Deck 16: Pain, Temperature Regulation, Sleep, and Sensory Function

Question 1

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

Answer 1

Norepinephrine and serotonin

Question 2

Where in the CNS does a person's learned pain response occur?

A) Cerebral cortex
B) Frontal lobe
C) Thalamus
D) Limbic system

Answer 2

Cerebral cortex

Question 3

What is a long-term complication of rewarming as a treatment for hypothermia?

A) Acidosis
B) Dysrhythmias
C) Shock
D) Renal failure

Answer 3

Renal failure

Question 4

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

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

Question 5

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

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

Question 6

Which spinal tract carries the most nociceptive information?

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

Question 7

Enkephalins and endorphins act to relieve pain by which process?

A) Inhibiting cells in the substantia gelatinosa
B) Stimulating the descending efferent nerve fibers
C) Attaching to opiate receptor sites
D) Blocking transduction of nociceptors

Question 8

The major relay station of sensory information is located in the:

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

Question 9

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 10

Where are the primary-order pain transmitting neurons located within the spinal cord?

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

Question 11

Which type of nerve fibers transmits pain impulses?

A) A-alpha (Aa) fibers
B) A-beta (Ab) fibers
C) A-delta (Ad) fibers
D) B fibers

Question 12

What is the term that denotes 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 13

Pain that warns of actual or impending tissue injury is referred to as what?

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

Question 14

How does the release (increase)of epinephrine raise body temperature?

A) The release of epinephrine causes shivering.
B) It affects muscle tone.
C) It raises the metabolic rate.
D) It increases and strengthens the heart rate.

Question 15

Massage therapy relieves pain by closing the pain gate with the stimulation which fibers?

A) Ab
B) Ad
C) B
D) C

Question 16

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

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

Question 17

Which description characterizes visceral pain?

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

Question 18

Which pain theory proposes that a balance of impulses conducted from the spinal cord to the higher centers in the central nervous system (CNS)modulates the transmission of pain?

A) GCT
B) Pattern theory
C) Specificity theory
D) Neuromatrix theory

Question 19

When caring for a person who has experienced pain for 3 days,anxiety is likely to produce which physical signs that a nurse would expect to find?

A) Fever and muscle weakness or reports of fatigue
B) Irritability and depression or reports of constipation
C) Decreased blood pressure or reports of fatigue
D) Increased heart rate and respiratory rate with diaphoresis

Question 20

The gate in the GCT of pain is located in the:

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

Question 21

A heat stroke is characterized by:

A) Core temperatures usually reaching approximately 39.9° C (103.9° F)
B) Sweat production on the face occurring even during dehydration
C) A rapidly decreasing core temperature as heat loss from the evaporation of sweat ceases
D) Symptoms caused by the loss of sodium and prolonged sweating

Question 22

Up to how many liters of fluid per hour may be lost by sweating?

A) 2
B) 4
C) 6
D) 8

Question 23

Prolonged high environmental temperatures that produce dehydration,decreased plasma volumes,hypotension,decreased cardiac output,and tachycardia cause which disorder of temperature regulation?

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

Question 24

What are the expected changes in sleep patterns of older adults?

A) Older adults experience difficulty falling asleep with less time spent in REM sleep.
B) They experience sound sleep during the night with approximately 50% of the time spent in REM sleep and dreaming.
C) Older men commonly experience interrupted sleep patterns later in life than do older women.
D) Older adults awaken often but with a rapid return to sleep; they awaken refreshed but often later in the morning.

Question 25

Which medication is used to reverse the effects of malignant hyperthermia?

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

Question 26

Coronary artery disease is most affected by which component of sleep?

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

Question 27

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 28

The sudden apparent arousal in which a child expresses intense fear or another strong emotion while still in a sleep state characterizes which sleep disorder?

A) Night terrors
B) Insomnia
C) Somnambulism
D) Enuresis

Question 29

The major sleep center is located in which section of the brain?

