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Medical Surgical Nursing NCLEX type model question paper part 6
1.The nurse is caring for a patient who is a devout
Orthodox Jew. The patient is on a patient-controlled analgesia (PCA) pump. What
accommodations might the nurse have to make to conform to the patient’s
cultural needs?
a. Ask the patient whether he will need alternative forms
of medication for the Sabbath.
b. Ask the patient specific questions because Jews
tend to be stoic regarding pain.
c. Medicate the patient “around the clock” instead of
as needed (“prn”).
d. Understand that Jews believe that suffering is a
consequence of actions in a previous life.
Ans A
Orthodox or Observant Jews may not use electrical
equipment during the Sabbath and on Holy Days; therefore, the staff should
program the PCA to achieve optimum pain relief. Alternative methods will be
needed during these times. Cultures vary regarding when to recognize pain, what
words to use in expressing pain, when to seek treatment, and what treatments
are desirable. Russians, Asians, and Native Americans tend to be stoic, whereas
Italians, Puerto Ricans, and Jews tend to be more expressive. The nurse should
ask the patient about his preferences. Some Hindu patients believe that
suffering is a consequence of actions in a previous life. For example, a belief
in the concept of Karma motivates the patient to bear the pain, refuse pain
medications, and suffer in silence. Some Jews view pain as a communal suffering
that they should share with others to affirm their life experience.
2. The patient is admitted with chronic pain. She
states that nothing takes the pain away totally, but that “Dilaudid works
best.” The fact that the patient calls the medication by name should alert the
nurse to:
a. suspect that the patient is drug seeking.
b. expect that the patient may need smaller doses than
normal.
c. assess the patient’s acceptable level of comfort.
d. accept the fact that nothing will help this
patient’s pain.
ANS: C
It is important to assess the patient’s acceptable
level of comfort so that both you and the patient are striving for the same
outcome. Some patients with prior pain conditions can alert the nurse to
pain-relieving measures that were successful. Patients with chronic/persistent
pain are often familiar with the names and actions of medications, including
opioid medications. This should not cause you to view the patient negatively or
with suspicion. Patients currently receiving opioids for chronic pain often
require higher doses of analgesics to alleviate new pain. Do not accept that
“there is nothing that will help this patient’s pain.” Learn the institutional
policy for how to proceed in this situation.
3. The nurse frequently must assess a patient who is
experiencing pain. When assessing the intensity of the pain, the nurse should:
a. ask whether there are any precipitating factors.
B. question the patient about the location of the
pain.
c. offer the patient a pain scale to objectify the
information.
d. use open-ended questions to find out about the
sensation.
ANS: C
Descriptive scales are an objective means of measuring
pain intensity. Use a pain intensity scale appropriate to the patient’s age,
developmental level, and comprehension, and ask the patient to rate the pain.
An appropriate pain rating scale is reliable, easily understood, and easy to
use, and it reflects changes in pain intensity. Asking the patient what
precipitates the pain does not assess intensity, but rather assesses the pain
pattern. Asking the patient about the location of pain does not assess the
intensity of the patient’s pain. To determine the quality of the patient’s pain,
the nurse may ask open-ended questions to find out about the sensation
experienced (e.g., “Tell me what your pain feels like”). This approach assists
in identifying the underlying pain mechanism (e.g., somatic or neuropathic
pain), but it may not reveal intensity or changes in intensity.
4. The nurse who is caring for a patient
postoperatively notes that he is expressing discomfort and is diaphoretic.
Which of the following interventions is most appropriate?
a. Straighten the bed linens.
b. Change the saturated surgical dressing.
c. Administer prescribed pain medications.
d. Check for displaced equipment underneath the
patient.
ANS: C
Administer pain-relieving medications as ordered.
