Chapter 36 Flashcards
(30 cards)
The nurse is teaching the student nurse the physiology involved in pain transmission.
Which of the following statements accurately describes a physiologic event in the nervous system related to pain transmission? Select all answers that apply.
A) Thermal stimulation may involve the release of mediators, such as histamine,
prostaglandins, leukotrienes, or bradykinin.
B) When nociceptors are activated by noxious stimuli, the stimuli are converted to
electrical impulses that are relayed to the spinal cord and brain.
C) Myelinated A-delta fibers are large fibers that conduct the impulse at very rapid
rates; unmyelinated small C fibers transmit the impulse slowly.
D) Once in the dorsal horn of the spinal cord, the nerve fibers divide and then cross to the opposite side and rise upward to the thalamus.
E) The point at which the person first feels the highest intensity of the painful stimulus is termed the pain threshold.
F) Peripheral sensitization allows the nerve fibers to react to a stimulus that is of
lower intensity than would be needed to cause pain.
B) When nociceptors are activated by noxious stimuli, the stimuli are converted to
electrical impulses that are relayed to the spinal cord and brain.
C) Myelinated A-delta fibers are large fibers that conduct the impulse at very rapid
rates; unmyelinated small C fibers transmit the impulse slowly.
D) Once in the dorsal horn of the spinal cord, the nerve fibers divide and then cross to the opposite side and rise upward to the thalamus.
F) Peripheral sensitization allows the nerve fibers to react to a stimulus that is of
lower intensity than would be needed to cause pain.
The nurse is managing children who have chronic diseases in a neighborhood clinic. Which of the following are examples of chronic conditions? Select all answers that apply. A) Diabetes mellitus B) Myocardial infarction C) Rheumatoid arthritis D) Compound fracture E) Acute asthma F) Bronchopneumonia
A) Diabetes mellitus
C) Rheumatoid arthritis
E) Acute asthma
The nurse is caring for a child who is recovering from an appendectomy. Which of the
following is the appropriate term for the pain this child is experiencing?
A) Nociceptive pain
B) Neuropathic pain
C) Chronic pain
D) Superficial somatic pain
A) Nociceptive pain
The nurse is conducting an assessment of a high school track athlete. He tells the nurse he is experiencing pain along his outer thigh. He describes it as tight, achy, and tender, particularly after he runs. The nurse understands that he is most likely experiencing what kind of pain? A) Cutaneous B) Neuropathic C) Visceral D) Deep somatic
D) Deep somatic
The nurse is caring for a child who is experiencing pain related to chemotherapy
treatment. Which of the following is a behavioral factor that might affect the child’s pain experience?
A) Knowledge of the therapy
B) Fear about the outcome of therapy
C) Participation in normal routine activities
D) Ability to identify pain triggers
C) Participation in normal routine activities
The nurse caring for infants in the neonatal intensive care unit (NICU) relies on the use
of behavioral and physiologic indicators for determining pain. Which of the following
examples are behavioral indicators? Select all answers that apply.
A) The infant grimaces.
B) The infant’s heart rate is elevated.
C) The infant flails his arms and legs.
D) The infant’s respiratory rate is elevated.
E) The infant is crying uncontrollably.
F) The infant’s oxygen saturation is low.
A) The infant grimaces.
C) The infant flails his arms and legs.
E) The infant is crying uncontrollably.
A nurse is providing teaching to the mother of an adolescent girl about how to manage
menstrual pain nonpharmacologically. Which of the following statements by the mother indicates a need for further teaching?
A) “I need to help her learn techniques to distract her, card games, for example.”
B) “I need to be able to identify the subtle ways she shows pain.”
C) “I need to follow these instructions exactly for them to work properly.”
D) “I need to encourage her to practice and utilize these techniques.”
C) “I need to follow these instructions exactly for them to work properly.”
The nurse is counseling the parents of a 9-year-old boy who is receiving morphine for postoperative pain. Which of the following statements from the nurse accurately reflects the pain experience in children?
A) “You can expect that your child will tell you when he is experiencing pain.”
B) “Your child will learn to adapt to the pain he is experiencing.”
C) “Your child will experience more adverse effects to narcotics than adults.”
D) “It is very rare that children become addicted to narcotics.”
D) “It is very rare that children become addicted to narcotics.”
The nurse is using the acronym QUESTT to assess the pain of a child. Which of the following is an accurate descriptor of this process?
A) Question the child’s parents.
B) Understand the child’s pain level.
C) Establish a caring relationship with the child.
D) Take the cause of pain into account when intervening.
D) Take the cause of pain into account when intervening.
When the nurse is assessing a child’s pain, which of the following is most important?
