Reply To: CPHON Prep: “Question of the Day”

  • Rebecca Kolenik

    Member
    October 2, 2013 at 1:53 pm

    Question: The nurse assesses a child with neuropathy in the play room, and finds him playing a video game and talking with a friend.  When asked to rate his pain, the patient reports it is 8/10.  The nurse’s response should be to:

    1. Talk with the team about the patient’s drug seeking behaviors.
    2. Ask the patient if he is sure his pain is really an 8/10.
    3. Administer the analgesic ordered for mild pain right away.
    4. Administer the analgesic ordered for severe pain right away.

    Answer: D is the correct answer; a patient’s self-report is the most important factor in pain assessment.  This patient may be using distraction effectively and is therefore showing few outward signs of pain, but if he is reporting severe pain then the nurse must treat it as such.

     

    A is not correct, because pain is a largely subjective experience and patients with chronic pain often do not exhibit the same signs as patients suffering acute pain; the nurse may speak with the team if a trend or other signs of drug seeking are present, but the information in this question is not sufficient to lead us toward that conclusion.

    B is not correct, because the nurse should trust the patient’s first response; questioning the patient’s report of his pain will limit trust and harm the nurse-patient relationship.

    C is not correct, because 7/10 pain is considered severe, not mild, and the medication ordered for severe pain should be administered instead.

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    Rebecca Kolenik
    Clinical Nurse Specialist
    New York, NY
    United States
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    Original Message:
    Sent: 09-24-2013 04:37 PM
    From: Mary Lynn Rae
    Subject: CPHON Prep: “Question of the Day”

    Thanks so much Rebecca! 🙂

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    Mary Lynn Rae, RN, MSN, CPON
    Ann & Robert Lurie Children’s Hospital of Chicago
    Chicago, IL
    United States
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    Original Message:
    Sent: 09-24-2013 12:00 PM
    From: Rebecca Kolenik
    Subject: CPHON Prep: “Question of the Day”

    Good morning everyone,

    During the Town Hall for Nurse Educators at our APHON Conference this past weekend, I shared that I have been helping my nurses prepare for the CPHON exam by sending out a “CPHON Question of the Day” (in quotes because these emails are not truly sent daily, to avoid oversaturation).

    These brief emails, sent every Monday and Thursday, are meant to help nurses become familiar with the CPHON question format and to highlight areas that are less familiar or where the CPHON answer may differ from institution-specific practice.  Each email includes the question plus (much further down the page, so no one can peek) the answer and rationale.  Including the answer and rationale means nurses do not have to send their response back to me, removing any fear or embarrassment about potential wrong answers.  The nurses have reported that this is their favorite CPHON prep tool to date, because it doesn’t require scheduled time (like a review class) and is a non-threatening way to study (since no one sees their answer).

    As discussed on Saturday, this thread will be a place to share our “Questions of the Day” with each other – a sort of question bank.  I have quite a few questions written already and will post here regularly.  Contributions from any of you are more than welcome!

    Here’s a question to kick off the thread:

    Question: Fevers during the first three days following surgery are most often due to:

    1. Fluid shifts
    2. Paralytic ileus
    3. Atelectasis
    4. Wound infection

    Answer: C is the correct answer; atelectasis is a common post-operative complication related to airways becoming obstructed (usually by bronchial secretions) when the patient is not taking deep breaths and not fully expanding his/her lungs. Most cases are mild and resolve as the patient increases their activity, resulting in deeper breathing and increased lung expansion.

     

    A, B, and D are not correct answers, because these are not the most common cause of fever in the first three days after surgery.

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    Rebecca Kolenik
    Clinical Nurse Specialist
    New York, NY
    United States
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