Chapter 12: Drugs for Pain Management
MULTIPLE CHOICE
1. What types of drugs have the main purpose of relieving pain?
a. Anticholinergics
b. Antagonists
c. Analgesics
d. Agonists ANS: C
Analgesics have the specific purpose of relieving pain either by changing the patient’s perception
of pain or by reducing painful stimulation at its source. Although some analgesics are opioid
agonists, the term agonist is not specific for a pain-relieving drug.
DIF: Cognitive Level: Remembering REF: p. 224
2. An adult patient has returned to the unit from an operative procedure. The healthcare
provider asks you to rate a patient’s postoperative pain. What is your best response?
a. “He is asleep now, so his pain level is acceptable.”
b. “I will ask the patient to rate his own pain.”
c. “His wife says he can still feel the incision when he turns or coughs.”
d. “Since he received 15 mg of morphine an hour ago, his pain is probably minimal.” ANS: B
Pain is always a subjective experience; that is, pain is a sensation the patient feels and that cannot
be felt or measured by someone else. Accurate pain assessment is best measured by the patient, if
he or she is not unconscious or confused. Being asleep does not mean that pain is relieved.
DIF: Cognitive Level: Applying REF: p. 221
, 3. You are caring for a female patient who is paralyzed from the waist down and has a large
open wound on her right heel. When asked about her pain in that foot, she tells you it is a 0 on a
0 to 10 pain rating scale. What does this response indicate?
a. The patient’s paralysis prevents the patient’s brain from perceiving the pain.
b. The patient has chronic pain that does not trigger the stress response.
c. The patient has demonstrated substance misuse behaviors from taking pain drugs too often.
d. The patient’s acute pain has been effectively managed by the prescribed pain drug.
ANS: A
Pain is felt or perceived in the brain rather than in the body area where it occurs. When a body
part is injured, this injury stimulates pain nerve endings in the thumb that then send (transmit)
electrical nerve impulses as a signal from the injury site along nerves to the spinal cord. At the
spinal cord, the original signal is transferred to special pain nerve tracts up the spinal cord to the
area of the brain where pain in that body site is perceived. Paralysis from the waist down in the
spinal cord prevents the transmission of a pain signal from the foot so that pain is not perceived
no matter how deep or bad the heel wound is.
DIF: Cognitive Level: Understanding REF: p. 222
4. A nursing student assigned to work with you asks you to explain why natural and synthetic
opioids are considered “high-alert drugs?” What is your best response?
a. “Opioids have an increased risk for causing a patient harm if given in error.”
b. “Opioids have a relatively high potential for addiction or abuse.”
c. “There is wide variation in the dosages between opioid types.”
d. “High-alert drugs are those that can be given by a variety of routes.” ANS: A
Although opioids can cause addiction or abuse, have different dosages ranges, and can be given
by the oral, intravenous, intramuscular, and transdermal routes, these are not the reasons they are
categorized as high-alert drugs. All natural and synthetic opioids are high-alert drugs because
they
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