Analgesics are the cornerstone of pain management. Smoothing wrinkles in bed
linens may reduce pressure and irritation to the skin; however, pain-relieving
medication should be given first. Changing a wet surgical dressing might not be
needed if the patient has received a wet-to-dry dressing as treatment, or if
not changing the dressing will reduce irritation to the skin but will not
address the discomfort. Reposition underlying tubes, wires, or equipment that
may apply pressure directly to dependent skin surfaces. Removing these stimuli
may maximize the response to pain-relieving interventions such as medication,
but pain-relieving medication should be administered first.
5. The patient’s family is concerned that the patient
may get too much pain medication after surgery and become addicted to the
medication if he is placed on a PCA pump. They also voice concern about the
effectiveness of the PCA. The nurse should instruct the family and the patient
that:
a. pain relief with the PCA pump is not as good as
when the nurse provides it, but it does save on nursing time.
b. pain relief is good when the medication peaks, but
less so when the levels drop, and that is when the patient will know that he
needs more.
c. because the device provides medication as soon as
the patient needs it, he will probably use less of the medication.
d. the patient will be kept in bed for several days
after surgery to make sure it is safe to ambulate.
ANS: C
Because the device provides medication on demand as
soon as the patient feels the need, the total amount of opioid use is reduced.
Because the blood level stays within a narrow range of the minimum effective
analgesia concentration for the individual, pain relief is enhanced, and the
incidence of side effects, such as sedation and respiratory depression, is
decreased. The PCA has several advantages. It allows more constant serum levels
of the opioid and, as a result, avoids the peaks and troughs of a large bolus.
An advantage of PCA is that when used postoperatively, fewer complications
arise because earlier and easier ambulation occurs as a result of effective
pain relief.
6. The nurse caring for a patient who has a PCA knows
that it:
a. allows the family to participate in pain management
for the patient.
b. prevents mistakes in medication administration.
c. can be used by all hospitalized patients.
d. provides a more constant level of medication.
ANS: D
PCA allows more constant serum levels of the opioid,
and, as a result, it avoids the peaks and troughs of a large bolus. Because the
blood level is maintained within a narrow range of the minimum effective
analgesia concentration for the individual, pain relief is enhanced, and the
incidence of side effects, such as sedation and respiratory depression, is
decreased. Potential concerns involving PCA use are pump failure, and operator
errors. Patients may misunderstand how PCA therapy works, may mistake the PCA
button for the nurse call button, or may have family members who operate the
demand button. Instruct the family not to push the timing device for the
patient unless the patient is unable to push the button himself, and the nurse
has instructed the family to do so. Use of a PCA pump does not prevent
mistakes. The pump may fail to deliver drug on demand, may have a faulty alarm
or a low battery, or may lack free-flow protection. Operators may incorrectly program
the dose, concentration, or rate. Not all patients are candidates for PCA.
Assess the patient’s cognitive ability to determine the appropriateness of PCA
pain management.
7. When evaluating the effects of PCA, the nurse notes
that the patient is sedated and is difficult to arouse. What step should the
nurse take next?
a. Insert an airway.
b. Turn patient to the side.
c. Stop the PCA.
d. Expect this as a patient outcome of the therapy.
ANS: C
If the patient is sedated and is not readily
arousable, stop the PCA. As long as the patient has spontaneous respirations,
instruct him or her to take deep breaths. Apply oxygen at 2 L via nasal
cannula. Elevate the head of the bed 30 degrees, unless contraindicated, to
facilitate respirations. Heavy sedation is not an expected outcome of PCA
therapy. Evaluate for the presence of analgesic side effects. Maintain a
slightly drowsy, easily aroused patient.
8. The patient is scheduled for surgery late in the
afternoon. His postoperative orders include PCA therapy. Which of the following
nursing interventions is appropriate to perform?
a. Teach the patient about PCA after the patient comes
out of recovery.
b. Teach the patient about PCA before surgery and
before preoperative medication administration.
c. Tell the patient not to use PCA unless he can no
longer tolerate the pain.
d. Inform the patient’s family to watch him carefully
and to depress the PCA administration button whenever they think he needs it.
