NCLEX quiz: Pain management for oncologic clients

A hospice client has increasing pain. Analgesics should be scheduled to provide:

Around-the-clock routine administration of analgesics
A semi-somnolent state for the client
Doses of analgesic when pain is a “5” on a 1-10 pain scale
An analgesic-free period so client can complete activities of daily living (ADLs)

A client with pancreatic cancer has developed a tolerance to morphine that is administered via subcutaneous pump. The nurse understands that this client:

Is experiencing physical dependence
Will require an increased dose to provide the same level of pain relief
Is tolerating the side effects of the medication well
Is now addicted to morphine

A client takes 150 mg oral long-acting morphine every 12 hours for abdominal pain related to advanced ovarian cancer. After hospital admission for complications, the physician discontinues the oral morphine, and orders 6 mg/hr IV. The nurse should:

Contact the physician to recommend starting the client at the equianalgesic dose of 4 mg/hr
Contact the physician to recommend starting the client at the equianalgesic dose of 8 mg/hr
Administer one final oral dose while starting the IV infusion
Administer the IV morphine infusion as ordered

An elderly female with metastatic breast cancer takes long-acting morphine 120 mg every 12 hours for pain. She can also have 20 mg immediate-release morphine every 3 to 4 hours for breakthrough pain. The physician should be contacted when the client uses more than ____ breakthrough doses of morphine in 24 hours.

Two
Four
Five
Seven

A client is taking nonsteroidal anti-inflammatory drug (NSAID) for pain management. Which body system of this client should be particularly assessed?

Hepatic
Renal
Pulmonary
Gastrointestinal

Which of the following sets of signs/symptoms are expected in a client experiencing chronic pain?

Elevated heart rate, grimacing, physical inactivity
Physical inactivity, moaning, normal vital signs
Physical inactivity, normal vital signs, normal facial expressions
Elevated heart rate, normal facial expressions, depression

A client with lung cancer is being cared for by his wife at home. His pain is increasing in severity. The nurse knows to reeducate the wife when she:

Substitutes acetaminophen (Tylenol) for breakthrough pain to avoid tolerance
Uses music for distraction from pain, along with hot and cold therapies
Administers long-acting pain formulas around the clock
Has the husband use a pain scale to rate his pain

A nurse assesses the pain of a client with bone cancer. Which of the following is the most significant aspect of pain for this client?

Intensity
Cause
Aggravating factors
Location

Meperidine (Demerol) is not recommended for chronic cancer-related pain because:

Morphine can be taken orally
It has a high potential for abuse
The agonist-antagonist properties limit functionality
It produces a metabolite that may cause seizures

A 60-year-old client with chronic cancer pain was placed on an opiod 4 months ago to treat a pain level of 8 on a 1 to 10 pain scale. Currently, this client is again complaining of a pain level of 8 on a 1 to 10 scale without any change in her cancer. This client is exhibiting:

Addiction to opiods
Withdrawal from opiods
Tolerance to opiods
Decreased placebo effect