Med Surg Ch 10 Pain

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  1. Pain is best described as

    A. an unpleasant, subjective experience.
    B. a maladaptive response to a stimulus.
    C. a creation a person's imagination.
    D. neurologic event resulting from activation of nociceptors
    (this multiple choice question has been scrambled)
  2. A neurotransmitter known for its involvement in pain modulation is

    A. prostaglandin
    B. norepineprine
    C. acetylcholine
    D. dopamine
    (this multiple choice question has been scrambled)
  3. Which of the following words is most likely to be used to describe neuropathic pain?

    A. mild
    B. dull
    C. burning
    D. aching
    (this multiple choice question has been scrambled)
  4. Unrelieved pain is

    A. expected after major surgery
    B. an annoying sensation, but it is not as important as other physical care needs
    C. expected in a person with cancer
    D. dangerous and can lead to many physical and psychologic complications
    (this multiple choice question has been scrambled)
  5. A cancer patient who reports ongoing, constant moderate pain with short periods of severe pain during dressing changes

    A. should be receiving both a long-acting and a short-acting opioid
    B. should be referred for surgical treatment of his pain
    C. should receive regulary scheduled short-acting opioids plus acetaminophen
    D. is probably exaggerating his pain
    (this multiple choice question has been scrambled)
  6. An example of distraction to provide pain relief is

    A. biofeedback
    B. music
    C. exercise
    D. TENS
    (this multiple choice question has been scrambled)
  7. An appropriate nonopioid analgesic for mild pain is

    A. codeine with acetaminophen (Tylenol #3)
    B. lorazepam (Antivan)
    C. oxycodone
    D. ibuprofen (Advil)
    (this multiple choice question has been scrambled)
  8. An important nursing responsibility related to is to

    A. leave the patient alone to rest
    B. believe what the patient says about the pain
    C. help the patient appear to not be in pain
    D. assume responsibility for eliminating the patient's pain
    (this multiple choice question has been scrambled)
  9. Providing opioids to a dying patient who is experiencing moderate to severe pain

    A. will likely hasten the person's death
    B. is an appropriate nursing action
    C. will probably be ineffective
    D. may cause addiction
    (this multiple choice question has been scrambled)
  10. A nurse believes that patients with the same type of tissue injury should have the same amount of pain. This statement reflects

    A. a belief that will contribute to appropriate pain management
    B. the nurse's lack of knowledge about pain mechanisms, which is likely to contribute to poor pain management
    C. an accurate statement about pain mechanisms and an unexpected goal of pain therapy
    D. a premise that the nurse's belief will have no effect on the type of care provided to people in pain
    (this multiple choice question has been scrambled)
  11. Pain has been defined as "whatever the person experiencing the pain says it is, existing whenever the patient says it does." The definition is problematic when caring for a patient who has

    A. been placed on a ventilator
    B. pain resulting from severe trauma
    C. decreased cognitive function
    D. a history of opioid addiction
    (this multiple choice question has been scrambled)
  12. On the first day following a bowel resection, the patient complains of abdominal and incisional pain rated 7 on a scale of 10. Postoperative orders include morphine, 4 to 10 mg IV q2-4hr. The nurse determine that it has been 3.5 hours since the last dose and plans to administer 4 mg of morphine. Routine administration of the smallest prescribed dose of a opioid analgesic when a range of doses is prescribed,

    A. indicates that the nurse understands the adage of "start low and go slow" in administering analgesics
    B. protects the patient from addiction and toxic effects of the drug
    C. contributes to unnecessary suffering and physical and psychological dysfunction
    D. prevents hastening or causing a patient's death from respiratory dysfunction
    (this multiple choice question has been scrambled)
  13. List the five dimensions of pain.

    • 1. Physiologic
    • 2. Affective
    • 3. Cognitive
    • 4. Behavioral
    • 5. Sociocultural
  14. During transmission of an action potential along a peripheral nerve fiber to the dorsal root of the spinal cord,

    A. the transmission may be interrupted by drugs such as local anesthetics
    B. nothing can stop the action potential along an intact nerve until it reaches the spinal cord
    C. the fiber produces neurotransmitters that may activate nearby nerve fibers to transmit pain impulses
    D. the action potential must cross several synapses, points at which the impulse may be blocked by drugs
    (this multiple choice question has been scrambled)
  15. While caring for an unconcious patient, the nurse discovers a stage 2 pressure ulcer on the patient's heel. During care of the ulcer the nurse

    A. should treat the area as a painful lesion, using gentle cleansing and dressing
    B. can throughly scrub the area because the patient is not able to perceive path
    C. knows that the patient will have a behavioral response if pain is perceived
    D. understand that all nociceptive stimuli that are transmitted to the brain result in the perception of pain
    (this multiple choice question has been scrambled)
  16. A patient comes to the clinic with a complain of a dull pain in the anterior and posterior neck. On examination, the nurse notes that the patient has full ROM of the neck and no throat redness or enlarged head or neck lymph nodes. The next appropriate assessment indicated by the patient's findings is

    A. palpation of the liver
    B. auscultation of bowel sounds
    C. palpation for the presence of left flank pain
    D. inspection of the patient's ears
    (this multiple choice question has been scrambled)
  17. Amitriptyline (Elavil) is prescribed for a patient with chronic pain from fibromyalgia. When the nurse explains that this drugs is an antidepressant, the patient states that she is in pain, not depressed. The nurse's best response to the patient is that

