A nurse is caring for a patient experiencing pain related to a musculoskeletal disorder. Which statement about chronic pain is most accurate?

Chronic pain could cause restlessness, pacing, grimacing, and other facial expressions of pain.

Chronic pain is limited and short in duration.

A patient with chronic pain may have physical signs of tissue injury.

Chronic pain may not manifest in a change of vital signs.

Answer and Explanation

The Correct Answer is A

Choice A rationale:

Chronic pain can manifest in various behavioral and physical symptoms, including restlessness, pacing, grimacing, and other facial expressions of pain. These behaviors are often unconscious attempts to cope with or distract from the pain.

They may also reflect the emotional distress that often accompanies chronic pain. Patients may feel frustrated, anxious, or even depressed due to the persistent nature of their pain and its impact on their lives.

It's crucial for nurses to recognize these behavioral signs of pain, as patients may not always readily report their pain verbally. By observing these behaviors, nurses can assess the patient's pain level more accurately and provide appropriate interventions.

Choice B rationale:

Chronic pain is defined as pain that persists for longer than three months, often for much longer. It is not limited and short in duration.

This distinguishes it from acute pain, which is typically associated with an injury or illness and resolves within a few days or weeks.

Choice C rationale:

While some patients with chronic pain may have physical signs of tissue injury, this is not always the case. Chronic pain can also be caused by nerve damage, inflammation, or changes in the central nervous system.

In some cases, the underlying cause of chronic pain may be unknown.

Choice D rationale:

Although chronic pain may not always cause a significant change in vital signs, it can still be a very real and debilitating experience for patients.

Vital signs, such as heart rate, blood pressure, and respiratory rate, are often more sensitive to acute pain.

Nurses should not rely solely on vital signs to assess chronic pain. Instead, they should consider the patient's self-report of pain, behavioral cues, and other factors.

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Correct Answer is B

Explanation

Choice A rationale:

Naloxone does not have any direct effect on respiratory secretions. It works by binding to opioid receptors in the brain and reversing the effects of opioids, such as respiratory depression.

While opioids can cause a decrease in respiratory secretions, this is not the primary reason for administering naloxone.

It is important to note that naloxone can actually worsen respiratory secretions in some patients, particularly those with chronic obstructive pulmonary disease (COPD) or other respiratory conditions.

Choice B rationale:

Naloxone is a medication that is specifically designed to block the effects of opioids on the central nervous system (CNS).

It is a competitive antagonist, which means that it binds to opioid receptors in the brain and prevents opioids from binding to those receptors.

This can reverse the effects of opioids, such as respiratory depression, sedation, and hypotension.

Naloxone is often used to treat opioid overdose, but it can also be used to prevent opioid-induced respiratory depression in patients who are receiving opioids for pain relief.

Choice C rationale:

Naloxone is not effective in treating nausea.

In fact, it can actually worsen nausea in some patients.

This is because naloxone can block the effects of opioids in the brain, and opioids can sometimes have a nausea-relieving effect.

Choice D rationale:

Naloxone is not effective in treating urinary retention.

Urinary retention is a common side effect of opioids, but it is not caused by the effects of opioids on the CNS. Urinary retention is typically caused by the effects of opioids on the bladder muscles.

A. Crackles B. Stridor C. Strong cough D. Deep breathing

Correct Answer is B

Explanation

Choice B rationale:

Stridor is a high-pitched, whistling sound that is heard during inspiration. It is a sign of upper airway obstruction, indicating a potentially life-threatening complication that requires immediate intervention.

Here's a detailed explanation of why stridor is the most concerning finding and why the other choices are not as indicative of a serious problem:

Stridor:

Mechanism: Stridor occurs when there is narrowing or obstruction of the upper airway, typically at the level of the larynx or trachea. This narrowing can be caused by various factors, including:

Laryngospasm: A sudden constriction of the vocal cords, often triggered by irritation or inflammation. Post-extubation edema: Swelling of the tissues in the airway after removal of the endotracheal tube.

Mucus plugging: Accumulation of thick secretions in the airway, which can partially block airflow.

Vocal cord dysfunction: Impairment of the vocal cords' movement, which can affect their ability to open and close properly.

Significance: Stridor is a serious sign because it indicates that airflow is significantly restricted. If left untreated, upper airway obstruction can lead to hypoxia (low oxygen levels) and respiratory failure.

Nursing intervention: If stridor is present, the nurse should immediately notify the provider and prepare for potential interventions to secure the airway, such as:

Reintubation: Reinserting the endotracheal tube to bypass the obstruction.

Nebulized racemic epinephrine: Medication to reduce swelling in the airway.

Heliox: A mixture of helium and oxygen that can improve airflow through a narrowed airway. Steroids: Medications to reduce inflammation in the airway.

Crackles (Choice A):

Description: Crackles are rattling, crackling sounds heard in the lungs, often during inspiration. They are typically associated with lower airway problems, such as pneumonia or pulmonary edema.

Significance: While crackles can indicate respiratory issues, they are not as immediately concerning as stridor in the context of post-extubation care.

Strong cough (Choice C):

Significance: A strong cough is generally a positive sign after extubation, as it indicates that the patient is able to clear secretions from their airway effectively.

Deep breathing (Choice D):

Significance: Deep breathing is also a positive sign, as it promotes lung expansion and oxygenation.

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A nurse is caring for a patient experiencing pain related to a musculoskeletal disorder. Which statement about chronic pain is most accurate?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a patient who is postoperative and receiving fentanyl via patient-controlled analgesia. The patient has a prescription for naloxone. What is the purpose of naloxone?

Correct Answer is B

Explanation

Choice A rationale:

Choice B rationale:

Choice C rationale:

Choice D rationale:

A nurse is collecting data from a client following removal of the client’s endotracheal tube. What findings should the nurse report to the provider?

Correct Answer is B

Explanation

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