Module 5

Question 1

Pain resulting from a profound, sudden loss of blood flow to an organ or tissues in a specific area of the body is referred to as:

a. chronic pain.
b. central pain.
c. cardiovascular pain.
d. ischemic pain.

Answer 1

d. ischemic pain.

Question 2

What is a common analgesic administered to control a moderate level of pain?

a. Meperidine
b. Acetaminophen
c. Codeine
d. Ibuprofen

Answer 2

c. Codeine

Question 3

What is the role of nociceptors? They are:

a. pain receptors that are stimulated by thermal, chemical, or physical means.
b. spinal nerves that conduct impulses from specific areas of the skin.
c. responsible for the state of arousal with pain.
d. useful in localizing pain to a specific area of the body.

Answer 3

a. pain receptors that are stimulated by thermal, chemical, or physical means.

Question 4

According to the gate-control theory, passage of pain impulses may be naturally blocked:

a. at the synapse by entry of other sensory impulses.
b. by the stress response.
c. by administration of morphine directly into the spinal cord.
d. by referring the pain to other parts of the body.

Answer 4

a. at the synapse by entry of other sensory impulses.

Question 5

Intractable pain is best defined as:

a. pain the is perceived as occurring in an amputated limb.
b. severe pain that cannot be controlled by medication.
c. pain perceived as coming from a source other than the actual source.
d. pain coming from a specific dermatome.

Answer 5

b. severe pain that cannot be controlled by medication.

Question 6

A headache that is related to changes in cerebral blood flow is classified as a/an ________ headache.

a. tension
b. sinus
c. migraine
d. intracranial

Answer 6

c. migraine

Question 7

Which of the following applies to spinal anesthesia?

a. It causes analgesia with loss of consciousness.
b. The drug is injected into cerebrospinal fluid (CSF) or the epidural space in the spinal cord.
c. The drug stimulates release of endorphins in the spinal cord.
d. The transmission of pain impulses is blocked in a small area of the body.

Answer 7

b. The drug is injected into cerebrospinal fluid (CSF) or the epidural space in the spinal cord.

Question 8

Which of the following is a characteristic of chronic pain?

a. It usually initiates a physiological stress response.
b. It always involves a strong emotional response such as high anxiety.
c. It is more difficult to diagnose and treat than is acute pain.
d. It involves tissue damage to a specific organ.

Answer 8

c. It is more difficult to diagnose and treat than is acute pain.

Question 9

Cancer-related pain has been broken down into three basic categories: pain caused by the advance of the disease and resultant damage to the body, pain that is the result of a coexisting disease unrelated to the cancer, and:

a. phantom pain as a result of amputation.
b. pain associated with the treatment of the disease.
c. pain caused by emotional stress and metabolic changes.
d. pain associated with damage to the peripheral nerves.

Answer 9

b. pain associated with the treatment of the disease.

Question 10

Pain perceived in the left arm during the course of a heart attack is an example of:

a. referred pain.
b. phantom pain.
c. chronic pain.
d. subjective pain response.

Answer 10

a. referred pain.

Question 11

Recommendations to reduce the risk factors and the progression of osteoporosis with aging include:

a. reducing vitamin D intake.
b. maintaining walking and weight-bearing exercise.
c. increasing bone resorption.
d. maintaining glucocorticoid therapy.

Answer 11

b. maintaining walking and weight-bearing exercise.

Question 12

Which of the following does NOT contribute to the increasing life span of the general population?

a. Reduced cognitive and social activities
b. Improved living conditions
c. Better nutrition
d. Advancements in health care

Answer 12

a. Reduced cognitive and social activities

Question 13

All are physiological changes that occur with aging EXCEPT:

a. reduced skeletal muscle mass.
b. degeneration of fibrocartilage in intervertebral discs in the spine.
c. increased basal metabolic rate (BMR).
d. reduced bladder capacity and incomplete bladder emptying.

Answer 13

c. increased basal metabolic rate (BMR).

Question 14

Lung expansion in the elderly may be reduced because of decreased:

1. tissue elasticity.
2. rib mobility.
3. control by the respiratory center.
4. skeletal muscle strength.

a. 1, 3
b. 1, 4
c. 2, 3, 4
d. 1, 2, 4

Answer 14

d. 1, 2, 4

Question 15

Which of the following factors lead to delayed wound healing in the elderly?

1. Reduced rate of mitosis
2. Inadequate circulation
3. High risk of infection
4. More effective immune system

a. 1, 2
b. 1, 3
c. 2, 4
d. 1, 2, 3

Answer 15

d. 1, 2, 3

Question 16

What is a major factor leading to increased occurrence of cancer in the elderly?

a. Widespread vascular degeneration
b. Cumulative exposure to carcinogens
c. Hereditary factors
d. Increased immune surveillance

Answer 16

b. Cumulative exposure to carcinogens

Question 17

Senescence refers to the period of time when:

a. mitosis is accelerated.
b. apoptosis is reduced.
c. aging changes become apparent.
d. cell death exceeds cell development.