    A. some antidepressant drugs relieve pain by releasing neurotransmitters that prevent pain impulses from reaching the brain
    B. antidepressants will improve the patient's attitude and prevent a negative emotional response to the pain
    C. chronic pain almost always leads to depression, and the use of this drug will prevent depression from occurring
    D. certain antidepressant drugs are metabolized in the liver to substances that numb the ends of nerve fibers
    (this multiple choice question has been scrambled)
  18. When teaching a patient with rheumatoid arthritis to avoid repetitive motions such as knitting, the nurse is addressing the

    A. behavioral componenet of pain
    B. affective component of pain
    C. cognitive component of pain
    D. sociocultural component of pain
    (this multiple choice question has been scrambled)
  19. A patient with trigeminal neuralgia has moderate to severe burning, shooting pain. In helping the patient manage the pain, the nurse recognizes that this type of pain

    A. can be well controlled with salicylates or nonsteroidal antiinflammatory drugs (NSAIDs)
    B. responds to small to moderate around-the-clock doses or oral opioids
    C. is chronic in nature and will require long-term treatmnet
    D. involves treatment that includes the use of adjuvant analgesics
    (this multiple choice question has been scrambled)
  20. A patient with bowel cancer has continous, poorly localized abdominal pain at an intensity of 5 on a scale of 1 to 10. The nurse teaches the patient to use pain medications

    A. when the pain cannot be controlled with distraction or relaxation
    B. by alternating two different types of drugs to prevent tolerance
    C. on an around-the-clock schedule
    D. as often as necessary to keep the pain controlled
    (this multiple choice question has been scrambled)
  21. A patient who has been taking ketoprofen (Orudis) and imipramine (Tofranil) for control of cancer pain is having increased pain. The nurse recommends that an appropriate change in the medication plan would be to

    A. substitute PO hydrocodone with acetaminophen (Lortab, Vicodin) for the other medication
    B. substitute PO propoxyphene (Darvon), a mild opioid, for the ketoprofen
    C. add transdermal fentanyl ( Duragesic) to the use of the other medications
    D. add PO oxycodone (OxyContin) to the other medications
    (this multiple choice question has been scrambled)
  22. A patient with chronic cancer-related pain has started using MS Contin for pain control and has developed common side effects of the drug. The nurse reassures the patient that tolerance will develop to most of these effects but that continued treatment will most likely be required for the

    A. pruritus
    B. nausea and vomiting
    C. dizziness
    D. constipation
    (this multiple choice question has been scrambled)
  23. The use of a continuous infusion of an analgesic with patient-controlled-analgesia (PCA) prevents what disadvantage of PCA?
    Patient-controlled analgesia (PCA) use is decreased at night when the patient sleeps, and without a continuous infusion of an analgesic, the patient is a likely to awaken in pain that will require substantial time to bring under control.
  24. A patient with multiple injuries resulting from an automobile accident tells that nurse that he has "bad" pain but that he can "tough it out" and does not require pain medication. To gain the patient's participation in pain management, the nurse explains that

    A. nonpharmacologic therapies can be used to relieve his pain if he is afraid to use pain medications
    B. patients have a responsibility to keep the nurse informed about their pain
    C. using pain medication rarely leads to addiction when they are used for actual pain
    D. unrelieved pain has many harmful effects on the body that can impair recovery
    (this multiple choice question has been scrambled)
  25. Arises from bone, join, muscle, skin, or connective tissue; usually aching or throbbing in quality and is well localized.
    Somatic pain
  26. Arises from visceral organs, such as the GI tract and bladder.
    Visceral pain
  27. Normal processing of stimulus that damamges normal tissue or has the potential to do so if prolonged. Usually responsive to nonopioid and/or opioid drugs.
    Nociceptive pain
  28. Abnormal preocessing of sensory input by the peripheral or central nervous system. Treatment usually includes adjuvant analgesics.
    Neuropathic pain
  29. Is the conversion of a mechanical, thermal, or chemical stimulus into a neuronal action potential.

    A. transmission
    B. perception
    C. brushing your teeth
    D. modulation
    E. transduction
    (this multiple choice question has been scrambled)
  30. Movement of pain impulses from the site of transduction to the brain.

    B. perception
    C. modulation
    D. transmission
    E. brushing your teeth
    (this multiple choice question has been scrambled)
  31. Occurs when pain is recognized, defined, and responded to by the individual experiencing the pain.

    A. brushing your teeth
    B. perception
    C. transmission
    D. modulation
    E. transduction
    (this multiple choice question has been scrambled)
  32. Involves the activation of descending pathways that exert inhibitory or facilitatory effects on the transmission of pain.

    A. brushing your teeth
    B. transmission
    C. perception
    D. modulation
    E. transduction
    (this multiple choice question has been scrambled)
  33. Pain known to radiate from the chest to the jaw or down the left arm.
    Angine pectoris
  34. Most common opioid side effect
  35. Increasing the dose beyond an upper limit provides no greater analgesia.
    Analgesic ceiling
  36. These medications, sometimes referred to as co-analgesics, are drugs used in conjunction with opioid and nonopioid analgesics.
    Adjuvant analgesic therapy
  37. Enhance the descending inhibitory system by preventing the cullular reuptake of serotonin and norepinephrine; sodium channel modulation, weak NMDA receptor modulation.
    Tricyclic antidepressants
  38. Sodium channel modulation, central calcium channel modulation, and changes in excitatory amino acids and other receptors. Effective for neuropathic pain and prophylactic treatment of migrain headaches.
    Antiseizure drugs or antiepileptic drugs (AEDs)
  39. Dose adjustment based on assessment of the adequacy of analgesic effect versus the side effects produced.
    Analgesic titration
  40. The physiologic process by which information about tissue damage is communicated to the central nervous system (CNS).
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Med Surg Ch 10 Pain
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