A nurse is teaching a newly licensed nurse about pain. Which of the following is an example of acute pain?
Peripheral neuropathy causes progressive, persistent pain that lasts longer than 6 months.
Fibromyalgia causes a progressive, persistent pain that lasts longer than 6 months.
Rheumatoid arthritis causes progressive, persistent pain that lasts longer than 6 months.
A surgical incision causes anticipated pain that lasts less than 6 months.
The Correct Answer is D
Choice A rationale
Peripheral neuropathy is a classic example of chronic or neuropathic pain. It involves damage to the nerves, often resulting from conditions like diabetes, and the pain typically lasts for months or years. Because the pain is persistent and persists well beyond the expected time for tissue healing, it does not meet the criteria for acute pain, which is characterized by a limited duration and a clear cause.
Choice B rationale
Fibromyalgia is a chronic pain syndrome characterized by widespread musculoskeletal pain, fatigue, and tenderness. The pain associated with fibromyalgia is long-term and often lacks a specific, localized injury that can be cured. Since the symptoms persist for significantly longer than six months and involve complex central sensitization, it is categorized as a chronic condition rather than an acute episode of pain following a specific injury.
Choice C rationale
Rheumatoid arthritis is a chronic autoimmune disorder that causes persistent inflammation of the joints. The resulting pain is long-standing and progressive, often requiring lifelong management. While clients may experience acute "flares," the underlying disease process and the pain it generates are considered chronic because they do not resolve within a short timeframe and are associated with permanent structural changes in the body.
Choice D rationale
Acute pain is typically sudden in onset and serves as a protective mechanism, signaling actual or potential tissue damage. A surgical incision causes acute pain because the duration is limited and it predictably subsides as the physical wound heals. Generally, pain that lasts less than six months and is directly related to a specific trauma or procedure is classified as acute, allowing for a focused treatment plan.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["15"]
Explanation
63 Step 1 is 15 mg ÷ 5 mg × 5 mL.
Step 2 is 3 × 5 mL.
Step 3 is 15 mL. The nurse should administer 15 mL.
Correct Answer is A
Explanation
Choice A rationale
Efficient peripheral perfusion is critical for pulse oximetry accuracy because the device relies on detecting pulsatile arterial blood flow. A capillary refill time of less than 2 seconds indicates adequate local circulation, ensuring that the sensor can effectively distinguish between oxygenated and deoxygenated hemoglobin. If perfusion is sluggish, the infrared light may not accurately detect the pulse, leading to false low readings or an inability to obtain a consistent waveform during the assessment process.
Choice B rationale
Most modern pulse oximeters provide a stable reading within 10 to 30 seconds after placement once a consistent pulse signal is detected. Waiting a full minute is generally unnecessary and could delay clinical decision-making in acute situations. The nurse should observe the waveform or signal strength indicator to ensure the reading is reliable. Prolonged waiting does not improve accuracy if the initial signal is already high quality, and it may lead to inefficiencies in nursing workflow.
Choice C rationale
Placing the sensor probe on the same extremity as a blood pressure cuff is contraindicated because the inflation of the cuff temporarily occludes arterial blood flow. This occlusion results in a loss of the pulsatile signal required by the oximeter, leading to inaccurate readings or triggering false alarms. To ensure continuous and accurate monitoring, the nurse should use the opposite limb or a site unaffected by the periodic pressure exerted by the blood pressure measurement device.
Choice D rationale
Sensor site rotation is a vital nursing intervention to prevent skin breakdown and pressure-related injuries, but the frequency should be higher than every 8 hours. Standard clinical practice typically requires relocating the sensor every 2 to 4 hours, especially in patients with fragile skin or poor circulation. Extended placement at a single site increases the risk of localized ischemia and thermal injury from the light source, so an 8-hour interval is considered too long for safety.
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