness of breath are characteristics of a(n): a. medication allergy. b. anaphylactic reaction. c. medication interaction. d. idiosyncratic reaction. 38.A(n) occurs when one medication modifies the action of another medication. a. medication allergy b. anaphylactic reaction c. medication interaction d. idiosyncratic reaction 39. When the effect of two medications combined is greater than the effects of the medications when given separately, the two medications are said to have a(n): a. synergistic effect. b. anaphylactic reaction. c. medication interaction. d. idiosyncratic reaction. MULTIPLE RESPONSE 1. Pharmacokinetics is the study of which of the following? (Select all that apply.) a. Absorption b. Distribution c. Metabolism d. Excretion e. Serious harm to patients 2. Factors that influence medication absorption are known as which of the following? (Select all that apply.) a. Ability of a medication to dissolve b. Blood flow c. Body surface area d. Water solubility of a medication e. Lipid solubility of a medication 3. Which of the following are topical medications? (Select all that apply.) a. Intradermal medications b. Throat swabs and eye drops c. Vaginal and rectal suppositories d. Ear drops and bladder instillations e. Nasal sprays 4. Which of the following are the basic units of measurement in the metric system? (Select all that apply.) a. Meter b. Teaspoon c. Liter d. Tablespoon e. Gram 5. The nurse is preparing to administer medications to a patient. In doing so the nurse should do which of the following? (Select all that apply.) a. Monitor medication effects. b. Assess the patients ability to self-administer medications. c. Determine if the patient should receive the medication. d. Educate the patient and family about medication administration. e. Delegate administration to nursing assistive personnel (NAP). 6. The passage of medication molecules from the site of administration into the blood is known as absorption. Factors that affect the rate of absorption include which of the following? (Select all that apply). a. The ability of a medication to dissolve b. Blood flow to the site of administration c. Body surface area d. Lipid solubility e. The rate of distribution OTHER 1.A nurse is preparing to administer a medication by IV bolus through an existing IV line. What is the correct order for administering the medication? (Separate letters by a comma and space as follows: A, B, C, D.) a.Perform hand hygiene and apply gloves. b.Aspirate for blood return before injecting the medication. c.Occlude the IV line by pinching the tubing just above the injection port. d. Verify the specified time recommendation for administration of this medication. ANS: D, A, C, B Chapter 30: Oxygenation 1. Which term should the nurse use to best describe the movement of air in and out of the patients lungs? a. Ventilation b. Diffusion c. Respiration d. Perfusion 2. The nurse is educating a patient who has recently been diagnosed with chronic obstructive pulmonary disease (COPD). The nurse explains how the gasses in the lungs move between the air spaces and the bloodstream. Which process is the nurse describing? a. Ventilation b. Diffusion c. Respiration d. Perfusion 3. The exchange of oxygen and carbon dioxide during cellular metabolism is best described as which of the following? a. Ventilation b. Diffusion c. Respiration d. Perfusion 4. When giving CPR, compressions are causing the heart to pump blood into and out of the lungs to the bodys organs. This movement of oxygenated blood is best described as which of the following? a. Ventilation b. Diffusion c. Respiration d. Perfusion 5. The patient is experiencing shortness of breath. Which of the following lab tests indirectly indicates the oxygen level in the blood system? a. Hemoglobin b. White blood cell count c. Electrolytes d. Creatinine 6. The nurse is admitting a patient with chronic obstructive pulmonary disease (COPD). During the initial head-to-toe assessment the patients pulse oximetry reading is 89% on room air. What is the nurses first priority? a. Administer oxygen immediately @ 4L/NC. b. Call the primary health care provider for an order for oxygen. c. Assist the patient into a recumbent position. d. Determine the patients normal pulse oximetry reading. 7.A 36-year-old patient diagnosed with meningitis has a fever of 102.3 F. A family member verbalizes a concern that the patient is breathing fast. Upon assessment, the nurse notes a respiratory rate of 20 breaths/min, pulse oximetry is 92% on 2L/O2, and lungs clear to auscultation. What is the best explanation for the rapid respiratory rate that the nurse can give the family member? a. He is most likely anxious because he is in the hospital. b. His fever has increased his metabolic rate and is causing him to breathe faster. c. He is hyperventilating because he needs more oxygen. d. He has an acid-base imbalance, which is causing him to hyperventilate. 