Deck 15: Pain, Temperature Regulation, Sleep, and Sensory Function

Question 1

Individuals who recover from heat exhaustion may have permanent damage to the thermoregulatory center.

Answer 1

False

Question 2

Depression frequently accompanies acute pain experiences.

Answer 2

False

Question 3

Fever is a complex,integrated cascade of behavioral,neurologic,and endocrine responses to an exogenous pyrogen.

Answer 3

True

Question 4

The nociceptors are at the ends of the large myelinated efferent neurons.

Question 5

In general,as people age,their pain thresholds decrease.

Question 6

During heat stroke,sweat production on the face is maintained even during dehydration to cool blood in the cerebral arteries.

Question 7

Infants have difficulty regulating body heat because they are not as well insulated with subcutaneous fat as adults.

Question 8

The gate theory of pain control states that a "closed gate" increases pain perception.

Question 9

Persistent chronic pain produces a physiologic response similar to that of acute pain.

Question 10

According to the specificity theory,there is a direct relationship between the intensity of pain and the extent of tissue injury.

Question 11

Early treatment of fever is important since fever has no therapeutic benefit.

Question 12

The fingers are more sensitive to pain than the back because the fingers have more nociceptors to pain.

Question 13

Heat exhaustion is more serious than heat stroke.

Question 14

Phantom pain is more likely to be experienced by people who had pain in the limb before it was amputated.

Question 15

Fever is a normal adaptive response to cytokines.

Question 16

All endorphins act by attaching to opiate receptors on the plasma membranes of afferent neurons.

Question 17

Temperature regulation is mediated hormonally by the thalamus.

Question 18

A person's pain threshold does not vary significantly over time.

Question 19

Older adults have difficulty regulating body heat because they have a decreased shivering response and diminished or absent sweating.

Question 20

Large A delta fibers transmit sharp,localized pain sensations.

Question 21

When caring for a patient who has had pain for 3 days,what physiologic signs of pain would the nurse expect to find?

A) Signs of fever and muscle weakness or reports of fatigue
B) Signs of irritability and depression or reports of insomnia
C) Signs of decreased blood pressure or reports of nausea and vomiting
D) Signs of increased heart rate and respiratory rate with diaphoresis

Question 22

Massage therapy relieves pain by stimulating the _____ that closes the pain gate?

A) A-beta fibers
B) A-delta fibers
C) B-fibers
D) C-fibers

Question 23

_____ pain is a warning of actual or impending tissue injury.

A) Chronic
B) Psychogenic
C) Acute
D) Phantom

Question 24

Which endogenous opioid is located in the hypothalamus and pituitary and is a strong
-receptor agonist?

A) Enkephalins
B) Endorphins
C) Dynorphins
D) Endomorphins

Question 25

How does the hypothalamus mediate temperature regulation?

A) Through the parasympathetic nervous system
B) By release of triiodothyronine (T₃)
C) Through the stimulation of epinephrine
D) By stimulation of the renin-angiotensin-aldosterone system

Question 26

Where in the central nervous system does pain perception occur?

A) Parietal lobe
B) Frontal lobe
C) Thalamus
D) Limbic system

Question 27

The _____ theory proposes that pain results from excessive stimulation of sensory receptors.

A) intensity
B) pattern
C) specificity
D) modality

Question 28

Chemical thermogenesis in brown adipose tissue is employed primarily in:

A) adults.
B) adolescents.
C) children.
D) newborns.

Question 29

What part of the brain provides the emotional response to pain?

A) Limbic system
B) Parietal lobe
C) Thalamus
D) Hypothalamus

Question 30

Release (increase)of epinephrine increases body temperature by increasing:

A) shivering.
B) muscle tone.
C) heat production.
D) the heat rate.

Question 31

Which neurotransmitters inhibit pain in the medulla and pons?

A) Norepinephrine and serotonin
B) Gamma aminobutyric acid (GABA)and aspartate
C) Glutamate and tumor necrosis factor alpha
D) Neurokinin A and nitric oxide

Question 32

How do enkephalins and endorphins act to relieve pain?

A) By inhibiting cells in the substantia gelatinosa
B) By stimulating the descending efferent nerve fibers
C) By attaching to opiate receptor sites
D) By blocking transduction of nociceptors

Question 33

Where is the gate located that is referred to in the gate control theory of pain?

A) Substantia gelatinosa
B) Marginal layer
C) Nucleus proprius
D) Dorsolateral tract of Lissauer

Question 34

Where is the major relay station of sensory information?

A) Basal ganglia
B) Midbrain
C) Thalamus
D) Hypothalamus

Question 35

Pricking one's finger with a needle would cause minimal pain,whereas cutting one's finger with a knife would produce more pain.This is an example of which theory of pain?

A) Gate control theory
B) Intensity theory
C) Specificity theory
D) Pattern theory

Question 36

Which type of nerve fibers transmit pain impulses?

