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

Question 1

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

Answer 1

Dorsal root ganglia

Question 2

Which spinal tract carries the most nociceptive information?

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

Answer 2

Lateral spinothalamic

Question 3

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

Answer 3

Specificity theory

Question 4

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

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

Question 5

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)Gate control theory (GCT)
B)Pattern theory
C)Specificity theory
D)Neuromatrix theory

Question 6

A patient's chart describes visceral pain. What does the healthcare professional understand about this term?

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 7

A healthcare professional is caring for a patient who was rewarmed after suffering from hypothermia. What possible long-term complication will the professional continue to assess the patient for?

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

Question 8

The healthcare professor states that a patient has reached pain tolerance. What further information from the professor is most accurate?

A)"The patient cannot endure a higher level of pain intensity at this point."
B)"The patient's pain tolerance is much lower because of consuming too much alcohol."
C)"The patient's pain in one place is higher because pain in multiple other sites."
D)"The patient now recognizes what is being felt is actually pain."

Question 9

A healthcare professional is caring for a person who has experienced pain for 3 days. What signs would the professional note if the patient has anxiety in addition to the pain?

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 10

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 11

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 12

Where is the gate in the gate control theory (GCT) of pain located?

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

Question 13

Where is the major relay station of sensory information located?

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

Question 14

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 15

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

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

Question 16

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

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

Question 17

A healthcare professional is trying to lower a patient's body temperature by convection. What action by the professional will accomplish this?

A)Lower the temperature in the patient's room.
B)Place the patient in a cooling blanket.
C)Obtain a fan and set it to blow over the patient.
D)Place cold moist towels over the patient.

Question 18

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 19

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

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

Question 20

A healthcare professional is working in a health tent at a marathon. A person enters the tent and reports profuse sweating for the last hour. How much fluid does the healthcare professional advise the person to drink to replace this fluid loss?

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

Question 21

A healthcare professional is caring for four postsurgical patients. Based on an understanding of the physiologic process of nociceptors, the nurse expects to give more pain medication to which patient?

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

Question 22

The healthcare professional working in a summer camp provides cooling to campers by radiation. What is the most appropriate action by the professional to accomplish this?

A)Have the campers sit inside the air-conditioned camp cafeteria.
B)Have the campers sit in front of a large fan.
C)Tell the campers to take cool showers.
D)Instruct the campers to lie still for an hour.

Question 23

Rapid eye movement (REM) sleep occurs in cycles approximately how often?

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

Question 24

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

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 25

What is the basis of the specificity theory of pain?

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 26

A patient is in the Emergency Department with heat stroke. What finding does the healthcare provider associate with this condition?

A)Core temperatures usually reaching approximately 39.5°C (103.1°F)
B)Absence of sweating despite a high core temperature
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 27

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 28

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

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

Question 29

Parents of a child report that the child wakes up from sleep expressing intense anxiety. What disorder does the healthcare professional educate the parents about?

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

Question 30

Why does open-angle glaucoma occur?

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 31

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 32

A patient reports loud snoring, fragmented sleep, chronic daytime sleepiness, and fatigue. What treatment does the healthcare professional anticipate teaching this patient about?

A)Continuous positive airway pressure while sleeping
B)Eventual adenotonsillectomy
C)Occupational assessment for safety
D)Administration of nightly gabapentin

Question 33

Which term is also used to refer to paradoxical sleep?

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

Question 34

A parent reports that her child has reddened eyes with purulent drainage. What instruction by the healthcare professional is most appropriate?

A)Give the child soothing saline eyedrops.
B)Tell the child not to go outside during recess.
C)Have the child wear well-fitting sunglasses.
D)Use a separate towel for this child only.

Question 35

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 36

Which neuropeptide dysfunction is linked to narcolepsy?

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

Question 37

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 38

A patient has been exposed to prolonged high environmental temperatures and now shows signs of dehydration, decreased plasma volumes, hypotension, decreased cardiac output, and tachycardia. What treatment does the healthcare professional prepare to administer to this patient?

A)Administer salty beverages to the patient.
B)Aggressive cooling methods to rapidly lower temperature
C)Encourage the patient to have genetic testing after recovery.
D)Give the patient plenty of cool fluids to drink.

Question 39

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 40

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 41

What does heat exhaustion result in? (Select all that apply.)

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

Question 42

Which cytokines are endogenous pyrogens? (Select all that apply.)

A)IL-1
B)IL-6
C)IL-4
D)IFN-g
E)TNF-a

Question 43

Which hormones help diminish the febrile response? (Select all that apply.)

A)Arginine vasopressin (AVP)
B)Melanocyte-stimulating hormone-alpha (a-MSH)
C)Adrenocorticotropic hormone (ACTH)
D)Thyroxine (T4)
E)Corticotropin-releasing factor

Question 44

What is true about a fever? (Select all that apply.)

A)It is a complex cascade involving several different systems.
B)It can be a result of a dysfunctional hypothalamus.
C)It should be eliminated as quickly as possible.
D)It triggers endocrine responses.
E)It is in response to a pyrogen.

Question 45

Which neurotransmitters inhibit pain in the medulla and pons? (Select all that apply.)

A)Norepinephrine
B)Serotonin
C)Glutamate
D)Tumor necrosis factor-alpha
E)Nitric oxide