Download Nursing Exam Questions and Answers: Pain Management, Mobility, and Sensory Issues and more Exams Nursing in PDF only on Docsity!
FPCC EXAM 3 2025/2026 /ACTUAL
420+Qs&As|LATEST UPDATE|A+GRADE
Transdermal, intradermal, subQ, into joints ANS:->> 4 routes that local and topical anesthesias can be administered through Change in heart rate, burning, itching, rash, decreased sensation ANS:-
5 side effects/precautions for local/topical anesthesia Massage, TENS, heat and cold, acupuncture ANS:->>4 types of cutaneous stimulation that are non- pharmacological interventions 6 ways to evaluate pain management - ANSWER- use a pain scale, reassess signs and symptoms of pain, vital signs, evaluate pain impact on physical and social function, evaluate family/friend's observations of patient pain, ASK how much or if pain prevents from ADLs - cutaneous ANS:->> this is superficial pain, arising from subQ tissue or skin (ex. paper cut, hot to touch) visceral ANS:->> this pain is caused by the stimulation of deep, internal pain receptors. Can be described as a tight pressure or cramping (ex. menstrual cramps, bowel disorders, labor pain, organ cancer) deep somatic ANS:->> this pain originates in ligaments, tendons, nerves, blood vessels, and bones. Localized and described as achy or tender. (ex. fracture, sprain, arthritis, bone cancer) psychogenic ANS:->> this pain is believed to originate from the mind; patient perceives pain despite no physical cause that can be identified. visceral, somatic ANS:->> two types of nociceptive pain are and.
neuropathic ANS:->>type of pain that is a complex and often chronic pain that arises when injury to one or more nerves results in repeated transmission of pain signals even in the absence of stimuli. acute ANS:->>which type of pain is protective- acute or chronic? whenever you take full set of vitals (routinely) ANS:->>when should pain be assessed on patient? patient self report ANS:->>what is the most reliable way to assess patient pain? mild, moderate or severe ANS:->>nonpharmacological interventions are good alternatives if experiencing pain, but should be used as complementary interventions if pain is or. heat ANS:->> promotes circulation, which speeds healing. contralateral stimulation ANS:->>stimulating skin in area opposite of the painful site localized, diffuse ANS:->>cutaneous stimulation is best for pain that is and not visual (watch TV), tactile (touch, stroking a pet), intellectual (puzzle), auditory (music therapy) ANS:->> 4 types of distraction that can use to help distract from pain guided imagery ANS:->>uses auditory and imaginary processes to affect emotions and help calm, divert, and relax. diaphragmatic ANS:->>what type of breathing promotes relaxation
restraints) ANS:->>3 categories to assess when assessing someone's mobility/immobility. sprain ANS:->>this is a torn ligament low, wide ANS:->>you want a patient with a center of gravity and a base of support flexibility, aerobic, resistance ANS:->> 3 types of exercise to encourage to your patients 1 - 1.5 ANS:->>daily protein intake should be - g/kg of body weight a day. high protein, high calorie, vitamins B and C ANS:->> 3 dietary implementations to encourage in an immobile patient to aid METABOLIC function chest physiotherapy, HOB up, hydrate (2500mL/day) ANS:->> 3 respiratory implementations to encourage in an immobile patient monitor color and amount of urine, acidify urine (cranberry juice), maintain positive fluid balance, assist to void on hourly rounds ANS:->>4 GU elimination implementations to encourage in an immobile patient clock in room, open shades during day, TV on, involve patient ANS:->> 4 psychosocial implementations to encourage in an immobile patient SCDs, 8 ANS:->>These are used to PREVENT venothrombic events, but not as a therapy; should change every hours.
demineralization ANS:->>the goal of musculoskeletal maintenance with immobile patients is reducing. hand splint ANS:->>these are used if patient gets hand contractures, but should NOT use a washcloth. xerostomia ANS:->>excessively dry mouth smoking, b12 and zinc deficiency ANS:->> 3 nutritional status indicators that can cause a loss of gustatory function anosmia ANS:->>sense of smell is lost yawning, sleepy, preoccupied with somatic complaints, decreased attention span, difficulty concentrating, problem solving, and remembering, hallucinations, tearful, irritable, depressed ANS:->>8 CMs of sensory deprivation fatigue, sleepless, irritable, anxiety, reduced ability to problem solve, scattered and racing thoughts, disoriented. ANS:->>7 CMs of sensory overload PICC, tunneled, nontunneled, implanted port ANS:->>4 types of Central Lines for central IV therapy antecubital ANS:->>where is a PICC line usually inserted into? antibiotic therapy, chemo, parenteral nutrition ANS:->>3 common uses for a PICC central line. sutured ANS:->>a non-tunneled catheter for central IV therapy is directly into the jugular, femoral, or subclavian and is into place. measuring central venous pressure (to assess blood volume) ANS:->>a
You will need at least two nurses for this procedure, more if the patient is large. Logrolling moves the patient's body as a unit. One nurse is positioned at the level of the patient's head. The other staff members are distributed along the length of the patient. Everyone must move the patient in unison. Trapeze bar ANS:->>Triangular- shaped device that is attached to an overhead bed frame. The patient can use the base of the triangle as a grip bar to move up in bed, turn, and pull up in preparation for getting out of bed or getting on & off the bed pan. Trochanter rolls ANS:->>made from tightly rolled towels, bath blankets, or foam pads. They are placed snuggly adjacent to the hips & thighs to prevent external rotation of the hips Transfer board ANS:->>a wood or plastic device designed to assist with moving patients.