8. What is the best indicator the nurse can use to determine the adequacy of a patients cardiac output? a. Stroke volume b. Myocardial contractility c. Afterload d. Cardiac index 9.A patient has been admitted to the cardiac unit with the diagnosis of bradycardia. The patient states I am confused about what the doctor said is wrong with me, he said my pacemaker is not working. I dont have a pacemaker. What is the nurses best response? a. The sinoatrial node is the pacemaker of your heart. b. Myocardial contractility determines your heart rate. c. The atrioventricular node is the pacemaker of your heart. d. The ventricular Purkinje network determines your heart rate. 10.A 45-year-old patient was diagnosed with an anterior myocardial infarction. The patient asks the nurse why his chest hurt when he had his heart attack. What is the best response from the nurse? a. One of your heart valves wasnt working properly and caused an obstructed blood flow. b. One of your coronary arteries had a spasm, and your heart muscle wasnt able to get enough blood. c. Your heart muscle was deprived of oxygen, which caused chest pain. d. The heart muscle is sensitive to changes in electrical conduction. 11.A patient was admitted to the surgical unit after surgical removal of an abdominal tumor. As the nurse performs a postsurgical assessment, the patients blood pressure is 90/54, heart rate is 94, and respiratory rate is 22. Based on these values, the nurse should be most concerned with which of the following conditions? a. Hypovolemia b. Left-sided heart failure c. Right-sided heart failure d. Hypervolemia 12. The guardians of a premature infant who was delivered at 31-weeks gestation is expected to be discharged from the hospital within the next few days. The guardians have voiced concern regarding how to prevent respiratory syncytial virus (RSV) exposure to the baby. What is the best response from the nurse? a. You will need to limit the babys exposure to crowds of people. b. You need to make sure that the car seat is facing backward in the back seat of your car. c. You do not need to be concerned; the baby has a natural protection against this disease. d. You must sterilize all the bottles for the first 6 months. 13.A 3-month-old infant is being seen for a well-child check at the pediatric clinic. The nurse is assessing the guardians knowledge level about the infants growth and development. One of the topics that the nurse has chosen to address in this session is the risk for airway obstruction. What is the main reason that the nurse has chosen this topic? a. Infants can have severe allergic reactions to food based on exposure to secondhand smoke. b. Infants are prone to lower airway infections that can become obstructive. c. Infants have a tendency to place foreign objects in their mouths. d. Infants can have airway obstruction from excessive drooling associated with teething. 14.A patient who is 7 months pregnant with her first child is visiting the health care provider for her scheduled prenatal checkup. She tells the nurse that she is short of breath and fatigued. What is the best response from the nurse? a. You should have let us know immediately instead of waiting until your appointment. b. Ill make a note of it on your chart. c. That is normal; your uterus is causing pressure on your diaphragm, making it more difficult to breathe d. Oxygen is needed for you and the baby. I will give you some oxygen to help you. 15.A 58-year-old Caucasian woman is at the clinic for her annual check-up. She tells the nurse that she noticed her blood pressure is higher than it was when she was younger. She asks the nurse why this would happen. What is the nurses best response? a. Your race and gender are predisposing factors for heart disease. b. Well, if you stop smoking your blood pressure would go down. c. As we age, our blood vessels become less elastic, which causes higher blood pressure. d. I dont think its anything to worry about. 