Deck 6: Pain

Question 1

Which statement is related to a simplex reflex arc?
1) Interpretation of the brain is necessary when it occurs in the body.
2) An efferent neuron connects with an interneuron in the substantia gelatinosa.
3) An interneuron connects to an afferent neuron that exits through the ventral horn.
4) An afferent neuron carries sensory impulses into the dorsal horn of the spinal cord.

Answer 1

4

Question 2

Which steps are necessary to identify the severity of pain in a client?
1) It is necessary to ask if the pain is aching, throbbing, or stabbing.
2) It is unnecessary to use a 0 to 10 scale.
3) It is necessary to ask the client for a number to describe the severity of pain.
4) It is necessary to ask about the associated symptoms such as depression.
5) It is unnecessary to obtain the history of the client.

Answer 2

1, 3, 4

Question 3

Pain that is dull or aching and that occurs in certain parts of the body is referred to as deep somatic pain. Explain how somatic pain is different from other pain.
1) Pain that occurs from ligaments, tendons, and bones
2) Pain originating in an amputated part of the body
3) Pain from deep organs resulting from disease processes
4) Pain originating from the chest and left arm

Answer 3

1

Question 4

The spinothalamic tract is a sensory pathway from the skin to the thalamus. Select the clinical significance of the spinothalamic tract.
1) Cross over at the medulla
2) Exit through the ventral horn
3) Descend downward in the spinal cord
4) Direct sensory neuronal impulses to hypothalamus
5) Direct sensory neuronal impulses to the upper regions of the brain cortex

Question 5

A client presents with symptoms of fibromyalgia. Which treatment option can be offered to the client?
1) Curative prescription drugs
2) Relieving and coping therapies
3) Preventive vaccines
4) Surgery

Question 6

Which clinical criteria should the physician follow to analyze pain?
1) Examine the area of pain first.
2) Assess the history of the client.
3) Listen to the client's complaint of pain.
4) Assess the pain.
5) Allow the client to point to the area of pain after a physical exam.

Question 7

What is the process by which the body responds to nonpharmacological treatments to relieve pain?
1)
1) The body responds by secreting inflammatory mediators.
2) The body responds by secreting endothelin-
3) Nonpharmacological treatments activate the body's prostaglandins.
4) Nonpharmacological treatments activate the body's own endorphins and enkephalins.

Question 8

Which statement is related to gate control theory?
1) The first neuron is an interneuron.
2) The second neuron is an afferent neuron.
3) Sensation travels both to and from the brain.
4) The interneuron is influenced by descending nerve tracts from the spinal cord.

Question 9

A client complains of pain in the neck that radiates down the right arm with numbness in the fingers. What would the client most likely be checked for?
1) Postherpetic neuralgia
2) Fibromyalgia
3) Complex regional pain syndrome
4) Cervical radiculopathy

Question 10

A client visits a primary health-care provider and complains of pain. The primary health-care provider diagnoses the pain as neuropathic pain. Which are the symptoms of neuropathic pain?
1) Arises as a result of sustained noxious stimuli
2) Is often acute and chronic
3) Is burning, tingling, and shooting in sensation
4) Occurs in the skin, muscles, and bones
5) Leads to conditions such as postherpetic neuralgias and spinal nerve radiculopathy

Question 11

Some forms of complex regional pain syndrome have no causes, and in some cases there are precipitating factors. What is the precipitating factor of complex regional pain syndrome?
1) Injury and surgery
2) Viral infection
3) Brain tumor
4) Radiculitis

Question 12

A client comes in with symptoms typical of a migraine attack. Which treatment option is the most apt for the client?
1) Tricyclic antidepressants
2) Beta blockers
3) Sumatriptan
4) Anticonvulsants

Question 13

What are the characteristics of afferent neurons?
1) They are motor nerves.
2) They extend to the muscles of the body.
3) They enter the dorsal horn.
4) They exit through the ventral horns.
5) They carry pressure sensations into the spinal cord.

Question 14

A client presents with a greater than 3-month history of widespread aches and pains. The client also points to several tender locations. On further questioning, the client mentions disturbed sleep and feeling fatigued. Which is the likely diagnosis for the client?
1) Complex regional pain syndrome
2) Fibromyalgia
3) Spinal nerve radiculopathy
4) Trigeminal neuralgia

Question 15

A client presents with episodic headache associated with muscular tightness in the neck and shoulders. The client is given a diagnosis of tension headaches based on which symptom?
1) Sharp, stabbing pain in the face with radiation to the jaw
2) Bandlike pain sensation in the head
3) Throbbing headache with associated symptoms of nausea
4) A perception of lights flashing in the visual field

Question 16

A 40-year-old client experiences problems such as sleeplessness, fear, irritability, anxiety, and stress. The client has pain that lasts longer than 6 months. Which type of pain can be diagnosed from the symptoms?
1) Acute pain
2) Chronic pain
3) Neuropathic pain
4) Phantom limb pain

Question 17

Which are the features of A-delta fibers?
1) Myelinated
2) Persisting dull pain
3) Small in diameter
4) Cause long-lasting pain
5) Conduct impulses slowly

Question 18

A client presents with symptoms of trigeminal neuralgia and wants the best pain management available. Which treatment will address the client's need?
1) Surgery
2) Acupuncture
3) Guided imagery
4) Anticonvulsants

Question 19

Pain is an unpleasant sensation that is associated with disease. The process by which people experience pain occurs in four phases. Choose the first phase that converts painful stimuli into neuronal impulses.
1) Perception
2) Modulation
3) Transduction
4) Transmission

Question 20

A client complains of headaches during morning hours and sleep, and also rhinorrhea and tearing of the eye. Which type of headache is likely to be diagnosed for the client?
1) Tension headache
2) Migraine
3) Cluster headache
4) Cephalgia

Question 21

A 35-year-old client presents with colicky pain. When seeking a diagnosis, which conditions are likely to be causing the pain in the client?
1) Hyperperistalsis
2) Muscular spasm
3) Cholecystitis
4) Esophagitis
5) Abdominal pain

Question 22

Depression is common in clients with chronic pain. Identify the signs and symptoms than can be observed in a client with depression.
1) Increased appetite
2) Restricted activity levels
3) Excess sleep
4) Hyperfocus or concentration
5) Chronic fatigue

Question 23

Which statements are true regarding intradiscal electrothermal therapy (IDET)?
1) It uses thoughts and suggestions to guide the imagination.
2) It uses heat to modify the nerve fibers of a spinal disc.
3) It uses electrodes to deliver electrical current through the skin.
4) It uses a wire called an electrothermal catheter that is placed through an incision into the spinal disc.
5) It uses thin solid metallic needles.

Question 24

A client prefers nonpharmacological treatment for regional complex pain syndrome. What treatment options can be offered to the client?
1) Counseling
2) Alternative medicine
3) Acupuncture
4) Transcutaneous electrical neural stimulation (TENS)
5) Guided imagery

Question 25

A nursing instructor is educating student nurses on the cause of bone pain in cancer clients. Which statement by a nurse student indicates effective learning?
1) "Metastasis of cancer to the bones is one of the reasons for bone pain."
2) "Entrapment of the spinal nerve in a herniated disc is a reason for bone pain."
3) "Excess glucose in the nerves leads to structural breakdown of the nerves."
4) "A tumor within the bone can cause bone pain."
5) "Enzyme and inflammatory mediators cause bone pain."