1. Place the board under the patient on the side in which he/she will
be moved.
2. It is best to use a draw sheet to slide the patient across the board.
Also used by patients with long-standing mobility problems to increase their independence Mechanical lift ANS:->>hydraulic device used to transfer patients. Place a fabric sling under the patient & attach chains or straps from the sling to the lifting device.
- Especially useful when providing care for *obese & immobile patient
- Often seen in home care.
- Most position patients in a seated position, ideal for sitting them in a chair.
- Some have the patient supine, maybe to transfer patient from bed to stretcher, or have them lifted up while we make their bed. Transfer belt ANS:->>a heavy belt several inches wide that is used to facilitate transfer or provide a secure mechanism to hold the patient when ambulating
- Apply belt around patient's abdomen, close to their center of gravity.
- The belt may have external grip holds, or you may grip the entire belt with your hand. Active range of motion (AROM) ANS:->>actively moving own extremity through ROM like extension, flexion. Want to encourage & teach clients to keep moving. Passive range of motion (PROM) ANS:->>movements of the joints through their range of motion by another person
- support above & below the joint
- take joint to point where pt starts to feel resistance
- avoid pain. if pt feels pain, stop
- slow & gentle movements
- pts can perform by themselves. pt should be taught to promote independence/control Continuous passive motion (CPM) ANS:->>device that repetitively but gently flexes & extends the knee joint the CPM machine is often used after knee replacement or other knee procedures to allow the joint to improve range of motion, eliminate problem of
Creates pressure on the lower scapula, ilium, and trochanter but relieves pressure from the heals and sacrum. Lateral recumbent position ANS:->>side-lying with legs in a straight line Oblique position ANS:->>patient is on side with the top hip & knee flexed, however the top leg is behind the body. Places less pressure on the trochanter than the lateral position. Prone position ANS:->>patient lies on the abdomen with his head turned to one side.
- Only position that allows full extension of the hips & knees.
- Also, allows secretions to drain freely from the mouth. What are the dangers of the prone position? ANS:->>- Most difficult to move a frail or unconscious patient to this position, because it requires the greatest amount of manipulation to position the patient appropriately.
- Creates lordosis (inward curving of the spine/back) and rotation of the neck, so this is not good for patients with cervical or spine problems.
- Inhibits chest wall expansion so not good for patients with cardiac or respiratory difficulty. Only use for short periods of time. Sim's position ANS:->>semi-prone position
- Lower arm is positioned behind the patient and the upper arm is flexed.
- The upper leg is more flexed than the lower leg.
- This facilitates drainage from the mouth and limits pressure on the trochanter and sacrum. Sim's position is ideal for ANS:->>enemas or a perineal procedure. Supine position ANS:->>dorsal recumbent position.
5. Place the transfer board against the patients back halfway between the
bed and the stretcher. Position a friction-reducing device over the transfer board. Turn the patient to his back and onto the transfer board with draw sheet.
6. On a count of three, use the draw sheet to slide the patient across the
transfer board onto the stretcher Technique for transferring the patient: bed to chair (9) ANS:->>1. Place nonskid footwear on the patient.
2. Place the bed low & locked with the head of the bed up.
3. Assist the patient to dangle at the bedside
4. Brace your feet & knees against the patient, bend your hips at the knees,
and hold onto the transfer belt.
5. If there are two nurses, have one on each side of the patient.
6. Instruct the patient to place their arms around you between your
shoulders and waist. Ask the patient to stand as you move to an upright position by straightening your legs & hips.
7. Instruct the patient to pivot & turn with you toward the chair.
8. Ask the patient to flex his/her hips & knees as he/she lowers him/herself
into the chair. Guide the motion while maintaining a firm hold on him/her
9. If it is a wheel chair, lock the wheels
Technique for ambulating the patient (11) ANS:->>1. Place nonskid footwear on the patient.
