A patient who had a motor vehicle crash 2 days ago is experiencing pain and is receiving patient-controlled analgesia (PCA). Which assessment finding indicates effective pain management with the PCA?
The patient has sufficient medication left in the PCA syringe.
The patient is sleeping and is difficult to arouse.
The patient rates pain at a level of 2 on a 0 to 10 scale.
The patient presses the control button to deliver pain medication.
The Correct Answer is C
Choice A reason: Sufficient medication in the PCA syringe does not indicate effective pain management. It may reflect underuse due to inadequate pain control or patient misunderstanding of PCA use. Pain relief is assessed by patient-reported outcomes, not medication volume remaining.
Choice B reason: Sleeping and being difficult to arouse suggests oversedation, a potential adverse effect of PCA, particularly with opioids. This indicates excessive dosing rather than effective pain management, risking respiratory depression or other complications, requiring immediate dose adjustment or monitoring.
Choice C reason: A pain rating of 2 on a 0 to 10 scale indicates effective pain management. PCA allows patients to self-administer doses within safe limits, achieving low pain levels without excessive sedation, reflecting optimal balance of analgesia and patient safety post-trauma.
Choice D reason: Pressing the PCA button shows patient engagement but not pain control effectiveness. Frequent pressing may indicate inadequate relief, while infrequent use could reflect sufficient control or misunderstanding. Patient-reported pain levels are the primary indicator of PCA efficacy.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A reason: High intake of animal fats or red meat is a recognized risk factor for colorectal cancer. These foods, high in saturated fats, may promote inflammation and alter gut microbiota, increasing carcinogenesis risk in the colon, supported by epidemiological studies linking diet to cancer.
Choice B reason: Rectal bleeding is a warning sign of colorectal cancer. It results from tumor erosion or ulceration in the colon or rectum, causing blood in stool. This symptom prompts diagnostic evaluation, like colonoscopy, to detect malignancy early, improving treatment outcomes.
Choice C reason: Smoking is a risk factor for colorectal cancer. Tobacco’s carcinogenic compounds, like polycyclic aromatic hydrocarbons, damage colonic mucosa, increasing mutation risk. Smoking also promotes inflammation, contributing to tumor development, making it a significant modifiable risk factor in colorectal cancer prevention.
Choice D reason: Diarrhea is not a specific warning sign of colorectal cancer. While it may occur, it’s more commonly associated with infections or irritable bowel syndrome. Cancer typically presents with persistent bleeding, weight loss, or bowel habit changes, making diarrhea less diagnostic and misleading for teaching.
Correct Answer is D
Explanation
Choice A reason: Offering narcotics immediately without assessing pain details or considering nonpharmacological options is not therapeutic. Pain management requires a tailored approach, evaluating pain characteristics and patient preferences, as narcotics carry risks like respiratory depression, especially post-surgery, necessitating cautious use.
Choice B reason: Dismissing pain based on stable vitals is not therapeutic. Pain is subjective, and normal vitals (e.g., 110/60 mmHg, 60 bpm) don’t negate severe pain. This response invalidates the patient’s experience, potentially eroding trust and delaying effective pain management.
Choice C reason: Stating the patient doesn’t look in pain is dismissive and non-therapeutic. Pain is subjective, and external appearance may not reflect internal experience, especially in stoic patients. This response risks undermining patient trust and delaying appropriate pain relief interventions.
Choice D reason: Asking what the patient wants to try is therapeutic, promoting patient-centered care. It validates the patient’s pain, encourages shared decision-making, and considers both pharmacological and nonpharmacological options, optimizing pain relief while respecting patient autonomy and preferences post-surgery.
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