Question 1
Exercise 1 - Writing Activity

This exercise will take approximately 15 minutes to complete.
Exercise 1 - Question 1
Identify several behavioral cues that may be associated with the presence of pain. (Hint:
See Box 21-1 in your textbook.)
Rigid body position
Restlessness
Frowning
Grimacing
Clenched teeth
Clenched fists
Crying
Question 2
Exercise 1 - Question 2
When caring for a patient in pain, which physiologic signs may be noted? Select all that
apply. (Hint: See Box 21-3 in your textbook.)
Tachycardia
Pallor
Diaphoresis
Constricted pupils
Nausea
Question 3
Exercise 1 - Question 3
For what types of pain are nonopioids usually prescribed?
Nonopioids are usually prescribed for mild to moderate pain.
Question 4
Exercise 1 - Question 4
For what types of pain are opioids normally prescribed?
Opioids are prescribed to manage moderate to severe pain.
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Question 5
Exercise 1 - Question 5
What should a nurse tell a patient who voices concerns about becoming addicted to
opioid-containing medications?
The actual rate of addiction occurring as a result of taking opioids for pain management is less than 1%. Although
physical dependence and tolerance may occur, this does not constitute addiction.
Question 6
Exercise 1 - Question 6
The physician has ordered a TENS unit for a patient experiencing back pain. When
discussing the device with the patient, what information should be included? Select all
that apply.
The TENS unit provides mild electrical currents.
It is believed that endorphins are released by the TENS unit, aiding in pain relief.
The TENS unit works to block pain impulses.
Question 7
Exercise 1 - Question 7
When administering NSAID medications, it is important that the nurse understand what
information? Select all that apply.
The risk for gastric toxicity from NSAIDs is greater in older adults than in younger
adults.
The maximum recommended dosage for acetaminophen is 4000 mg in a 24-hour
period.
NSAIDs are effective in the management of moderate pain.
NSAIDs are associated with gastrointestinal bleeding.
Question 8
Exercise 1 - Question 8
Which issues are associated with the undertreatment of pain by health care providers?
Select all that apply.
Inadequate information about the drugs ordered
Anxiety about potential patient injuries suffered while being medicated
Concerns about fostering an addiction
Question 9
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Exercise 1 - Question 9
[response] is felt at a site other than the injured or diseased organ or part of the body.
Referred pain
Question 10
Exercise 2 - Virtual Hospital Activity

This exercise will take approximately 45 minutes to complete.






Sign in to work at Pacific View Regional Hospital for Period of Care 1.
(Note: If you are already in the virtual hospital from a previous exercise,
click on Leave the Floor and then Restart the Program to get to the
sign-in window.)
From the Patient List, select Kathryn Doyle (Room 503).
Click Get Report and read the Clinical Report.
Click Go to Nurses' Station and then click 503 at the bottom of the
screen to enter the patient's room.
Read the Initial Observations.
Click Take Vital Signs.
Exercise 2 - Question 1
How does Kathryn Doyle describe her pain?
Kathryn Doyle says she is having pain and rates her pain at a 3.
Question 11
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
Click Chart and then 503 to view Kathryn Doyle's chart.
Click the History and Physical tab and review the report.
Exercise 2 - Question 2
Explain the reason for Kathryn Doyle's continued hospitalization.
Kathryn Doyle had n ORIF 2 weeks ago. Since the surgery, her recovery has been complicated by anemia, infection,
and uncontrolled pain.
Question 12
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Click Return to Room 503.
Click MAR and then click tab 503 to view Kathryn Doyle's Medication
Administration Record.
Review the medications prescribed.
Click Return to Room 503.
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
Click the Drug icon at the bottom of the screen to review the drug
resource guide.
Exercise 2 - Question 3
Which medications have been prescribed for Kathryn Doyle to help reduce her pain?
Select all that apply.
Oxycodone
Ibuprofen
Acetaminophen
Question 13
Exercise 2 - Question 4
For each medication you selected in the previous question, indicate whether it has been
ordered on a scheduled or prn basis. Explain why each drug has been ordered.
Ibuprofen: Ordered as "scheduled." Ibuprofen has a dual function. In addition to being useful for pain management, it
also has antiinflammatory properties. This is beneficial to a postoperative patient.
Acetaminophen: Ordered as "prn." May be used for mild pain and as an antipyretic.
Oxycodone: Ordered as "prn." May be used for moderate to severe pain.
Question 14
Exercise 2 - Question 5
Identify the classifications of each of the medications identified in the preceding
questions.
Ibuprofen: nonnarcotic analgesic, NSAID, antipyretic
Acetaminophen: nonnarcotic analgesic, antipyretic
Oxycodone: narcotic analgesic
Question 15
Exercise 2 - Question 6
What special considerations should be evaluated when administering pain medications
to Kathryn Doyle?
The risk for renal toxicity is increased.
There may be an increased risk for susceptibility to side effects of opioids because of changes in the patient's serum
proteins, liver, and renal function, as well as a reduction in her cardiac output
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Opioids may cause respiratory depression.
Question 16
Exercise 2 - Question 7
What best explains the rationale for ibuprofen being prescribed on a scheduled rather
than prn basis?
Ibuprofen has antiinflammatory properties that aid the surgical patient in the recovery
process.
Question 17
Exercise 2 - Question 8
When administering oxycodone, the nurse is aware that which are potential side effects
of the medication? Select all that apply.
Drowsiness
Hypotension
Anorexia
Question 18
Exercise 2 - Question 9
What should be assessed before the administration of oxycodone? Select all that apply.
Time of last dosage
Level of pain
Vital signs
Question 19
Exercise 2 - Question 10
What patient education should be provided to Kathryn Doyle concerning oxycodone?
Explain the side effects associated with the medication.
Avoid ambulating unassisted.
Do not chew or break tablets.
Advise against the use of alcohol while taking oxycodone.
Question 20
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Exercise 2 - Question 11
When administering oxycodone, the nurse should be aware that the duration of a
dosage of the medication is what time period?
4 to 6 hours
Question 21
Exercise 2 - Question 12
In addition to medication therapy, what nursing interventions may be implemented to
reduce Kathryn Doyle's level of pain?
Straighten bed linens to reduce wrinkles.
Assist her with repositioning.
Assess what she has done to manage complaints of pain in the past.
Investigate the use of distraction techniques.
Question 22
Exercise 2 - Question 13
Indicate whether the following statement is true or false:
Kathryn Doyle is suffering from chronic pain.
False
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