A) A-alpha fibers
B) A-beta fibers
C) A-delta fibers
D) B-fibers

Question 37

Where do primary efferent pain fibers enter the spinal cord?

A) Lateral root ganglia
B) Dorsal root ganglia
C) Anterior root ganglia
D) Medial root ganglia

Question 38

Pain _____ is the duration of time or the intensity of pain that a person will endure before outwardly responding.

A) tolerance
B) perception
C) threshold
D) dominance

Question 39

Which are characteristics of visceral pain?

A) It is sharp and well defined when transmitted by A-delta fibers.
B) It is perceived as poorly localized and is transmitted by the sympathetic nervous system.
C) It arises from connective tissue,muscle,bone,or skin.
D) It is perceived as dull,aching,and poorly localized when transmitted by C fibers.

Question 40

Which spinal tract carries the most nociceptive information?

A) Archeospinothalamic tract
B) Paleospinothalamic tract
C) Dorsal spinothalamic tract
D) Lateral spinothalamic tract

Question 41

What are characteristics of heat stroke?

A) Core temperatures usually reaching about 103.9° F
B) Sweat production by the face occurring even during dehydration
C) Core temperature decreasing rapidly as heat loss from the evaporation of sweat ceases
D) Symptoms caused by loss of sodium and prolonged sweating

Question 42

Using a fan to reduce body temperature is an example of which mechanism of heat loss?

A) Evaporation
B) Radiation
C) Convection
D) Conduction

Question 43

_____ is/are characterized by sudden apparent arousal in which a child expresses intense fear or another strong emotion.

A) Night terrors
B) Nightmares
C) Somnambulism
D) Parasomnias

Question 44

Which hormones help diminish the febrile response?

A) Arginine vasopressin,alpha-melanocyte-stimulating hormone (-MSH),and corticotrophin releasing factor
B) Adrenocorticotropin hormone (ACTH),thyroid stimulating hormone,and thyroxine (T₄)
C) Antidiuretic hormone,growth hormone,and aldosterone
D) None;hormones only facilitate the increase of core body temperature

Question 45

Which disorder of temperature regulation is caused by prolonged high environmental temperatures that produce dehydration,decreased plasma volumes,hypotension,decreased cardiac output,and tachycardia?

A) Heat cramps
B) Heat stroke
C) Malignant hyperthermia
D) Heat exhaustion

Question 46

Why are children more susceptible to heat stroke than adults?

A) Because children produce more metabolic heat when exercising
B) Because children have less surface area-to-mass ratio
C) Because children have more sweating capacity
D) Because a child's hypothalamus is underdeveloped

Question 47

Which neuropeptide promotes wakefulness?

A) Prostaglandin D₂
B) L-tryptophan
C) Hypocreatins
D) Growth factors

Question 48

Loud snoring,a decrease in oxygen saturation,fragmented sleep,chronic daytime sleepiness,and fatigue are clinical manifestations of which sleep disorder?

A) Obstructive sleep apnea
B) Upper airway resistance syndrome
C) Somnambulism
D) Narcolepsy

Question 49

Heat loss from the body via convection occurs by:

A) emanations of electromagnetic waves.
B) transfer of heat through currents of liquids or gas.
C) dilation of blood vessels bringing blood to skin surfaces.
D) direct heat loss from molecule to molecule transfer.

Question 50

In acute hypothermia,what physiologic change shunts blood away from the colder skin to the body core in an effort to decrease heat loss?

A) Hypotension
B) Peripheral vasoconstriction
C) Voluntary muscle movements
D) Shivering

Question 51

_____ is known as paradoxical sleep.

A) Non-REM sleep
B) Light sleep
C) REM sleep
D) Delta wave sleep

Question 52

How often does rapid eye movement (REM)sleep occur in cycles?

A) About every 45 minutes
B) About every 90 minutes
C) About every 120 minutes
D) About every 150 minutes

Question 53

A medication used to reverse effects of malignant hyperthermia is:

A) Propranolol
B) Diazepam
C) Dantrolene sodium
D) Sodium carbonate

Question 54

Which cytokines are endogenous pyrogens?

A) Interleukin-3 (Il-3),interleukin-10 (Il-10),and interleukin-18 (Il-18)
B) Interleukin-2 (Il-2),interleukin-8 (Il-8),and beta interferon (ß-INF)
C) Interleukin-4 (Il-4),interleukin-12 (Il-12),colony stimulating factor,and alpha interferon (-INF)
D) Interleukin-1 (Il-1),interleukin-6 (Il-6),tumor necrosis factor-alpha (TNF-),and gamma interferon (

Question 55

What are expected changes in sleep patterns of older adults?

A) They experience frequent awakenings during the night with less time spent in stage IV sleep.
B) They experience sound sleep during the night with about 50% of the time spent in REM sleep and dreaming.
C) Commonly,they experience nocturia,which interrupts sleep and requires them to nap during the day.
D) They awaken often,but with rapid return to sleep;often have difficulty awakening in the morning.

