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 C

Explanation

Choice A rationale:

Avoiding crossing legs at the knees is a correct practice for people with PVD. It helps to prevent constriction of blood flow in the legs. When legs are crossed, pressure is applied to the veins in the lower leg, which can impede blood flow. This can lead to several problems, including:

Increased risk of blood clots Worsening of swelling in the legs Increased pain and discomfort Potential skin damage

Reinforcing this practice with the client is important.

Choice B rationale:

Not going barefoot is also a correct practice for people with PVD. It helps to protect the feet from injuries and infections. People with PVD may have reduced sensation in their feet, making them more susceptible to injuries they may not notice. Additionally, PVD can impair wound healing, so even minor injuries can become serious problems.

Reinforcing this practice with the client is important.

Choice C rationale:

Using a thermometer to check bath water temperature is not directly relevant to PVD management. While it's generally a good safety practice to avoid excessively hot water, which can burn the skin, it's not specifically related to the blood flow issues associated with PVD.

This statement indicates a need for further teaching to focus on PVD-specific self-care measures.

Choice D rationale:

Wearing stockings with elastic tops is generally recommended for people with PVD. These stockings, often referred to as compression stockings, help to improve blood flow in the legs by applying gentle pressure. This can help to reduce swelling, pain, and the risk of blood clots.

Reinforcing this practice with the client is important.

A. The wound is tender to touch. B. The wound has a halo of erythema on the surrounding skin. C. The wound is draining serosanguineous fluid. D. The wound has pink, shiny tissue with a granular appearance.

Correct Answer is B

Explanation

Choice A rationale:

Tenderness to touch is a common finding in wounds healing by secondary intention. It's often due to inflammation, which is a normal part of the healing process. The inflammation brings in cells and substances that promote healing. However, increased tenderness, especially when accompanied by other signs of infection, should be reported.

Choice B rationale:

A halo of erythema on the surrounding skin is a sign of infection. This is a serious complication that can delay healing and lead to further complications. The erythema indicates that the infection is spreading beyond the wound edges and needs prompt attention.

Choice C rationale:

Drainage of serosanguineous fluid is also common in wounds healing by secondary intention. This fluid is a mixture of serum (clear yellowish fluid) and blood. It's a sign that the wound is cleaning itself and new tissue is forming. While excessive drainage or a change in color or odor could signal a problem, drainage itself is not necessarily a cause for concern.

Choice D rationale:

Pink, shiny tissue with a granular appearance is a sign of healthy granulation tissue. This is a type of tissue that forms during the healing process. It's rich in blood vessels and collagen, which are essential for wound healing. The presence of granulation tissue indicates that the wound is healing well.

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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?

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