HESI PN COMPREHENSIVE PREDICTOR EXAM

1. The nurse is caring for a patient to ease modifiable factors that

contribute to pain. Which areas did the nurse focus on with this patient?

a. Age and gender

b. Anxiety and fear

c. Culture and ethnicity

d. Previous pain experiences and cognitive abilities

ANS: B

Some examples of modifiable contributors to pain are anxiety and fear. The

nurse can take measures to ease the patient’s anxiety and fear related to

pain. Age, gender, culture, ethnicity, cognitive abilities, and previous pain

experience are all nonmodifiable factors that the nurse can help the patient

to understand, but the nurse cannot alter them.

2. The nurse is evaluating the effectiveness of guided imagery for

pain management as used for a patient who has second- and thirddegree burns and needs extensive dressing changes. Which finding best

indicates the effectiveness of guided imagery?

a. The patient’s facial expressions are stoic during the procedure.

The patient rates pain during the dressing change as a 6 on a scale of 0

b. to 10.

The patient’s need for analgesic medication decreases during the

c. dressing changes.

The patient asks for pain medication during the dressing changes only

d. once throughout the procedure.

ANS: C

If the patient needs less pain medication during dressing changes, then guided

imagery is helping to manage the patient’s pain. The purpose of guided

imagery is to allow the patient to alter the perception of pain. Guided imagery

works in conjunction with analgesic medications, potentiating their effects. A

rating of 6 on a 0 to 10 scale indicates that the patient is having moderate pain

and shows that this patient is not experiencing pain relief at this time. A

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person who is stoic is not showing feelings, which makes it difficult to know

whether or not the patient is experiencing pain. Having to ask for pain

medication during the dressing changes indicates the guided imagery is not

effective.

19.A nurse is providing medication education to a patient who just started

taking ibuprofen. Which information will the nurse include in the teaching

session?

Ibuprofen helps to depress the central nervous system to decrease pain

a. perception.

b. Ibuprofen reduces anxiety, which will help you cope with your pain.

c. Ibuprofen binds with opiate receptors to reduce your pain.

d. Ibuprofen inhibits the production of prostaglandins.

ANS: D

NSAIDs like ibuprofen likely work by inhibiting the synthesis of

prostaglandins to inhibit cellular responses to inflammation. Ibuprofen does

not depress the central nervous system, nor does it enhance coping with pain.

Opioids bind with opiate receptors to modify perceptions of pain.

20.The nurse has brought a patient the scheduled pain medication. The

patient asks the nurse to wait to give pain medication until the time for the

dressing change, which is 2 hours away. Which response by the nurse is

most therapeutic?

“This medication will still be providing you relief at the time of your

a. dressing change.”

“OK, swallow this pain pill, and I will return in a minute to change

b. your dressing.”

“Would you like medication to be given for dressing changes in

c. addition to your regularly scheduled medication?”

“Your medication is scheduled for this time, and I can’t adjust the time

d. for you. I’m sorry, but you must take your pill right now.”

ANS: C

Additional doses of medication can be given to patients in certain

circumstances, as with an extensive dressing change, when the health care

provider is notified that more medication is needed. It is the nurse’s

responsibility to communicate with the provider and with the patient about a

pain-control plan that works for both. By asking to hold off on the dose, the

patient is indicating that the dressing changes are extremely painful. The

regularly scheduled dose might not be as effective for the patient 2 hours later

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when the dressing change is scheduled.

Oral medications take 30 to 60 minutes to take effect. If the nurse began the

dressing change right then, the medication would not have been absorbed yet.

The patient has the right to refuse to take a medication.

21.A nurse receives an order from a health care provider to administer

hydrocodone and acetaminophen (Vicodin ES 7.5/750), to a patient who is

experiencing 8/10 postsurgical pain. The order is to give 2 tablets every 6

hours by mouth as needed for pain. What is the nurse’s next best action?

Give the Vicodin ES to the patient immediately because the patient is

a. experiencing severe pain.

Ask the health care provider for a nonsteroidal antiinflammatory drug

b. (NSAID) order.

Ask the health care provider to verify the dosage and frequency of the

c. medication.

Give the Vicodin ES in addition to playing soothing music for the

d. patient