16.A healthy 33-year-old mother of three children reports having no energy. She asks the nurse, how she could increase her energy level. What is the best response for the nurse to give? a. You should decrease iron intake. b. Daily exercise has been shown to increase a persons energy level. c. Energy caffeinated drinks are a good substitute for exercise. d. Try to exercise 90 minutes every other day. 17. The family member of a 73-year-old patient with chronic obstructive pulmonary disease (COPD) is concerned about the patients recent weight loss. When questioned by the nurse, the patient denies any change in diet or activity, but admits to losing 10 lb in the past 6 weeks. What is the nurses best response to the family members concern? a. Maybe the patient has a higher metabolic rate than you. b. It doesnt seem fair that some people can lose weight so easily. c. This disease affects the respiratory system and causes the body to burn more calories to supply the ene d. You need to discuss this with the health care provider so testing can be ordered for tuberculosis. 18.A college student who smokes asks a healthcare professional if there really is a connection between smoking and lung cancer. What is the healthcare workers best response? a. The risk for lung cancer for smokers than for nonsmokers is 5 times greater. b. The risk for lung cancer for smokers than for nonsmokers is 10 times greater. c. The risk for lung cancer for smokers than for nonsmokers is 50 times greater. d. Lung cancer affects smokers and non-smokers equally due to occupational hazards. 19.A patient on the surgical unit is 1 day postoperative for surgery to remove stomach cancer. In addition to the physiological stress this patient has undergone, the nurse recognizes that this patient will have to deal with the psychological stress of finding out that the cancer has metastasized to the liver. Which physiological change would the nurse expect to see as a response to stress? a. Decreased heart rate b. Increased hemoptysis output c. Increased respiratory rate d. Decreased cardiac output 20.A 47-year-old woman with a history of diabetes and hypertension calls the clinic complaining of epigastric pain and shortness of breath with activity. She has taken antacids with no relief. What type of pain is the patient experiencing? a. Pericardial pain b. Pleuritic chest pain c. Musculoskeletal pain d. Cardiac pain 21.A patient has been admitted to the pulmonary unit of the hospital with right lower lobe pneumonia and history of chronic obstructive pulmonary disease (COPD). During the initial assessment the nurse notes that the patient has a respiration rate of 18 with retractions, tachycardia, and complains of dyspnea and dizziness. The nurse identifies that these are clinical signs of which condition? a. Paroxysmal nocturnal dyspnea b. Orthopnea c. Hemoptysis d. Hypoxia 22.A health care worker received an annual tuberculosis test administered 56 hours ago. The injection site is very red and flat. The certified nurse who is reading the test should take which action? a. Advise the health care worker another test must be done because the test was not read within the prope c. Document the results as a negative reaction. d. Measure the area in millimeters. 23. The nursing student is formulating a nursing care plan for a patient with pneumonia. The care plan is directed toward meeting the potential oxygenation needs of the patient. Which of the following examples would be the best way for the nursing student to write an expected outcome for the care plan? a. The patient will have less pain. b. The patient will be able to breathe better. c. The patients pulse oximetry reading will remain greater than 92%. d. The patients interactions will be normal. 24. The RN and nursing assistive personnel (NAP) are caring for six patients on the pulmonary unit. Which of the following tasks would be most appropriate for the nurse to delegate to the NAP? a. Taking vital signs on a 56-year-old man with severe dyspnea b. Suctioning a patient with hemoptysis c. Encouraging a postoperative patient to use the incentive spirometer d. Performing chest percussion on a patient with atelectasis 25.A student nurse caring for a patient with a chest tube has been asked what equipment should be at the bedside to assess for an air leak. Which information indicates the student nurse has a correct understanding of the equipment needed? a. Suction equipment wrapped in plastic to keep instrument clean b. Hemostat covered with gauze to prevent penetration of the chest tube c. Cup of water to place the end of the chest tube d. Petroleum gauze to use as a dressing 26.A nurse is being oriented to work for an intensive care unit. The hemodynamic data indicate that the patient has a decreased preload. Which information indicates the nurse has a correct understanding of the concept of preload? a. It is the amount of blood ejected from the left ventricle each minute. b. It is the amount of blood in the heart at the end of ventricular diastole. c. It is the resistance to the ejection of blood from the left ventricle. d. It is the rhythmic relaxation and contraction of the heart chambers. 