2. Place the bed low & locked with the head of the bed up.
3. Assist the patient to dangle at the bedside
4. Brace your feet & knees against the patient, bend your hips at the knees,
and hold onto the transfer belt.
5. If there are two nurses, have one on each side of the patient.
6. Instruct the patient to place their arms around you between your
shoulders and waist. Ask the patient to stand as you move to an upright position by straightening your legs & hips.
7. Allow patient time to steady themselves.
8. One nurse: stand at the patient's side, placing both hands on the transfer
belt, stand on weaker side.
9. Two nurses: one nurse stands on each of the patient's sides,
grasping hold on the transfer belt.
10. *Slowly guide the patient forward, observe for signs of dizziness or
fatigue.*
11. Have a goal or outcome to how far you want the patient to walk.
Single ended cane with a half circle handle is used for a patient who ANS:-
needs minimal support and is able to negotiate stairs.
Single ended cane with a straight handle is used for patients with ANS:-
hand weakness with good balance.
Up with the good & down with the bad.
- When leaning on the crutch, they are at risk for damaging their nerves & cutting off their circulation in their arms. Restraints are a resort ANS:->>LAST Use restraints to ANS:->>1. reduce fall risk
2. prevent interruption of therapy
3. maintain life support
4. reduce risk to others
DO NOT use restraints just because it's easier for the nurse. 2 types of restraints ANS:->>1. physical
- chemical Physical restraints ANS:->>ANY manual method, physical or mechanical device, material, or equipment that immobilizes or reduces the ability of a patient to move his or her arms, legs, body, or head freely. Chemical restraints ANS:->>medications that are used to restraint (sedates or calms anxiety)
Restraints are a intervention ANS:->>dependent needs to happen face to face. provider must come & look at the patient How often should an order for restraints be renewed? ANS:->>order should never last more than 24 hrs. when you hit that mark, the patient needs to be reassessed by the provider Never accept an order for restraints ANS:->>PRN (as necessary) Alternatives used to maintain a restraint-free environment (8) ANS:->>1. treat the cause
2. distraction
3. relaxation techniques
4. physical activity
5. frequent assessment
6. anticipate needs
7. modify the environment
8. provide consistency
Assessment of the restrained patient ANS:->>1. reassess- constantly reassess that the behavior that triggered the need for the restraint is still there. Remove restraints if the need is gone.
- Neurovascular assessment-
How many fingers should you be able to get under a restraint? ANS:->> 1 - 2 fingers to keep it from restricting circulation Documentation for a restrained client ANS:->>1. all nursing interventions that were done to eliminate the need for restraints
2. reason for placing the restraint
3. the initial restraint placement, location, circulation, & skin integrity
4. the teaching session with the patient & family members
5. circulation checks, & restraint removal per agency protocol.
6. entries on fall risk assessment sheet, restraint flowsheet, and
nursing notes according to agency policy Culture & sensory function ANS:->>people of different cultural backgrounds tend to prefer differing amounts of eye contact, personal space, & physical touch Illness & sensory function ANS:->>1. neurological disorders such as MS slow the transmission of nerve impulses
2. diseases that affect circulation may impair function of the sensory
receptors and the brain, altering perception & response.
3. reduced or lack of oxygen harms & even destroys cells, causing
widespread damage to the neurological system Medications & sensory function ANS:->>medications that cross the blood brain barrier affect neurologic or sensory function by damaging or killing brain cells Stress & sensory function ANS:->>stress can cause too much stimulation. stressors may lead to stimulation overload-- more stimuli than the person can handle
Personality/lifestyle & sensory function ANS:->>clients are at risk for sensory alterations if their previous level of stimuli does not match their current level Kinesthesia ANS:->>muscle sense. a complex process involving proprioceptors that detect stretch in muscles to create a mental picture of how the body is positioned Stuporous ANS:->>requires vigorous stimulation before responding Obtunded ANS:->>dull the sensitivity of Myopia ANS:->>nearsightedness, means that the patient is able to see close objects well but not distant objects Presbyopia ANS:->>a change in vision associated with aging. the lens becomes less elastic & less able to accommodate to near objects Glaucoma ANS:->>vision loss caused by increased pressure in the anterior cavity of the eyeball that distorts the shape of the cornea & shifts the position of the lens, resulting in loss of peripheral vision Macular degeneration ANS:->>loss of central vision due to damage to the central portion of the retina Vision assessment ANS:->>1. age- around 40 can assume near vision will diminish
2. medical history- diabetes affects vision, ask for recent changes
3. assistive devices- glasses or contacts
4. ability to perform self-care- can the pt read expiration dates?