ANS: B
Instruct surgical patients preoperatively. Encourage the
patient to push the button on the timing unit whenever he feels pain. Tell the
patient not to delay if he is experiencing pain. Pain is easier to prevent than
to treat. Inform the patient and family that the patient cannot overdose with
PCA if only the patient pushes the button. The family should not push the
button unless instructed to do so by the nurse.
9. The nurse knows that an advantage of intraspinal
analgesia is the:
a. smaller doses of epidural than intrathecal
medication.
b. lack of significant patient complications.
c. systemic distribution of morphine faster than
fentanyl.
d. ability to achieve appropriate analgesia with
smaller dosages.
ANS: D
Because opioids are delivered close to their site of
action, the central nervous system (CNS), they have greater bioavailability and
thus require much smaller doses to achieve adequate pain relief. Epidural and
intrathecal doses are not equivalent. Intrathecal doses are much smaller than
epidural doses. As an example, the epidural dose of morphine is 10 to 20 times
greater than that required for an intrathecal dose. The catheter poses a threat
to patient safety because of its anatomical location, its potential for
migration through the dura, and its proximity to spinal nerves and vessels.
Migration of an epidural catheter into the subarachnoid space can produce
medication levels too high for intrathecal use. Fentanyl and sufentanil are
hydrolipid, which causes them to have a quicker onset and a shorter duration of
action (2 hours). Morphine and hydromorphone are hydrophilic, resulting in a
longer onset and a longer duration of action (up to 24 hours with a single
bolus dose).
10. The patient is in the hospital undergoing major
abdominal surgery. When the patient returns from the recovery room, the nurse
expects that he most likely will be receiving pain medication:
a. by mouth.
b. intramuscularly.
c. via the epidural route.
d. intravenously.
ANS: C
Research shows the epidural route to be most effective
in managing postoperative pain from thoracic and abdominal surgeries.
11. While reviewing a patient’s medication history,
the nurse determines that intraspinal analgesia is contraindicated as a result
of:
a. previous spinal anesthesia.
b. recent administration of anticoagulants.
c. a history of cardiac problems.
d. a diagnosis of advanced cancer.
ANS: B
Recent anticoagulants sometimes contraindicate the
placement of an epidural catheter because of the risk for epidural hematoma at
the insertion site. Certain conditions may make epidural analgesia the method
of choice for pain control: following surgery, for patients with trauma or
advanced cancer that is not responsive to other pain management modalities, and
those predisposed to cardiopulmonary complications because of a preexisting
medical condition or surgery. Previous spinal anesthesia is not a
contraindication for receiving subsequent spinal anesthesia.
12. A nurse checks the continuous IV infusion for the intraspinal
analgesia. The IV setup should be changed if:
a. tubing with a Y-port is attached.
b. an infusion pump is attached.
c. the tubing connections are all taped.
d. a diluted, preservative-free medication is used.
ANS: A
Use tubing without Y-ports for continuous infusions.
Use of tubing without Y-ports prevents accidental injection or infusion of
another medication meant for vascular space into epidural space. Normal
equipment used for intraspinal infusion includes an infusion pump and
compatible tubing without Y-ports. Catheter and injection cap or infusion pump
tubing should be securely taped and labeled. Closed, intact systems prevent
entry of pathogens and disruption of the flow of medication. Medication should
be prediluted, preservative-free opioid or local anesthetic as prescribed by
the physician and prepared for use in an IV infusion pump (usually prepared by
pharmacy). Preservatives may be toxic to nerve tissue.
13. Before administering an epidural medication, the
nurse aspirates and suspects that the catheter has migrated into the
subarachnoid space when:
a. clear drainage is noted.
b. no drainage is noted.
c. purulent drainage is noted.
d. redness, warmth, and edema are noted.
