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

Question 1

Temperature regulation is mediated hormonally by the thalamus.

Answer 1

False

Question 2

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

Answer 2

True

Question 3

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 the _____ theory of pain.

A)gate control
B)intensity
C)specificity
D)pattern

Answer 3

specificity

Question 4

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

Question 5

Heat exhaustion is more serious than heat stroke.

Question 6

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

Question 7

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

Question 8

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

Question 9

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

Question 10

Depression frequently accompanies acute pain experiences.

Question 11

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

Question 12

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

Question 13

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

Question 14

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

Question 15

Fever is a normal adaptive response to cytokines.

Question 16

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

Question 17

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

Question 18

A-delta (Aσ) fibers transmit sharp, localized pain sensations.

Question 19

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

Question 20

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

Question 21

Which spinal tract carries the most nociceptive information?

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

Question 22

How do enkephalins and endorphins act to relieve pain?

A)Inhibit cells in the substantia gelatinosa
B)Stimulate the descending efferent nerve fibers
C)Attach to opiate receptor sites
D)Block transduction of nociceptors

Question 23

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 24

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

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

Question 25

Massage therapy relieves pain by stimulating the _____ that close the pain gate.

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

Question 26

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 27

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

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

Question 28

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

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

Question 29

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 30

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

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

Question 31

Chemical thermogenesis in brown adipose tissue is used primarily in:

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

Question 32

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 33

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 34

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

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

Question 35

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

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

Question 36

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 37

Where in the central nervous system does pain perception occur?

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

Question 38

Where is the major relay station of sensory information?

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

Question 39

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

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

Question 40

Which type of nerve fibers transmit pain impulses?

A)Aα fibers
B)Aβ fibers
C)A-delta fibers
D)B fibers

Question 41

Which cytokines are endogenous pyrogens?

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

Question 42

Which neuropeptide promotes wakefulness?

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

Question 43

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 44

Which hormones help diminish the febrile response?

A)Arginine vasopressin, melanocyte-stimulating hormone-alpha (MSH-α), 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 45

What are characteristics of heat stroke?

A)Core temperatures usually reaching about 39.9° C (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 46

Open-angle glaucoma occurs because of _____ humor.

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

Question 47

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 48

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 49

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 50

Coronary artery disease is most affected by _____ sleep.

A)non-REM
B)light
C)rapid eye movement (REM)
D)delta wave

Question 51

_____ sleep is known as paradoxical sleep.

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

Question 52

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 53

Pinkeye is characterized by inflammation of the:

A)eyelids.
B)sebaceous glands.
C)meibomian glands.
D)conjunctiva.

Question 54

Children are more susceptible to heat stroke than are adults because:

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

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; they often have difficulty awakening in the morning.

Question 56

A sensorineural hearing loss may be a result of:

A)Ménière disease.
B)aging.
C)diabetes mellitus.
D)noise exposure.
E)outer ear trauma.

Question 57

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

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

Question 58

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 59

Where is the major sleep center?

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

Question 60

A medication used to reverse effects of malignant hyperthermia is:

A)propranolol.
B)diazepam.
C)dantrolene sodium.
D)sodium carbonate.

Question 61

Match the phrases with the corresponding terms.
Hemianopia

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

Question 62

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

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

Question 63

Match the phrases with the corresponding terms.
Parageusia

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

Question 64

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 65

Match the phrases with the corresponding terms.
Nystagmus

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

Question 66

Match the phrases with the corresponding terms.
Anosmia

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

Question 67

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 (SMP)

Question 68

Match the phrases with the corresponding terms.
Scotoma

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

Question 69

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; 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)