Chapter 27: Pain and Comfort Touhy: Ebersole & Hess' Toward Healthy Aging, 9th Edition MULTIPLE CHOICE 1. When performing a pain assessment on a client who is aphasic, the nurse should consider: a. reports from the family or staff at the nursing home about changes in functional
status. b. that the patient is lying quietly in bed so she is not likely to be experiencing pain. c. that the patient’s previous stroke interrupted pain pathways so she does not feel
pain. d. that older adults do not tolerate opioid analgesics well and may exhibit side effects. ANS: A
When an individual is not able to verbally communicate complaints of pain, reports from family or caregivers are important. In addition, in older adults, pain is often manifested as changes in functional status. To assume that the patient is not in pain because she is lying quietly in bed is incorrect. One should not assume that she feels no pain due to her stroke. Older adults tolerate opioid analgesics. DIF: Cognitive Level: Understanding REF: pp. 344–345 TOP: Integrated Process: Teaching/Learning MSC: Client Needs: Physiological Adaptation 2. An older adult is admitted to the hospital after a serious fall. When noting that the client has
been prescribed meperidine (Demerol) for muscle pain, the nurse: a. administers the medication so as to prevent the client from developing the fear of pain. b. questions the client and family concerning any allergies to analgesic medications. c. calls the physician to question the appropriateness of this medication order. d. conducts a pain assessment and determines the client’s need for an analgesic medication. ANS: C
Some medications used in younger adults, for example, meperidine (Demerol), are always contraindicated in the older adult. The metabolites of Demerol can cause confusion, psychotic behavior, and seizure activity. The remaining options would not be inappropriate, except for the fact that they relate to the administration of an inappropriate medication. DIF: Cognitive Level: Understanding REF: p. 348 TOP: Integrated Process: Teaching/Learning MSC: Client Needs: Pharmacological and Parenteral Therapies 3. Compared with acute pain, persistent pain requires the nurse to: a. monitor vital signs more frequently. b. document the character of the pain as burning. c. administer analgesics at least every 4 hours. d. educate the client to the benefit of specific lifestyle changes. ANS: D
