A nurse is caring for a client who is receiving morphine via a patient-controlled analgesia (PCA) infusion device after abdominal surgery. Which of the following statements by the client indicates correct understanding of the PCA device?

“I’ll wait to use the device until it’s absolutely necessary.”

“I’ll be careful about pushing the button so I don’t get an overdose.”

“I should tell the nurse if the pain doesn’t stop after I use this device.”

“I will ask my son to push the dose button when I am sleeping.”

Mild

Answer and Explanation

The Correct Answer is C

Patient-controlled analgesia (PCA) is a method that allows clients to self-administer small doses of opioid medication to manage pain. It provides a safe, controlled, and timely approach to pain relief. It is essential that clients understand how to use the PCA appropriately and recognize when to notify the nurse if the pain is not being effectively controlled.

Rationale for Correct Answer:

C. “I should tell the nurse if the pain doesn’t stop after I use this device.”: This shows appropriate understanding that PCA is intended to relieve pain, and persistent pain may require dose adjustment or reassessment by the healthcare team.

Rationale for Incorrect Answers:

A. “I’ll wait to use the device until it’s absolutely necessary.”: PCA works best when used early and consistently at the onset of pain. Waiting until pain becomes severe makes it harder to control.

B. “I’ll be careful about pushing the button so I don’t get an overdose.”: PCA devices have built-in safety limits (lockout intervals) to prevent overdose. This statement reflects unnecessary fear that may lead to underuse.

D. “I will ask my son to push the dose button when I am sleeping.”: This is unsafe and contraindicated. Only the client should activate the PCA to prevent oversedation or respiratory depression, a practice known as “PCA by proxy” is never appropriate.

Key Takeaways:

Clients should notify the nurse if PCA is not relieving pain adequately.
Only the client should press the PCA button to ensure safe use.
PCA should be used proactively, not delayed until pain becomes severe.

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Correct Answer is ["B","C","D"]

Explanation

Neuropathic pain arises from damage or dysfunction in the nervous system, rather than from direct tissue injury. It is often described using distinctive sensory terms that reflect abnormal nerve signaling. Clients with neuropathic pain commonly report sensations that are burning, shooting, or electric shock-like. This type of pain may be chronic and difficult to treat with standard analgesics.

Rationale for Correct Answers:

B. Burning: A hallmark of neuropathic pain, often due to irritated or damaged nerves.

C. Shooting: Suggests pain that radiates or travels along a nerve pathway.

D. Shock-like: A classic description of sudden, stabbing nerve pain often seen in neuropathic conditions such as diabetic neuropathy or trigeminal neuralgia.

Rationale for Incorrect Answers:

A. Dull: This is more typical of nociceptive pain, such as that from musculoskeletal injury or visceral pain.

E. Mild: This describes pain intensity rather than quality. Neuropathic pain may be mild, but intensity alone is not a defining feature.

Key Takeaways:

Neuropathic pain is often described as burning, shooting, or electric shock-like.
It results from nerve injury or dysfunction, not from tissue damage alone.
Descriptive terms help distinguish neuropathic from nociceptive pain and guide appropriate treatment.

A. Urinary incontinence B. Diarrhea C. Bradypnea D. Orthostatic hypotension E. Nausea

Correct Answer is ["C","D","E"]

Explanation

Opioid analgesics are effective for moderate to severe pain but are associated with a variety of adverse effects, particularly involving the central nervous system and gastrointestinal system. Nurses must monitor for these expected reactions to ensure prompt recognition and intervention.

Rationale for Correct Answers:

C. Bradypnea: Opioids depress the respiratory center in the brainstem, which can lead to respiratory depression, especially at higher doses or in opioid-naïve clients.

D. Orthostatic hypotension: Opioids can cause vasodilation and reduced sympathetic tone, leading to a drop in blood pressure when changing positions.

E. Nausea: A common early side effect, nausea occurs due to opioid stimulation of the chemoreceptor trigger zone in the brain.

Rationale for Incorrect Answers:

A. Urinary incontinence: Opioids more commonly cause urinary retention, not incontinence, due to increased sphincter tone and decreased bladder contractility.

B. Diarrhea: Opioids cause constipation, not diarrhea, by slowing gastrointestinal motility through action on opioid receptors in the gut.

Key Takeaways:

Common adverse effects of opioids include bradypnea, orthostatic hypotension, nausea, constipation, and urinary retention.
Respiratory depression is the most serious side effect and requires immediate attention.
Nurses must monitor vital signs, GI status, and bladder function closely during opioid therapy.

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A nurse is caring for a client who is receiving morphine via a patient-controlled analgesia (PCA) infusion device after abdominal surgery. Which of the following statements by the client indicates correct understanding of the PCA device?

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Naxlex Comprehensive Predictor Exams

A nurse is assessing a client with suspected neuropathic pain. Which descriptions are most consistent with this type of pain? Select all that apply

Correct Answer is ["B","C","D"]

Explanation

A nurse is monitoring a client who is receiving opioid analgesia. Which of the following adverse effects should the nurse anticipate? Select all that apply

Correct Answer is ["C","D","E"]

Explanation

A nurse is caring for a terminally ill client experiencing moderate to severe pain. Providing opioids in this situation:

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