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Unit 3: Pain Management & Neuro-Psychotherapeautics

Total questions: 10

Worksheet time: 10mins

Name
Class
Date
1.

For best results when treating severe pain associated with pathologic spinal fractures related to metastatic bone cancer, the nurse should remember that the best type of dosage schedule is to administer the pain medication

a)

as needed

b)

around the clock

c)

on schedule during waking hours only

d)

around the clock, with additional doses as needed for breakthrough pain

2.

A patient is receiving an opioid via a PCA pump as part of his postoperative pain management program. During rounds, the nurse finds him unresponsive, with respirations of 8 breaths/min and blood pressure of 102/58 mm Hg. After stopping the opioid infusion, what should the nurse do next?

a)

Notify the charge nurse

b)

Draw arterial blood gases

c)

Administer an opiate antagonist per standing orders

d)

Perform a thorough assessment, including mental status evaluation

3.

The physician has requested “lidocaine with epinephrine.” The nurse recognizes that the most important reason for adding epinephrine is that it

a)

helps to calm the patient before the procedure

b)

minimizes the risk for an allergic reaction

c)

enhances the effect of the local lidocaine

d)

reduces bleeding in the surgical area

4.

Which nursing diagnosis is possible for a patient who is now recovering after having been under general anesthesia for 3 to 4 hours during surgery?

a)

Impaired urinary elimination related to the use of vasopressors as anesthetics

b)

Increased cardiac output related to the effects of general anesthesia

c)

Risk for falls related to decreased sensorium for 2 to 4 days postoperatively

d)

Impaired gas exchange due to the CNS depressant effect of general anesthesia

5.

During a patient's recovery from a lengthy surgery, the nurse monitors for signs of malignant hyperthermia. In addition to a rapid rise in body temperature, which assessment findings would indicate the possible presence of this condition? (Select all that apply.)

a)

Respiratory depression

b)

Tachypnea

c)

Tachycardia

d)

Seizure activity

e)

Muscle rigidity

6.

The nurse is reviewing the prescriptions for a patient who will be discharged to home after being hospitalized for a hysterectomy. The patient asked for a sleeping pill, and the surgeon wrote a prescription for Ambien, 20 mg at bedtime as needed for sleep. What is the nurse's priority action at this time?

a)

Review the potential adverse effects with the patient.

b)

Suggest that the patient try drinking a glass of wine at bedtime.

c)

Contact the prescriber to question the dose of the Ambien.

d)

Assist the patient to find a pharmacy to fill the prescription on her way home.

7.

A patient with narcolepsy will begin treatment with a CNS stimulant. The nurse expects to see which adverse effect?

a)

Bradycardia

b)

Nervousness

c)

Mental clouding

d)

Drowsiness at night

8.

A hospitalized patient is complaining of having difficulty sleeping. Which action will the nurse take first to address this problem?

a)

Administer a sedative-hypnotic drug if ordered.

b)

Offer tea made with the herbal preparation valerian.

c)

Encourage the patient to exercise by walking up and down the halls a few times if tolerated.

d)

Provide an environment that is restful, and reduce loud noises.

9.

A patient has been admitted to the emergency department because of an overdose of an oral benzodiazepine. He is very drowsy but still responsive. The nurse will prepare for which immediate intervention?

a)

Hemodialysis to remove the medication

b)

Administration of flumazenil

c)

Administration of naloxone

d)

Intubation and mechanical ventilation

10.

A patient is about to undergo cardioversion, and the nurse is reviewing the procedure and explaining moderate sedation with propofol. The patient asks, “I am afraid of feeling it when they shock me.” What is the nurse's best response?

a)

“You won't receive enough of a shock to feel anything.”

b)

“You will feel the shock but you won't remember any of the pain.”

c)

“These medications will help ease any pain during the procedure, and many patients often report having no recollection of the procedure.”

d)

“They will give you enough pain medication to prevent you from feeling it.”