Deck 6: Pain

Question 1

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

Answer 1

3

Question 2

Which clinical criteria does the nurse follow to analyze pain? Select all that apply.
1)Examine the area of pain first
2)Assess the history of the client
3)Listen to the client's account of pain
4)Assess any pain the client reports
5)Ask the client to point to the area of pain

Answer 2

2, 3, 4, 5

Question 3

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

Answer 3

3, 4, 5

Question 4

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

Question 5

A client visits a primary health-care provider and reports pain. The client is diagnosed with neuropathic pain. The nurse is aware of which characteristics of neuropathic pain? Select all that apply.
1)Arises as a result of sustained noxious stimuli
2)Can be described as acute or chronic
3)Is burning, tingling, and shooting in sensation
4)Often in the legs, back, feet, thighs, and toes
5)Can be caused by spinal nerve radiculopathy

Question 6

The facility in which a nurse is employed is adopting the World Health Organization (WHO) step ladder approach for analgesic treatment. In which scenario is the nurse correctly using the WHO step ladder?
1)Initially, a client with cancer receives morphine for pain.
2)A client with generalized muscle pain receives an NSAID.
3)Dental surgery pain at a level 6 is treated with a nonopioid.
4)Postoperative joint replacement clients are placed on step 2.

Question 7

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.

Question 8

The nurse is attending a client who presents with colicky pain. Other symptoms include nausea and vomiting. Which conditions does the nurse suspect as possible causes of the presenting symptoms? Select all that apply.
1)Pancreatitis
2)Nephrolithiasis
3)Cholecystitis
4)Appendicitis
5)Duodenum peptic ulcer

Question 9

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 ascending nerve tracts.

Question 10

Which are characteristics of afferent neurons? Select all that apply.
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 11

The nurse is providing care for a client experiencing pain who wishes to manage the pain without medication. Which explanation of the process by which the body responds to nonpharmacological treatments does the nurse provide?
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 12

An adult client experiences problems such as sleeplessness, fear, irritability, anxiety, and stress. The client has pain lasting 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 13

The nurse is updating the medical history of a client who is 4 weeks postoperative for a total knee replacement. The client reports pain at a level of 8 on a scale of 0 to 10 and requests "something stronger" for pain management. For which predictors of possible substance abuse does the nurse assess? Select all that apply.
1)Occurrence of withdrawal syndrome
2)History or treatment for depression
3)Increased pain level from last visit
4)Recent event requiring use of naloxone
5)Past history of needing extended pain relief

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 diagnosis does the nurse suspect for the client?
1)Complex regional pain syndrome
2)Fibromyalgia
3)Spinal nerve radiculopathy
4)Trigeminal neuralgia

Question 15

The nurse is educating a client about the cause of bone pain in cancer clients. Which statement by the client indicates effective learning? Select all that apply.
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."

Question 16

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

Question 17

Which features belong to A-delta fibers? Select all that apply.
1)Myelinated
2)Cause persistent, dull pain
3)Small in diameter
4)Cause sharp, long-lasting pain
5)Conduct impulses slowly

Question 18

Which assessment actions does the nurse use to identify the severity of pain in a client? Select all that apply.
1)Ask for a description of the pain
2)Select a client-appropriate pain scale
3)Ask the client to identify the cause of the pain
4)Inquire about what makes the pain better
5)Have the client point to the area of pain

Question 19

Which statements are true regarding intradiscal electrothermal therapy (IDET)? Select all that apply.
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 placed through an incision into the spinal disc.
5)It uses thin, solid, metallic needles.

Question 20

The nurse is performing a physical assessment on a client. When checking for a patellar reflex, the nurse notes an expected response. Which additional facts are relevant to this response? Select all that apply.
1)Impulses cross over at the medulla
2)Sensory impulse exits through the ventral horn
3)Impulse descends downward in the spinal cord
4)The reaction is referred to as a simple reflex arc
5)Sensory neuronal impulses ascend the brain cortex

Question 21

The nurse is providing postoperative care for a client after a lower limb amputation. The client reports having pain as severe as the pain prior to the amputation. Which action does the nurse take to promote comfort for this client?
1)Repositions the remaining lower extremity
2)Encourages visual confirmation of the loss
3)Medicates for pain and anxiety at bedtime
4)Reinforces that the pain is temporary in nature

Question 22

A client reports pain in the neck that radiates down the right arm with numbness in the fingers. For which condition does the nurse expect the client to be checked?
1)Postherpetic neuralgia
2)Fibromyalgia
3)Complex regional pain syndrome
4)Cervical radiculopathy

Question 23

A client presents with episodic headache associated with muscular tightness in the neck and shoulders. Which type of medication treatment does the nurse expect to be prescribed using the World Health Organization (WHO) step ladder approach?
1)Acetaminophen with codeine
2)Aspirin, acetaminophen, or NSAIDs
3)Morphine with addition of an NSAID
4)Acetaminophen and cold compresses

Question 24

A client comes in with symptoms of trigeminal neuralgia. Which treatment option is the best choice for the client?
1)Tricyclic antidepressants
2)Injected corticosteroid
3)Topical pain relievers
4)Anticonvulsants

Question 25

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