A client in an outpatient pain management clinic reports that their leg pain began 1 year ago after an injury that affected the spinal nerves. The pain has an intense sharp quality "like an electric shock". The client rates the pain level 9 on (0-10) scale after taking opioids & non-steroidal anti-inflammatory agents and receiving acupuncture. What are appropriate descriptors of the pain for the nurse to document? (SELECT ALL THAT APPLY)

chronic

visceral

intractable

neuropathic

cutaneous

Answer and Explanation

Correct Answer : A,C,D

A. Chronic:

Chronic pain is characterized by pain that persists beyond the expected time for tissue healing, typically lasting for more than 3 to 6 months.

In this scenario, the client's pain has been present for 1 year, indicating a prolonged duration consistent with chronic pain.

Documenting the pain as chronic provides important information about the nature and duration of the client's pain experience.

C. Intractable:

Intractable pain refers to pain that is difficult to manage or control despite various treatment modalities.

The client's report of intense, sharp pain persisting at a high level (rated 9 out of 10) despite opioid analgesics, non-steroidal anti-inflammatory drugs (NSAIDs), and acupuncture suggests that the pain is intractable.

Documenting the pain as intractable highlights the challenges associated with managing the client's pain and the need for additional interventions or referral to specialized pain management services.

D. Neuropathic:

Neuropathic pain arises from damage or dysfunction of the nervous system and is often described as sharp, shooting, burning, or like an electric shock.

The client's description of their leg pain as "an intense sharp quality 'like an electric shock'" is consistent with neuropathic pain.

Documenting the pain as neuropathic helps identify the underlying pathophysiology of the pain and guides appropriate treatment strategies targeting neuropathic pain mechanisms.

B. Visceral:

Visceral pain originates from internal organs and is typically described as deep, dull, or cramping.

While the pain in this scenario is associated with spinal nerve injury, which can involve visceral pain pathways, the client's description of the pain as sharp and electric shock-like is more indicative of neuropathic pain rather than visceral pain.

Therefore, visceral pain may not be an appropriate descriptor for the client's pain experience in this case.

E. Cutaneous:

Cutaneous pain arises from the skin or subcutaneous tissues and is often described as superficial, sharp, or burning.

While the client's leg pain may involve cutaneous innervation, the description provided ("like an electric shock") suggests involvement of deeper structures and neuropathic pain mechanisms rather than purely cutaneous pain.

Therefore, cutaneous pain may not fully capture the nature of the client's pain experience in this scenario.

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Correct Answer is B

Explanation

A. Functional incontinence: Functional incontinence occurs when a person has difficulty reaching the toilet due to physical or cognitive impairments. Cloudy, amber urine with an unpleasant odor is not indicative of functional incontinence.

B. Urinary tract infection (UTI): Cloudy, amber urine with an unpleasant odor is a common symptom of a UTI. UTIs often cause changes in urine color, odor, and clarity due to the presence of bacteria and inflammatory cells in the urine.

C. Ketone bodies in the urine: Ketones in the urine can occur in conditions such as uncontrolled diabetes or during periods of fasting. However, cloudy, amber urine with an unpleasant odor is more indicative of a UTI rather than the presence of ketones.

D. Nocturia: Nocturia refers to waking up during the night to urinate. While it may be associated with certain urinary conditions, it does not directly correlate with the appearance and odor of the urine.

A. lithotomy with a drape for privacy B. Supine with arms at their sides C. left decubitus D. a position that feels most comfortable for the client

Correct Answer is B

Explanation

A. Lithotomy with a drape for privacy: The lithotomy position, where the client lies on their back with hips and knees flexed and legs supported in stirrups, is typically used for gynecological examinations or procedures. While this position provides access to the abdominal area, it is not typically used for routine abdominal assessments. Additionally, draping for privacy may not be necessary for a routine abdominal assessment.

B. Supine with arms at their sides: This is the most appropriate position for performing an abdominal assessment. In the supine position, the client lies on their back with arms at their sides, which allows for easy access to the abdomen. The supine position provides optimal relaxation of abdominal muscles and facilitates palpation and auscultation of abdominal organs.

C. Left decubitus: The left decubitus position, where the client lies on their left side with the right knee flexed, is sometimes used to facilitate gastric emptying and reduce gastroesophageal reflux. While this position may provide some access to the abdominal area, it is not typically used for routine abdominal assessments.

D. A position that feels most comfortable for the client: While it is essential to consider the client's comfort during any assessment, the position that feels most comfortable for the client may not always be the most suitable for performing an abdominal assessment. The supine position with arms at their sides is the standard position for abdominal assessments due to its ease of access and optimal relaxation of abdominal muscles.

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Naxlex Comprehensive Predictor Exams

The client's urine is cloudy, amber, and has an unpleasant odor. The nurse should make the inference that the client may have:

Correct Answer is B

Explanation

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Correct Answer is B

Explanation

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