ANS: A
Aspiration of more than 1 mL of clear fluid or bloody
return means that the catheter may have migrated into the subarachnoid space or
into a vessel. Do not inject the drug. Notify the physician. Purulent drainage
is a sign of infection, indicating that local inflammation and superficial skin
infection at the insertion site have occurred.
14. The nurse is preparing to administer a bolus of
epidural medication. The nurse must remember to:
a. clean the injection cap of the epidural catheter
with an anti-infective according to agency policy.
b. clean the injection cap of the epidural catheter
with alcohol.
c. inject opioids quickly and smoothly.
d. flush with saline after the injection.
ANS: A
Clean the injection cap of the epidural catheter with
povidone-iodine, or substitute anti-infective according to agency policy.
Alcohol causes pain and is toxic to neural tissue. Inject opioid at a rate of 1
mL over 30 seconds. Slow injection prevents discomfort by lowering the pressure
exerted by fluid as it enters the epidural space. The catheter is in a space,
not a blood vessel; thus flushing with saline is not required.
15. A nurse is evaluating the epidural catheter
insertion site and suspects that the intraspinal catheter has punctured the
dura when _____ noted.
a. clear drainage is
b. bloody drainage is
c. purulent drainage is
d. redness, warmth, and swelling are
ANS: A
Clear drainage may indicate puncture of the dura.
Bloody drainage may indicate that the catheter has entered the blood vessel.
Purulent drainage is a sign of infection. Redness, warmth, and swelling are
signs of inflammation. Local inflammation and superficial skin infection can
occur at the insertion site.
16. When assessing a local infusion pump site, the
nurse notes that which of the following requires an intervention?
a. The device is labeled, indicating that an
anesthetic is being used.
b. The catheter connections are loose.
c. Surgical dressings are dry and intact.
d. No blood backup is present in the tubing.
ANS: B
Assess the catheter connections; all should be firmly
attached. If connections become detached, do not reattach because infection
could occur. Notify the physician. The label on the device provides information
regarding type of anesthetic, concentration, volume, flow rate, date and time
prepared, and the name of the person who prepared it. The nurse should read
this label. The dressing should be dry and intact. If not, stop the infusion
and notify the physician. The catheter may not be placed properly. Assess for
blood backing up in the tubing. If blood is present, stop the infusion and
notify the physician. This indicates possible displacement of the catheter into
a blood vessel.
17. The patient had knee replacement surgery and has a
local infusion pump to provide a local anesthetic to the surgical site. The
patient puts on the call light and complains that pain at the site is more
intense than it has ever been and is getting worse. The nurse checks the site
and finds that the dressing is damp but intact. The infusion pump is pumping,
and there is medication in the bag. The most probable cause of the problem
might be the:
a. catheter may be clogged.
b. pump may be releasing too much drug into the site.
c. catheter may be displaced.
d. patient may be exaggerating the pain.
ANS: C
Assess the surgical dressing and the site of catheter
insertion. The dressing should be dry and intact. Determine whether the
catheter is properly placed. If the catheter is clogged, infusion of medication
will stop. Pain levels will increase but the dressing will be dry, and the pump
should alarm. If the pump is releasing too much medication, the nurse should
expect to see symptoms of local anesthetic adverse reaction. It is not the
patient’s responsibility to convince the nurse that he has pain; it is the
nurse’s responsibility to believe the patient.
18. A nonpharmacological approach that the nurse may
implement for patients who are experiencing pain that focuses on diverting the
patient’s attention away from the pain sensation by promoting pleasurable and
meaningful stimuli is:
a. massage.
b. heat/cold.
c. guided imagery.
d. distraction.