27.A patient with pulmonary congestion needs to cough to clear secretions. The nurse instructs the patient to inhale and perform a series of coughs during exhalation. What type of cough did the nurse teach the patient? a. Quad b. Huff c. Cascade d. Splinting 28. The nurse is evaluating a patient who has a chest tube. To properly maintain chest tube function, what is the nurses best action? a. Strip the tube every hour to maintain drainage. c. Double clamp the tubes except during assessments. d. Remove the tubing from the drainage device to check for proper suctioning. 29.A patient presents with an acute myocardial infarction that resulted in right ventricular damage. The nurse needs to assess the patient for right-sided heart failure, which includes which of the following? a. Crackles on auscultation b. Jugular neck vein distention c. Increased myocardial perfusion d. Orthopnea 30.A patient reports chest pain. The nurse is attempting to assess the pain to differentiate the pain as cardiac, respiratory, or gastrointestinal. The nurse can properly identify the pain as cardiac in origin when the patient states that the cardiac pain: a. does not occur with respiratory variations. b. is peripheral and may radiate to the scapular areas. c. is aggravated by inspiratory movements. d. is nonradiating and occurs during inspiration. 31.A patient with a tracheostomy is experiencing thick and tenacious secretions. To maintain this patients airway, what is the most appropriate action for the nurse? a. Tracheal suctioning c. Nasotracheal suctioning d. Orotracheal suctioning 32. The assistive personnel reports that an older patient is complaining of shortness of breath and palpitations. The nurse connects the patient to an electrocardiogram monitor and analyzes the rhythm with normal P wave and normal QRS and T waves. The rate is 116 beats per minute and regular. The nurse identifies this rhythm as which of the following? a. Sinus bradycardia b. Ventricular tachycardia c. Sinus tachycardia d. Normal sinus rhythm MULTIPLE RESPONSE 1. On entering the room, a nurse finds the patient sitting upright in bed with the upper torso resting on the over-bed table. The nurse assesses that this patient is experiencing acute hypoxemia. Which of the following are symptoms of acute hypoxemia? (Select all that apply.) a. Cyanosis b. Arrhythmias c. Eupnea d. Restlessness e. Diaphoresis 2. The home care nurse is admitting a patient with COPD. The primary healthcare provider has ordered O2 /nasal cannula at 3 L/min. To promote safety, the nurse would instruct the patient on which of the following safety measures? (Select all that apply.) a. Place No smoking signs in all areas where oxygen will be used. b. Instruct family and visitors who smoke that they must smoke a minimum of 10 feet from the patient. c. Store tanks in a small closet, trunk of a car, or near the hot water heater. d. Oxygen tanks should stay a minimum of 6 feet from space heaters, fireplaces, and appliances with an e e. Know the exit routes and where the fire extinguisher are located in the home. 3. An adult collapsed at the grocery store. Before being transported to the emergency department, an automated external defibrillator (AED) was used. The nurse remembers learning that the AED is effective in saving a life because of which factors? (Select all that apply.) a. Use of an AED strengthens the chain of survival. b. The AED can be used by nonmedical personnel. c. The AED sends heart rhythm to the closest emergency room (ER) for the physician to analyze and giv d. Every minute without defibrillation decreases the survival rate by 7% to 10%. e. The AED will automatically deliver a shock to the victim after announcing, Everyone stand back. Chapter 32: Pain Management 1.A patient is admitted to the trauma unit with the diagnosis of spinal cord injury resulting from an ATV accident. The health care provider has diagnosed the patient as a paraplegic. Which of the following is one of the most important topics for patient teaching to prevent further injury to the patient? a. Reminding him that he can be injured and not feel pain below his waist b. Suggesting that his parents purchase a motorized wheelchair to prevent arm muscle strain c. Reminding the patient to decrease fluid intake due to lack of mobility d. Reminding the patient to drink plenty of fluids to maintain hydration 2.A graduate nurse is working for a diabetes unit. The nurse manager has prepared a very thorough orientation, which includes check-offs for taking vital signs. The nurse manager has informed the graduate nurse that their hospital has adopted the Joint Commissions