CHPNA Pain and Symptom Management 1 — Questions and Answers
Question 1: Which pain scale uses faces to rate pain level and is commonly used with cognitively impaired patients?
- Numeric Rating Scale (NRS)
- Wong-Baker FACES Pain Scale (Correct answer)
- Visual Analog Scale (VAS)
- McGill Pain Questionnaire
Correct answer: Wong-Baker FACES Pain Scale
The Wong-Baker FACES Pain Scale uses facial expressions to help patients who cannot verbally rate their pain, making it useful for cognitively impaired or pediatric patients.
Question 2: What does 'breakthrough pain' mean in palliative care?
- Pain that occurs only at night
- A sudden flare of pain occurring despite baseline pain control (Correct answer)
- Pain caused by the medication itself
- Pain that requires surgical intervention
Correct answer: A sudden flare of pain occurring despite baseline pain control
Breakthrough pain is a transient, sudden flare of intense pain that occurs despite a patient being on a scheduled pain medication regimen.
Question 3: When should the nursing assistant report a change in a patient's pain level?
- Only at the end of the shift
- Only if the patient asks them to
- Immediately when a significant change is observed (Correct answer)
- Only when the family is present
Correct answer: Immediately when a significant change is observed
Any significant change in a patient's pain level should be reported to the supervising nurse immediately so appropriate interventions can be made.
Question 4: Which non-pharmacological comfort measure may help relieve pain in hospice patients?
- Prescribing stronger opioids
- Repositioning and gentle massage (Correct answer)
- Administering IV fluids
- Ordering laboratory tests
Correct answer: Repositioning and gentle massage
Non-pharmacological measures such as repositioning, gentle massage, heat/cold application, and relaxation techniques can help complement pain medication.
Question 5: Which of the following is a common sign of uncontrolled pain in a non-verbal patient?
- Relaxed facial muscles
- Slow, deep breathing
- Facial grimacing, moaning, or restlessness (Correct answer)
- Increased appetite
Correct answer: Facial grimacing, moaning, or restlessness
Non-verbal signs of pain include facial grimacing, furrowing of brows, moaning, guarding, and increased restlessness or agitation.
Question 6: Opioids used in hospice care are primarily prescribed to:
- Hasten death
- Sedate the patient permanently
- Relieve pain and dyspnea (Correct answer)
- Replace all other medications
Correct answer: Relieve pain and dyspnea
Opioids in hospice care are used to relieve pain and dyspnea (difficulty breathing), improving patient comfort and quality of life.
CHPNA Pain and Symptom Management 1
Which pain scale uses faces to rate pain level and is commonly used with cognitively impaired patients?