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NUR 209 FINAL EXAM PREP STUDY GUIDE QUESTIONS CORRECTLY ANSWERED WITH EXPLANATIONS.
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NUR 209 FINAL EXAM PREP STUDY GUIDE QUESTIONS CORRECTLY ANSWERED WITH EXPLANATIONS.
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NUR 209 FINAL EXAM PREP STUDYGUIDE QUESTIONS CORRECTLY
ANSWERED WITH EXPLANATIONS.
The nurse is teaching a class about caloric intake. Which statement should
the nurse use to describe why weight loss may occur when a client has an
infection?
✔✔Infection increases the basal metabolic rate and causes more calories
to be utilized.
-Explanation: Dietary patterns should be adjusted to maintain a balance
between caloric intake and energy expenditure. Basal metabolism is the
amount of energy required to carry out involuntary activities at rest (e.g.,
breathing, circulating blood, maintaining body temperature). Men usually
have a higher basal metabolic rate (BMR) than do women because of their
proportionally greater muscle mass. Other factors, such as growth,
infection, fever, stress, and extreme environmental temperatures, can
increase BMR. Perspiration does not burn calories. Diarrhea can cause a
lack of nutrients to be absorbed, but not all infections cause diarrhea. An
increased respiratory rate is not known to increase BMR
The nurse is assessing a client who is experiencing pain. The nurse notes the
client is experiencing acute rather than chronic pain when the client makes
which statement?
✔✔"The pain is really sharp in this one spot."
-Explanation: Acute pain can be differentiated from chronic pain because it
is specific and localized, whereas chronic pain tends to be nonspecific and
generalized. Clients experiencing acute pain will indicate a recent onset
whereas chronic pain has a remote onset. Acute pain is associated with
sympathetic nervous system responses such as hypertension, tachycardia,
,restlessness, and anxiety, whereas chronic pain features the absence of
autonomic nervous system responses and manifests with depression and
irritability. Acute pain responds favorably when pain medication is
administered. Chronic pain requires more frequent and higher doses of pain
medication to elicit a positive response due to the threshold people build to
the efficacy over time
A client prescribed pain medication around the clock experiences pain 1
hour before the next dose of the pain medication is due. Which is the most
appropriate action by the nurse?
✔✔Assess for medication prescription for breakthrough pain.
-Explanation: Breakthrough pain is a temporary flare-up of moderate to
severe pain that occurs even when the client is taking pain medication
around the clock. It can occur before the next dose of analgesic is due (end
of dose pain). It is treated most effectively with supplemental doses of a
short-acting opioid taken on an "as needed basis." Therefore, the nurse
should check for a prescription for breakthrough pain medication. Telling
the client that he or she has to wait is not a therapeutic action by the nurse.
Administering the next dose of pain medication is a violation of nursing
practice and does not follow the standard of care. The nurse needs to assess
for the therapeutic effects of the pain medication and not opioid addiction
The spouse of a client with cancer asks why the client's breakthrough doses
of morphine have recently needed to be higher and more frequent for the
client to achieve pain relief? Which response by the nurse is appropriate?
✔✔Higher doses are needed because the client has developed a tolerance
to the morphine.
-Explanation: This client is likely developing drug tolerance, which occurs
when the body becomes accustomed to the opioid and needs a larger dose
each time for pain relief. This is not a pathologic finding and does not
,necessarily indicate physical dependence. Addiction is the fact or condition
of being addicted to a particular substance, thing, or activity. Tolerance does
not indicate addiction or a heightened risk for addiction. A drug interaction
is a reaction between two (or more) drugs or between a drug and a food or
beverage
A client with chronic pain uses a machine to monitor his physiologic
responses to pain. The unit transforms the data into a visual display and
through seeing the pain responses, the client is taught to regulate his
physiologic response and control pain through relaxation, imagery, or
breathing exercises. This technique for pain control is known as:
✔✔biofeedback.
-Explanation:
Biofeedback is a technique that uses a machine to monitor physiologic
responses through electrode sensors on the client's skin. The unit
transforms the data into a visual display, and through seeing the pain
responses, the client is taught to regulate his physiologic response and
control pain through relaxation, imagery, or breathing exercises.
Transcutaneous electrical nerve stimulation (TENS) is a noninvasive
alternative technique that involves electrical stimulation of large-diameter
fibers to inhibit transmission of painful stimuli carried over small-diameter
fibers. Hypnosis is an alteration in a person's state of consciousness so that
pain is not perceived as it normally would be. Therapeutic Touch involves
using one's hands to direct an energy exchange consciously from the
practitioner to the client in order to facilitate healing or pain relief
The young female client had emergency surgery for appendicitis. She is a
cigarette smoker, is breast-feeding her infant, and expressed a desire to
continue to breast-feed when discharged from the hospital. The surgeon has
prescribed acetaminophen/oxycodone for pain relief at home. What
, instructions would the nurse include when providing discharge teaching?
Select all that apply.
✔✔The nurse will provide instructions about the medication prescribed for
pain relief. This medication is an opioid, and extra precautions are required.
The client is not to drive a vehicle while taking an opioid due to slowed
reflexes and decreased cognitive thinking. The client is not to breast-feed
her infant without checking with her primary care provider. The opioid may
be absorbed into the breast milk and fed to the infant, which may adversely
affect the infant. The client is to keep a diary about her pain experiences,
which includes level of pain and time the medication was taken. This
provides a more accurate documentation of the pain experience and
prevents overdosage from taking the medication too frequently. The client is
not to drink alcohol. Alcohol will depress the central nervous system when
taken with an opioid and may lead to respiratory failure. The client may
smoke, but someone will need to be present (for safety reasons) since the
client may fall asleep due to the opioid. It does not matter whether it is day
or night. The medication is not better absorbed when taken on an empty
stomach. The client takes the pain medication with food, since nausea is a
frequent side effect when the opioid is taken on an empty stomach.
The nurse is conducting a pain assessment with an older adult client. The
nurse notices that the client grimaces when the nurse asks the client to lean
forward. The client, however, rates pain as 3 out of 10 on the numerical pain
rating scale. The nurse recognizes that the client may be reporting pain
inaccurately for which reason(s)? Select all that apply.
✔✔Older adults may not report pain for several reasons, such as not
wanting to be perceived as a nuisance or a complainer, believing that pain is
expected with aging or is an indicator of weakness, fearing addiction to pain
medication, or misperceiving that nothing can be done to alleviate the pain.
By recognizing and exploring possible reasons for the incongruence
between the objective and subjective assessment data, the nurse can
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