A) Obtaining a pain rating from the child with each assessment
B) Using the same tool to assess the child’s pain each time
C) Documenting the child’s pain assessment
D) Asking the parents about the child’s pain tolerance
B) Using the same tool to assess the child’s pain each time
Which tool would be the least appropriate scale for the nurse to use when assessing a 4- year-old child's pain? A) FACES pain rating scale B) Oucher pain rating scale C) Poker chip tool D) Numeric pain intensity scale
D) Numeric pain intensity scale
The nurse uses the FLACC behavioral scale to assess a 6-year-old’s level of
postoperative pain and obtains a score of 9. The nurse interprets this to indicate that the
child is experiencing:
A) Little to no pain
B) Mild pain
C) Moderate pain
D) Severe pain
D) Severe pain
The nurse is assessing the pain of a postoperative newborn. The nurse measures the infant’s facial expression, body movement, sleep, verbal or vocal ability, consolability, and response to movements and touch. Which behavioral assessment tool is being used by the nurse?
A) Riley Infant Pain Scale
B) Pain Observation Scale for Young Children
C) CRIES Scale for Neonatal Postoperative Pain Assessment
D) FLACC Behavioral Scale for Postoperative Pain in Young Children
A) Riley Infant Pain Scale
The nurse is researching behavioral-cognitive pain relief strategies to use on a 5-year- old child with unrelieved pain. Which of the following methods might the nurse choose?
Select all answers that apply. A) Relaxation B) Distraction C) Biofeedback D) Thought stopping E) Massage F) Sucking
A) Relaxation
B) Distraction
C) Biofeedback
D) Thought stopping
The nurse tells a joke to a 12-year-old to distract him from a painful procedure. What
pain management technique is the nurse using?
A) Relaxation
B) Distraction
C) Imagery
D) Thought stopping
B) Distraction
The nurse is providing instructions to a mother on how to use thought stopping to help her child deal with anxiety and fear associated with frequent painful injections. Which of the following statements indicates the mother understands the technique?
A) “We will imagine that we are on the beach in Florida.”
B) “We can talk about our favorite funny movie and laugh.”
C) “She can let her body parts go limp, working from head to toe.”
D) “We’ll repeat ‘quick stick, feel better, go home soon’ several times.”
D) “We’ll repeat ‘quick stick, feel better, go home soon’ several times.”
The student nurse is learning about the effects of heat and cold when used in a pain
management plan. Which of the following accurately describes one of these effects?
A) Cold results in vasodilation.
B) Cold alters capillary permeability.
C) Heat results in vasoconstriction.
D) Heat decreases blood flow to the area.
B) Cold alters capillary permeability.
The nurse is teaching an 8-year-old child and his family how to manage cancer pain
using nonpharmacologic methods. Which of the following parent statements signifies successful child teaching?
A) “I will avoid using descriptive words like pinching, pulling, or heat.”
B) “I will not use positive reinforcement until the technique is perfected.”
C) “I will begin using the technique before he experiences pain.”
D) “I will be honest and tell him that the procedure will hurt a lot.”
C) “I will begin using the technique before he experiences pain.”
For which of the following children would nonopioid analgesics be recommended?
A) A child with juvenile arthritis
B) A child with end-stage cancer
C) A child with a broken arm
D) A child with severe postoperative pain
A) A child with juvenile arthritis
Prior to administering morphine to a 10-year-old child, the nurse reviews the adverse effects of the drug. Which system is primarily affected by the drug causing most of the adverse effects? A) Central nervous system B) Peripheral nervous system C) Digestive system D) Musculoskeletal system
A) Central nervous system
The nurse is administering pain medication for a child with continuous pain from
internal injuries. Which of the following methods would be ordered to dispense the
medication?
A) Administer the medication PRN (as needed).
B) Administer the mediation when pain has peaked.
C) Administer the medication around the clock at timed intervals.
D) Administer the medication when the child complains of pain.
C) Administer the medication around the clock at timed intervals
The nurse has applied EMLA cream as ordered. How does the nurse assess that the cream has achieved its purpose?
A) Assess the skin for redness.
B) Note any blanching of skin.
C) Lightly tap the area where the cream is.
D) Gently poke the child with a needle.
C) Lightly tap the area where the cream is.
The nurse is preparing to administer a topical anesthetic for a 10-year-old girl with a chin laceration. The nurse would expect to apply which of the following as ordered in preparation for sutures? A) TAC (tetracaine, epinephrine, cocaine B) Iontophoretic lidocaine C) EMLA D) Vapocoolant spray
A) TAC (tetracaine, epinephrine, cocaine
The nurse is caring for a child who is complaining of chronic pain. Which of the
following is the priority nursing assessment?
A) How the pain impacts the child’s and family’s stress level
B) The pain’s history, onset, intensity, duration, and location
C) The child’s and parents’ feeling of anxiety and depression
D) The child’s cognitive level and emotional response
B) The pain’s history, onset, intensity, duration, and location