pain standard and that they will be assessing five vital signs. The graduate nurse knows that the fifth vital sign is which of the following? a. Arterial blood gasses b. Blood sugar c. Blood pressure d. Pain 3.A registered nurse working for the emergency department sees a lot of patients who seek services because of pain. The nurse is aware that pain is which of the following? a. Caused by a single physiological sensation b. Caused by a specific stimulus c. Subjective d. Universally the same for everyone 4.A registered nurse, who has practiced for more than 20 years and has had a lot of experience caring for postsurgical patients, was questioned by a student nurse about why many nurses do not give the full amount of pain medication ordered by surgeons. The nurse replied that the literature shows that many nurses do not give the full amount of pain medication because they: a. do not believe that the patient is experiencing that much pain. b. do not want to contribute to pain medication addiction. c. believe that limiting the amount of pain medication lowers costs. d. are concerned about drug interactions with pain medication and other postsurgical medications. 5. When a person touches a hot stove, the resulting cellular damage causes a reaction that converts the stimuli into a pain impulse. What is the term for this conversion? a. Transduction b. Transmission c. Perception d. Modulation 6. When a person cuts a finger, nerve impulses travel to the spinal cord along afferent peripheral nerve fibers. What is this process? a. Transduction b. Transmission c. Perception d. Modulation 7. Pain impulses are sent to the brain, where the central nervous extracts information regarding location, duration and quality of the pain impulse. What is this process? a. Transduction b. Transmission d. Modulation 8. When a person accidentally touches a hot pan, their protective reflex causes them to immediately withdraw their hand from the hot pan. This protective reflex is known as which of the following? a. Transduction b. Transmission c. Perception d. Modulation 9. The patient who has undergone triple cardiac bypass surgery 1 week ago is being seen for a follow up appointment at their health care facility. The incisions are healing well, but the patient is complaining of pain at the incision sites on his legs. The nurse knows that this is pain. a. acute b. chronic/persistent noncancer c. chronic episodic d. idiopathic 10.A student nurse is caring for an elderly patient with rheumatoid arthritis. The patient states that he or she experiences constant pain, is having difficulty sleeping, and has lost weight over the past 2 months. The patient is very tearful and states, Im not sure how long I can keep going with this pain. What is the most important question for the student nurse to ask the patient? a. Have you started a new diet? b. Have you ever thought of suicide? d. Do you take naps during the day? 11. An older adult nurse has been seeing a rheumatologist for the management of Rheumatoid Arthritis (RA). The patient also uses herbal remedies and seeks acupuncture for pain relief and reads the latest research regarding RA. This coping style is best described as a(n) loci of control. a. external b. interior c. internal d. exterior 12.A student nurse is assessing the pain of a teenage patient with cancer. The student nurse ask the patient about precipitating factors, quality, relieving factors, where the pain is, the severity of pain, and the effect of the pain has on the patient. What is the other indicator that the student nurse should make part of this pain assessment? a. Medications the patient is taking for pain b. Timing of the pain c. Side effects of the patients chemotherapy d. The patients ability to take oral pain medication 13.A patient has a morphine sulfate patient controlled analgesia (PCA) to control postoperative pain. When the nurse enters the room, the patient complains of pain. The nurses first response is which of the following? a. Stop the infusion. b. Call the physician or health care provider immediately. c. Ask the patient to describe the pain. d. Speak to the patient in a calming tone to reduce anxiety. 14.A patient in sickle cell crisis states that the pain is lessened when watching television. The patients physiological response is best attributed to which of the following? a. The perception of pain b. Nociceptor stimulation c. A negative protective reflex response d. The application of the gate control theory 15. According to established standards, nurses must frequently assess patients experiencing pain. The most appropriate action for the nurse to take when assessing a patients pain is which of the following? a. Ask what precipitates pain. b. Question the patient about the location of the pain. c. Offer the patient a pain scale to objectify the patients response. d. Use closed-ended questions to find out about the patients sensations. 