Answer 17

d. cell death exceeds cell development.

Question 18

Vision in the elderly may be impaired when the eyeball becomes less elastic, thus preventing accommodation and resulting in:

a. presbyopia.
b. cataracts.
c. glaucoma.
d. damage to the retina.

Answer 18

a. presbyopia.

Question 19

All of the following changes are associated with aging EXCEPT:

a. loss of elastic fibers.
b. decreased metabolic rate.
c. decreased secretion of all hormones.
d. degenerative vascular changes.

Answer 19

c. decreased secretion of all hormones.

Question 20

The term given to the change that occurs in women at around age 50 with the cessation of the menstrual cycle is:

a. menopause.
b. dysmenorrhea.
c. amenorrhea.
d. menarche.

Answer 20

a. menopause.

Question 21

What is the term used to describe the degree of pain that is endured before an individual takes action?

a. Pain threshold
b. Referred pain
c. Phantom pain
d. Pain tolerance

Answer 21

d. Pain tolerance

Question 22

Pain that is caused by trauma or disease involving the peripheral nerves is referred to as:

a. neuropathic pain.
b. central pain.
c. neurogenic pain.
d. referred pain.

Answer 22

a. neuropathic pain.

Question 23

Pain perceived in the left arm during the course of a heart attack is an example of:

a. referred pain.
b. phantom pain.
c. chronic pain.
d. subjective pain response.

Answer 23

a. referred pain.

Question 24

In which structure do pain impulses ascend the spinal cord?

a. Reticular formation
b. Corticospinal tract
c. Spinothalamic tract
d. Relevant dermatome

Answer 24

c. Spinothalamic tract

Question 25

Which of the following is a characteristic of acute pain but not of chronic pain? a. Depression and debilitation b. A perception of increased generalized pain and discomfort c. Fatigue and lower pain tolerance d. Severe but short term

Answer 25

d. Severe but short term

Question 26

Which of the following statements is TRUE? a. The brain is more aware of pain impulses when the reticular activating system is depressed. b. Acute pain does not cause a reflex response at the spinal cord synapses. c. Young infants typically response to pain with tachycardia and increased blood pressure. d. Chronic pain is easier to tolerate without negative effects.

Answer 26

c. Young infants typically response to pain with tachycardia and increased blood pressure.

Question 27

What is the definition of endorphins? a. Neurotransmitters at the nociceptors b. Transmitters for sensory impulses c. Opiate-like blocking agents in the central nervous system d. Pain-causing chemical mediators

Answer 27

c. Opiate-like blocking agents in the central nervous system

Question 28

The impulses related to acute pain are usually transmitted by: a. nociceptors. b. myelinated A delta fibers. c. unmyelinated C fibers. d. any sensory fiber with a low pain threshold.

Answer 28

b. myelinated A delta fibers.

Question 29

With advancing age, the major change in the cardiovascular system involves: a. irregular impulse conduction in the heart. b. a reduced number of collagen fibers to support cardiac muscle. c. vascular degeneration, leading to arteriosclerosis and atherosclerosis. d. the heart valves becoming thin and weak.

Answer 29

c. vascular degeneration, leading to arteriosclerosis and atherosclerosis.

Question 30

Which of the following may develop in an elderly patient who has several medical problems and is markedly obese? a. Osteoarthritis and cardiovascular complications b. Decreased activity and diabetes mellitus c. Undesirable interactions with multiple prescription drugs and over-the-counter (OTC) medications d. A, B, and C

Answer 30

d. A, B, and C

Question 31

Ibuprofen is classified as an NSAID and is particularly useful in treating: a. severe pain. b. pain caused by inflammation. c. intracranial pain. d. pain in young infants.

Answer 31

b. pain caused by inflammation.

Question 32

A headache that results from pressure on the meninges surrounding the brain is referred to as a/an: a. intracranial headache. b. intrameningeal headache. c. migraine headache. d. cerebral headache.

Answer 32

a. intracranial headache.

Question 33

Predisposing factors to osteoporosis in older women include all of the following EXCEPT: a. decreased estrogen secretion. b. genetic factors. c. sedentary lifestyle. d. decreased parathyroid hormone.

Answer 33

d. decreased parathyroid hormone.

Question 34

Theories about the causes of aging include: a. apoptosis. b. wear and tear. c. altered protein (amyloid) accumulation. d. All the above

Answer 34

d. All the above

Question 35

Which of the following analgesics acts to reduce pain at the peripheral site? a. Acetaminophen b. Morphine c. Codeine d. Intravenous general anesthesia

Answer 35

a. Acetaminophen

Question 36

Pain resulting from a profound, sudden loss of blood flow to an organ or tissues in a specific area of the body is referred to as: a. chronic pain. b. central pain. c. cardiovascular pain. d. ischemic pain.

Answer 36

d. ischemic pain.