ANS: D
Distraction is a technique that diverts an
individual’s attention away from the pain sensation. By introducing meaningful
stimuli, the nurse helps the patient refocus attention. Distraction directs a
patient’s attention to something else and thus can reduce awareness of pain and
even increase tolerance. A proper massage not only blocks the perception of
pain impulses but also helps relax muscle tension and spasm that otherwise
might increase pain. Massage hastens the elimination of wastes stored in
muscles, improves oxygenation of tissues, and stimulates the relaxation
response in the nervous system. Heat produces vasodilation, reduced blood viscosity,
reduced muscle tension, and increased tissue metabolism. Heat helps relieve
muscle spasms and joint stiffness. Cold produces vasoconstriction, reduced cell
metabolism, and increased blood viscosity. Cold is effective for inflamed
joints and muscles. The goal of imagery is to have the patient use one or
several of the senses to create an image of the desired result. This image
creates a positive psychophysiological response. Guided imagery can be used as
a distraction technique.
19. The patient is unable to rest even after pain
medication has been administered. The nurse decides to give the patient a
backrub. Which of the following strokes should the nurse use when finishing the
backrub?
a. Long firm stroking movements down the back
b. Light strokes while moving up the back in a
circular motion
c. Kneading movements toward the sacrum
d. Circular motion upward from buttocks to shoulders
ANS: A
The nurse should end the backrub with long firm
strokes down the back. This is the most soothing of massage movements. The
backrub is not finished with light strokes while moving up the back in a
circular motion. Kneading movements toward the sacrum are done before the
backrub is ended with long firm strokes down the back. The nurse should begin a
backrub by massaging in a circular motion upward from buttocks to shoulders.
20. The patient is admitted for chronic pain. He
states that morphine sulfate (Morphine) has been used to relieve his pain, but
recently he has been needing to use more of the medication to relieve pain.
This patient’s plan of care will have to incorporate interventions to deal with
which of the following?
a. Addiction
b. Pseudoaddiction
c. Drug tolerance
d. Physical dependence
ANS: C
Drug tolerance is defined as a state of adaptation in
which exposure to a drug induces changes that result in diminution of one or
more of the drug’s effects over time. Addiction is defined as a primary,
chronic, neurobiological disease with genetic, psychosocial, and environmental
factors that influence its development and manifestations. It is characterized
by behaviors that include one or more of the following: impaired control over
drug use, compulsive use, continued use despite harm, and craving.
Pseudoaddiction is a term that describes patient behavior that may occur when
pain is undertreated. Patients with unrelieved pain may focus on obtaining
medications, may “clock watch,” or otherwise may seem inappropriately “drug
seeking.” Even such behaviors as illicit drug use and deception can occur in
the patient’s efforts to obtain relief. Pseudoaddiction can be distinguished
from true addiction in that behaviors resolve when pain is effectively treated.
Physical dependence is a state of adaptation that often includes tolerance and
is manifested by a drug class–specific withdrawal syndrome that can be produced
by abrupt cessation, rapid dose reduction, decreased blood level of the drug,
and/or administration of an antagonist.
21. Which of the following patient conditions is
categorized as a neurobiological disease?
a. Physical dependence
b. Addiction
c. Pseudoaddiction
d. Drug tolerance
ANS: B
Addiction is defined as a primary, chronic,
neurobiological disease with genetic, psychosocial, and environmental factors
that influence its development and manifestations. It is characterized by
behaviors that include one or more of the following: impaired control over drug
use, compulsive use, continued use despite harm, and craving. Physical
dependence is a state of adaptation that often includes tolerance and is
manifested by a drug class–specific withdrawal syndrome that can be produced by
abrupt cessation, rapid dose reduction, decreased blood level of the drug,
and/or administration of an antagonist. Pseudoaddiction is a term that
describes patient behavior that may occur when pain is undertreated. Patients
with unrelieved pain may focus on obtaining medications, may “clock watch,” or
otherwise may seem inappropriately “drug seeking.” Even such behaviors as
illicit drug use and deception can occur in the patient’s efforts to obtain
relief. Pseudoaddiction can be distinguished from true addiction in that
behaviors resolve when pain is effectively treated. Drug tolerance is defined
as a state of adaptation in which exposure to a drug induces changes that
result in diminution of one or more of the drug’s effects over time.
