ABPANC ABPANC Pain Management & Comfort Care 1 — Questions and Answers
Question 1: Which pain assessment tool is most appropriate for a non-verbal PACU patient who cannot self-report pain?
- Numeric Rating Scale (NRS 0–10)
- Visual Analog Scale (VAS)
- Behavioral Pain Scale (BPS) or CPOT (Correct answer)
- Wong-Baker FACES scale
Correct answer: Behavioral Pain Scale (BPS) or CPOT
The Behavioral Pain Scale (BPS) and Critical Care Pain Observation Tool (CPOT) are validated for non-verbal or sedated patients who cannot self-report.
Question 2: A patient in PACU rates pain 8/10 and has received the maximum ordered IV opioid dose. What is the appropriate next nursing action?
- Reassess pain in 2 hours and document only
- Notify the anesthesia provider or surgeon to request additional analgesic orders (Correct answer)
- Administer an additional opioid dose beyond the ordered maximum
- Apply ice packs and reposition the patient as sole interventions
Correct answer: Notify the anesthesia provider or surgeon to request additional analgesic orders
When pain exceeds the available ordered analgesics, the provider must be contacted for additional orders to ensure adequate pain management.
Question 3: What is multimodal analgesia in the perioperative setting?
- Using the highest dose of a single opioid for maximum pain control
- Combining multiple analgesic agents and techniques targeting different pain pathways to reduce opioid use (Correct answer)
- Administering analgesics via multiple routes simultaneously without dose adjustment
- Providing pain relief exclusively through non-pharmacologic means
Correct answer: Combining multiple analgesic agents and techniques targeting different pain pathways to reduce opioid use
Multimodal analgesia combines agents such as NSAIDs, acetaminophen, local anesthetics, and opioids to achieve better pain control with lower opioid requirements.
Question 4: Which non-pharmacologic intervention is appropriate in the PACU to help manage post-operative pain?
- Encouraging ambulation immediately after all surgeries
- Positioning for comfort, applying ice to surgical sites as ordered, and providing distraction (Correct answer)
- Withholding all pharmacologic analgesics to assess true pain levels
- Placing the patient in complete isolation to reduce stimulation
Correct answer: Positioning for comfort, applying ice to surgical sites as ordered, and providing distraction
Non-pharmacologic measures including positioning, ice application, and distraction complement pharmacologic pain management in the PACU.
Question 5: Ketorolac (Toradol) is ordered for a post-operative patient in the PACU. Which patient finding is a contraindication to its administration?
- Mild post-operative nausea
- A history of peptic ulcer disease and current renal impairment (Correct answer)
- Pain rating of 5/10
- Post-operative temperature of 37.8°C
Correct answer: A history of peptic ulcer disease and current renal impairment
Ketorolac is an NSAID contraindicated in patients with peptic ulcer disease and renal impairment due to risks of GI bleeding and nephrotoxicity.
Question 6: What does PACU nursing documentation of pain management include?
- Only the final pain score at discharge
- Pain assessments, interventions, reassessments after interventions, and patient response (Correct answer)
- Surgical operative notes and anesthesia record only
- Pain scores without interventions documented
Correct answer: Pain assessments, interventions, reassessments after interventions, and patient response
Complete pain management documentation requires initial assessment, intervention given, reassessment timing, and patient's response to determine effectiveness.
ABPANC ABPANC Pain Management & Comfort Care 1
Which pain assessment tool is most appropriate for a non-verbal PACU patient who cannot self-report pain?