A patient reports severe pain during intercourse since being sexually assaulted three years ago. What is the first step in confirming the diagnosis of a pain disorder?
a. Evaluating the patient's understanding of the emotional effects of the assault
b. Asking the patient to keep a journal of her feelings regarding the assault
c. Assessing the patient for posttraumatic stress disorder
d. Ruling out a physical cause of the pain
ANS: D
While psychological factors have an important role in the onset, severity, exacerbation, or maintenance of the pain, initially the presence of a physical cause of the pain must be ruled out. The assessment of the patient's understanding of the disorder or recording of feelings regarding the trauma are not priorities until a diagnosis of pain disorder is made. Posttrau-matic stress disorder is not generally characterized with reports of sustained pain.
You might also like to view...
If the coefficient alpha for a stress scale was computed to be .80, the scale would be which of the following?
A) More reliable than a scale with an alpha of .50 B) A valid indicator of stress C) Of indeterminate reliability until the scale's test–retest reliability was assessed D) Of unacceptably low reliability
The nurse would expect to assess which finding in a patient with allodynia?
A) A diminished response to pain B) A hypersensitive response to an innocuous stimulus such as light touch C) An increased sensitivity to thermal stimulation D) A decreased sensitivity to tactile stimulation
A client cries every time the client talks with the nurse about the situation at home. Which of the following actions of the nurse is characteristic of acceptance? The nurse:
A) Offers to tell the client's family how the client feels. B) Tells the client not to cry, but be strong. C) Offers to call the client's family for the client. D) Gives the client a tissue.
The nurse, providing patient care in an "open" ICU, would most likely be working with a:
1. Multidisciplinary team with physicians who are also responsible for patients on other units 2. Multidisciplinary team that includes a physician employed by the hospital 3. Physician in charge of patient care who is a specialist in critical care 4. Primary care physician who must consult a critical care specialist