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A patient who uses a fentanyl ( Duragesic ) patch for chronic cancer pain complains to the nurse of the rapid onset of pain at a level 9 ( 0 to 10 scale ) and requests "something for pain that will work quickly." The nurse will document this as


A) somatic pain.
B) referred pain.
C) neuropathic pain.
D) breakthrough pain.

E) B) and C)
F) A) and B)

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The nurse is caring for a diabetic patient who has chronic burning leg pain even when taking oxycodone (OxyContin) twice daily. Which of these prescribed medications is the best choice for the nurse to administer as an adjuvant to decrease the patient's pain?


A) aspirin (Ecotrin)
B) celecoxib (Celebrex)
C) amitriptyline (Elavil)
D) acetaminophen (Tylenol)

E) A) and C)
F) B) and C)

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A patient with chronic cancer pain is receiving imipramine (Tofranil) in addition to long-acting morphine for pain control. Which information is the best indicator that the imipramine is effective?


A) The patient sleeps 8 hours every night.
B) The patient has no symptoms of anxiety.
C) The patient states, "I feel much less depressed since I've been taking the imipramine."
D) The patient states, "The pain is manageable, and I can accomplish my desired activities.

E) A) and C)
F) A) and B)

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