22. Which of the following statements about evaluating
patients in pain is true?
a. The best judge of the existence of pain is the
nurse.
b. Visible signs always accompany pain.
c. Patients often are hesitant to report pain.
d. Nonpharmacological interventions are better than
pain medications.
ANS: C
Patients often are hesitant to report pain for fear of
being labeled as complainers, hypochondriacs, or addicts. The patient’s
self-report is the most reliable indicator of the existence and intensity of
pain. Even with severe pain, periods of physiological and behavioral adaptation
occur, leading to periods of minimal or no observable signs of pain. Lack of
pain expression does not necessarily mean lack of pain. Nonpharmacological
interventions are synergistic with medications, but are not a substitute for
pharmacological management of pain.
23. Which of the following are characteristics of
cancer pain? (Select all that apply.)
a. It may be acute.
b. It may be chronic.
c. It usually is related to tumor recurrence or
treatment.
d. It often is of less intensity than the patient
reports.
ANS: A, B, C
Cancer pain may be acute, chronic, or intermittent,
and it usually is related to tumor recurrence or treatment. The patient is the
only one who knows whether pain is present and what the experience is like. It
is not the patient’s responsibility to convince the nurse that he has pain; it
is the nurse’s responsibility to believe the patient.
24. The patient has morphine sulfate ordered for pain
every 4 hours “prn.” The patient complains of severe pain and usually requests
more morphine an hour before it is due. The nurse should: (Select all that
apply.)
a. Request a “placebo order” from the physician.
b. Offer the patient medication “around the clock”
instead of “prn”.
c. Offer the patient massage between medication doses.
d. Offer the patient a nonopioid medication between
morphine doses if ordered.
ANS: B, C, D
Some patients exhibit drug-seeking behaviors when in
fact they are seeking pain relief. Occasionally, a physician will order a
placebo to discredit a patient’s report of pain. This is unethical and should
be avoided. Timely administration before a patient’s pain becomes severe is
crucial to ensure optimal relief. Pain is easier to prevent than to treat. In
most circumstances, administration of pharmacological agents “around-the-clock”
rather than on an “as-needed” (prn) basis is preferable. Often a combination of
nonopioids and opioids is effective in managing pain. Using an integrated
approach that considers both pharmacological and nonpharmacological therapies
in managing pain is recommended.
25. The patient voices concern to the nurse regarding
his PCA pump. He states that he is afraid of getting an overdose if he pushes
the button too many times. The nurse reassures the patient that: (Select all
that apply.)
a. there is a time delay (lockout) between patient
doses.
b. there is a maximum dose the patient can receive.
c. the patient has a right to be concerned and needs to
be careful.
d. the patient could be put on a continuous infusion
instead, because it is safer.
ANS: A, B
PCA prevents overdosing by interposing a preprogrammed
delay time or “lockout” (usually 6 to 16 minutes) between patient-initiated
doses. In addition, the prescriber may limit the total amount of opioid that
the patient may receive in 1 to 4 hours (Pasero, 1999). Use basal (continuous)
infusions cautiously because studies have not shown superior analgesic benefit.
Continuous infusion increases the risk for opioid overdose.
26. The patient states that the PCA is not controlling
his pain. The nurse checks the infusion setup and IV site and then evaluates
the patient’s ability to use the system. All looks in order. The nurse should
notify the physician to: (Select all that apply.)
a. report suspected drug-seeking behavior.
b. possibly change the drug being used.
c. adjust the dosage of the drug being used.
d. request placebo medication to evaluate true pain.
ANS: B, C
Instruct the patient to check with the nurse or
physician with questions and concerns, or if medication is not controlling the
pain. The drug may have to be changed, or the dosage may need to be adjusted.