Question 56

What occurs when one has "pink eye"?

A) Inflammation of the eyelids
B) Inflammation of the sebaceous glands of the eyelids
C) Inflammation of the meibomian
D) Inflammation of the conjunctiva

Question 57

Coronary artery disease is most affected by _____ sleep.

A) non-REM
B) light
C) REM
D) delta wave

Question 58

Open angle glaucoma occurs because of:

A) decreased production of aqueous humor.
B) increased production of vitreous humor.
C) obstructed outflow of aqueous humor.
D) excessive destruction of vitreous humor.

Question 59

As much as _____ L of fluid per hour may be lost by sweating.

A) 2.0
B) 4.0
C) 6.0
D) 8.0

Question 60

Where is the major sleep center?

A) Thalamus
B) Brain stem
C) Frontal lobe
D) Hypothalamus

Question 61

How does glaucoma cause blindness?

A) By infection of the cornea
B) By pressure on the optic nerve
C) By creating opacity of the lens
D) By obstruction of the venous return from the retina

Question 62

Match the types of chronic pain with its description.Types of pain may be used more than once.
Pain described as constant,dull,viselike ache,accompanied by paroxysms of burning or electric shocklike sensations

A)Myofascial pain syndrome
B)Neuropathic pain
C)Deafferentation pain
D)Sympathetically maintained pain (SMP)

Question 63

Match the types of chronic pain with its description.Types of pain may be used more than once.
Pain that results from tumor infiltration of nerve tissue;trauma or chemical injury to the nerve;or damage from radiation,chemotherapy,or surgical sectioning of the nerve

A)Myofascial pain syndrome
B)Neuropathic pain
C)Deafferentation pain
D)Sympathetically maintained pain (SMP)

Question 64

Match the types of chronic pain with its description.Types of pain may be used more than once.
Pain described as paroxysmal with paresthesia,burning,shooting,or stabbing sensations

A)Myofascial pain syndrome
B)Neuropathic pain
C)Deafferentation pain
D)Sympathetically maintained pain (SMP)

Question 65

MATCHING
Match the phrases with the corresponding terms.
Scotoma

A)Loss of ability to smell
B)Perversion of sense of taste
C)Smelling nonexistent odors
D)Defective vision in half of a visual field
E)Defect in central field of vision
F)Involuntary movement of eyeballs

Question 66

Which are characteristics of sensorineural hearing loss?

A) Caused by ototoxicity or Ménière disease
B) Interferes with air conduction
C) Occurs when transfer of sound to the inner ear is impaired
D) Causes deafness if not treated

Question 67

Match the types of chronic pain with its description.Types of pain may be used more than once.
Pain is the result of muscle spasms,tenderness,and stiffness that leads to muscle guarding that limits muscle motion

A)Myofascial pain syndrome
B)Neuropathic pain
C)Deafferentation pain
D)Sympathetically maintained pain (SMP)

Question 68

MATCHING
Match the phrases with the corresponding terms.
Parageusia

A)Loss of ability to smell
B)Perversion of sense of taste
C)Smelling nonexistent odors
D)Defective vision in half of a visual field
E)Defect in central field of vision
F)Involuntary movement of eyeballs

Question 69

MATCHING
Match the phrases with the corresponding terms.
Nystagmus

A)Loss of ability to smell
B)Perversion of sense of taste
C)Smelling nonexistent odors
D)Defective vision in half of a visual field
E)Defect in central field of vision
F)Involuntary movement of eyeballs

Question 70

Match the types of chronic pain with its description.Types of pain may be used more than once.
Thought to be caused by development of hyperactivity of neurons in the spinal cord and thalamus as a result of the accumulation of sodium ion channels at sites of nerve injury and demyelination

A)Myofascial pain syndrome
B)Neuropathic pain
C)Deafferentation pain
D)Sympathetically maintained pain (SMP)

Question 71

MATCHING
Match the phrases with the corresponding terms.
Anosmia

A)Loss of ability to smell
B)Perversion of sense of taste
C)Smelling nonexistent odors
D)Defective vision in half of a visual field
E)Defect in central field of vision
F)Involuntary movement of eyeballs

Question 72

MATCHING
Match the phrases with the corresponding terms.
Hemianopia

A)Loss of ability to smell
B)Perversion of sense of taste
C)Smelling nonexistent odors
D)Defective vision in half of a visual field
E)Defect in central field of vision
F)Involuntary movement of eyeballs

Question 73

Match the types of chronic pain with its description.Types of pain may be used more than once.
Pain that occurs after peripheral nerve injury and is described as continuous and severe sensations with a burning quality

A)Myofascial pain syndrome
B)Neuropathic pain
C)Deafferentation pain
D)Sympathetically maintained pain (SMP)