A) Thalamus
B) Brainstem
C) Frontal lobe
D) Hypothalamus

Question 30

Which term is also used to refer to paradoxic sleep?

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

Question 31

Which hormones help diminish the febrile response?

A) Arginine vasopressin (AVP), melanocyte-stimulating hormone-alpha (a-MSH), and corticotropin-releasing factor
B) Adrenocorticotropic 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 32

Rapid eye movement (REM)sleep occurs in cycles approximately every:

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

Question 33

Heat loss from the body via radiation 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 34

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 35

How can glaucoma cause blindness?

A) Infection of the cornea
B) Pressure on the optic nerve
C) Opacity of the lens
D) Obstruction of the venous return from the retina

Question 36

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 37

Which neuropeptide promotes wakefulness?

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

Question 38

Which cytokines are endogenous pyrogens?

A) IL-3, IL-10, and IL-18
B) IL-2, IL-8, and IFN-b
C) IL-4, IL-12, colony-stimulating factor, and IFN-a
D) IL-1, IL-6, TNF-a, and IFN-g

Question 39

When comparing the effects of acute and chronic pain on an individual,chronic pain is more often:

A) The external event that results in a sense of fear
B) Viewed as being meaningful but undesirable
C) A factor that contributes to depression
D) A sense of internal unease

Question 40

Pinkeye is characterized by inflammation of which structure?

A) Eyelids
B) Sebaceous glands
C) Meibomian glands
D) Conjunctiva

Question 41

Which factors contribute to sensorineural hearing loss? (Select all that apply.)

A) Ménière disease
B) Aging
C) Diabetes mellitus
D) Noise exposure
E) Outer ear trauma

Question 42

It is true that a fever: (Select all that apply.)

A) Is a complex cascade involving several different systems.
B) Can be a result of a dysfunctional hypothalamus.
C) Should be eliminated as quickly as possible.
D) Triggers endocrine responses.
E) Is in response to a pyrogen.

Question 43

Which statement is true regarding the gate control theory (GCT)of pain?

A) The pain gate is located in the brain.
B) A closed gate increases pain perception.
C) The brain primarily controls the pain gate.
D) An open gate facilitates the brain in processing the pain.

Question 44

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

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

Question 45

Based on an understanding of the physiologic process of nociceptors,the nurse expects which surgical procedure to create more pain?

A) Repair of several crushed fingers
B) External fixation of a dislocated shoulder
C) Cyst removal on the internal surface of an ovary
D) Repair of a ruptured spleen

Question 46

The basis of the specificity theory of pain is that:

A) Injury to specific organs results in specific types of pain.
B) Chronic pain is generally less intense than acute pain.
C) The greater the tissue injury, the greater the pain.
D) Acute pain is specific only to certain injuries.

Question 47

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,from trauma or chemical injury to the nerve,or from damage from radiation,chemotherapy,or surgical sectioning of the nerve

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

Question 48

Heat exhaustion results in: (Select all that apply.)

A) Profuse sweating
B) Profound vasodilation
C) A need to ingest warm liquids
D) Permanent damage to the hypothalamus
E) An increased risk for future heat exhaustion

Question 49

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 with severe sensations and a burning quality

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

Question 50

When considering the risk factors for the development of phantom limb pain,the nurse recognizes which as a primary contributing factor?

A) Age, with adolescent patients being at a higher risk than adults
B) Presence of pain in the limb before amputation
C) Patient's previous experience with managing pain
D) Cultural views regarding the acceptance of pain

Question 51

Why are children more susceptible to heat stroke than are adults? (Select all that apply.)

A) Children produce more metabolic heat when exercising.
B) They have more surface area-to-mass ratio.
C) Children have less sweating capacity.
D) They an underdeveloped hypothalamus.
E) Children have an overdeveloped ability to perceive heat.

Question 52

Match the types of chronic pain with its description.Types of pain may be used more than once.
Pain that is thought to be caused by trauma or disease of nerves and leads to abnormal processing of sensory information by the peripheral and central nervous systems

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