27. Drugs administered in the epidural space spread
by: (Select all that apply.)
a. diffusion through the dura mater.
b. transport through blood vessels.
c. absorption by fat.
d. absorption through muscle.
ANS: A, B, C
A drug administered in the epidural space spreads (1)
by diffusion through the dura mater into the cerebrospinal fluid (CSF), where
it acts directly on receptors in the dorsal horn of the spinal cord; (2) via
blood vessels in the epidural space for systemic delivery; and/or (3) by means
of absorption by fat in the epidural space, creating a depot where the drug is
released slowly into the systemic circulation.
28. Pain is experienced differently by different
people, because pain perception is based on which of the following? (Select all
that apply.)
a. Past pain experiences
b. Personal values
c. Cultural expectations
d. Emotions
ANS: A, B, C, D
Because higher centers in the brain influence
perception greatly, the pain experience is a product of a person’s past pain
experiences, values, cultural expectations, and emotions.
29. ___________ has an identifiable cause and rapid
onset and generally disappears with healing.
ANS: Acute pain
Acute pain or transient pain has an identifiable
cause, has a rapid onset, varies in intensity, is of short duration, and
generally disappears with healing.
30. Pain that extends beyond the period of healing and
often lacks an identified pathology is known as _______________.
ANS: chronic pain
Chronic pain or persistent pain extends beyond the
period of healing, often lacks identified pathology, rarely has autonomic
signs, does not provide a protective function, disrupts sleep and activities of
daily living, degrades the health and function of an individual, and may be
cancer or noncancer/nonmalignant in origin.
31. ________________ is a method of preventing pain
while reducing overall opioid use.
ANS: Preemptive analgesia
Preemptive analgesia is a method of preventing pain
while reducing overall opioid use.
32. __________________ is an interactive method of
pain management that permits patient control over pain through
self-administration of analgesics.
ANS:Patient-controlled analgesia (PCA)
Patient-controlled analgesia (PCA) is an interactive
method of pain management that permits patient control over pain through
self-administration of analgesics.
33. The _______________ is a potential space between
the vertebral bones and the dura mater, the outermost meninges covering the
brain and spinal cord.
ANS: epidural space
The epidural space is a potential space between the
vertebral bones and the dura mater, the outermost meninges covering the brain
and spinal cord.
34. Catheter migration into the______________ can
produce dangerously high medication levels. Only physicians and nurse
anesthetists administer drugs in this space
ANS: subarachnoid space
Only physicians and nurse anesthetists administer
spinal drugs due to the increased risk associated with them.
35. The application of touch and movement to muscles,
tendons, and ligaments without manipulation of the joints is called
_________________.
ANS: massage
A gentle massage, a form of cutaneous stimulation, is
the application of touch and movement to muscles, tendons, and ligaments
without manipulation of the joints.
36. ________________ draws on internal experiences of
memories, dreams, fantasies, and visions; explores the inner world of
experience; protects the privacy of the patient; and fosters the imagination.
ANS: Guided imagery
Guided imagery is a creative sensory experience that
effectively reduces pain perception and minimizes reaction to pain. It draws on
internal experiences of memories, dreams, fantasies, and visions; explores the
inner world of experience; protects the privacy of the patient; and fosters the
imagination. The goal of imagery is to have the patient use one or several of
the senses to create an image of a desired result.
37. Massaging upward and outward from the vertebral
column and back again is known as __________________.
ANS: effleurage
Effleurage is massaging upward and outward from the
vertebral column and back again. Gliding strokes, used without manipulation of
deep muscles, smooth and extend muscles, increase nutrient absorption, and
improve lymphatic and venous circulation.
38. _______________________ is a massage technique
used on tense muscles to “knead” muscles, promote relaxation, and stimulate local
circulation.
ANS: Pétrissage
Pétrissage is used on tense muscle groups to “knead”
muscles, promote relaxation, and stimulate local circulation.
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