16. An adult patient has just undergone surgery for repair of a torn left knee anterior cruciate ligament (ACL). When informing the patient of several pain relief interventions, the nurse most appropriately urges the patient to select which of the following? a. NSAIDs b. Nonopioids c. Adjuvant therapy d. Patient-controlled analgesia pain management 17.A smiling and cooperative patient complains of severe pain. Nurses caring for patients who report pain need to recognize and avoid common misconceptions and myths about pain. To properly care for patients in pain, nurses need to remember which of the following? a. Chronic pain is psychological in nature. b. Patients are the best authority of their pain experience. c. Regular use of narcotic analgesics leads to drug addiction. d. The amount of tissue damage is reflected in the severity of the pain perceived. 18.A patient with developmental disabilities and poor verbal communication skills has been admitted for observation after a motor vehicle accident. The patient has been moaning, facial grimacing, and restless since being admitted to the floor. The nurse needs to first assess the patient for which of the following? a. Safety, because the patient will not use the call light b. Hydration, because the patient is not able to verbally communicate his or her needs c. Bathroom privileges, because of lack of communication skills d. Pain, because the patient is unable to communicate effectively 19.Aspirin and ibuprofen are classified as: a. narcotics. b. nonopioids. c. opioids. d. nonsteroidal antiinflammatory analgesics. a. Giving medications as needed b. Using the World Health Organization three-step approach c. Using a holistic approach to pain management d. Holding regular doses to prevent life-threatening side effects 21.A patient is started on morphine via patient-controlled analgesia (PCA) to control persistent cancer pain. The nurse knows that to prevent central nervous system (CNS) depression the patient should do which of the following? a. Monitor IV site for patency. b. Monitor the patient closely for the 15 minutes. c. Record baseline blood pressure and respiratory rates before the start of the medication. d. Give a small dose of naloxone prior to starting the morphine. 22. The hospice nurse is assessing the patient at home for the first time. The patient has a lot of questions regarding what the role hospice will have as the illness progresses. The patient states, I dont want to be in pain and kept alive, but Im not ready to die either. What is the best response that will educate the patient of the role hospice will play in his or her care? a. Hospice will make sure you are pain free, how long you live is up to you and the doctor. b. Hospice focuses on the quality of life, including pain management, rather than how long you will live. c. Hospice will give you enough pain medication to keep you pain free. This is a higher priority than qua d. Hospice allows you time to get your affairs in order. MULTIPLE RESPONSE because of which of the following? (Select all that apply.) a. The patient appears very apprehensive. b. It has very few side effects. c. The potential for hemorrhage precludes the use of IV anesthesia. d. It produces temporary loss of sensation by inhibiting nerve conduction. e. It allows sedative effects to calm the patient. 2. The student nurse is working on the surgical floor. The student nurse is assigned to take care of a patient with hemiplegia and communication deficits from a previous stroke. The patient is 1- day postoperative from abdominal surgery. Which of the following interventions would promote comfort and help the patient remain pain free? (Select all that apply.) a. Keep the bed sheet wrinkle free. b. Only change wet dressings or bed linens once a shift. c. Remove noxious stimuli from the room. d. Continue to use the establish pain scale for this patient. e. Give pain medication after ambulation down the hall. 3. The patient is being seen for chronic back pain. The patient states, Im always in pain, and I dont like taking the pain medication because it makes me sleepy. I have to work to support my family. The nurse is aware that this patient may be a candidate for cutaneous stimulation. Cutaneous stimulation includes which of the following? (Select all that apply.) a. TENS unit b. NSAIDs c. Massage d. Yoga e. Ice bags [Show More]

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