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Pain Test > Sample Test Questions > Flashcards

Sample Test Questions Flashcards

1
Q

Which nerve fibers are responsible for what is known as “first pain”?

  1. A delta fibers (fast)
  2. Beta fibers
  3. C fibers
  4. Mu Fibers
A

1.

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2
Q

Nerve fibers that are unmyelinated, thin, slower transmitters, transmit dull, aching visceral pain that is diffuse in nature.

  1. Delta Fibers
  2. Beta Fibers
  3. C Fibers
  4. Mu Fibers
A

3.

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3
Q

Which of the following is correct sequence of events describing pain transmission

  1. Modulation, transmission, perception, transduction
  2. Transmission, transduction, modulation, perception
  3. Transduction, transmission, perception, modulation
  4. Transmission, perception, modulation, transduction
A

3.

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4
Q

Which theory has resulted in the most innovative treatments in the past 50 years

  1. Psychosocial theory
  2. Specificity theory
  3. Pattern theory
  4. Gate control theory
A

D.

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5
Q

Pain that is an ABNORMAL processing in central and/or peripheral nervous system producing pain that serves no purpose and is difficult to treat

  1. Acute
  2. Neuropathic
  3. Visceral
  4. Chronic
A

B.

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6
Q

Regarding pain physiology: the transfer of energy from one form to another BEST describes:

  1. Transduction
  2. Transmission
  3. Modulation
  4. Perception
A

1.

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7
Q

Cardiovascular effects due to unrelieved pain may include:

  1. Decreased heart rate, decreased B/P, hypocoagulability
  2. Increased heart rate, decreased catecholamine release, hypercoagulability
  3. Increased heart rate, increased B/P, hypercoagulable state
  4. Parasympathetic nervous system activation causing increased heart rate and decreased B/P
A

3.

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8
Q

During your initial assessment of Mrs. Jones’ pain, she tells you that she thinks she is in terrible pain, but she just wants to endure if. The best response to this statement would be to:

  1. Tell her not to endure the pain
  2. Further explore what she means by this statement
  3. Provide information about the harmful effects of unrelieved pain
  4. Offer her analgesic medication
A

2.

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9
Q

73yo patient with cancer is in hospital for pain control & rates pain as “12” on numeric scale of 0 to 10. Thirty min after receiving IV pain medication, the patient reports no pain relief. The pain management nurse calls the physician for additional orders for pain medication. The nurse’s actions demonstrate:

A

Patient advocacy

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10
Q

The pain management nurse observed a patient with complex regional pain syndrome who is not wearing the right-side jacket sleeve. The patient reports pain upon light touch. The nurse recognizes this pas as:

A

Allodynia

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11
Q

35 yo male patient with testicular cancer is joking and playing cards with his roommate. When assessed by the pain management nurse, the patient rates his pain as a 7 on the numeric rating scale. The nurse concludes the patients behavior is:

A

May be in conflict with the pain rating, and accepts the report of pain.

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12
Q

An older adult patient is discharged from the hospital on nortriptyline (pamelor) for neuropathic pain. Which statement indicates the patient’s need for additional education?

  1. I will chew sugarless gum and mints
  2. I will drink carbonated beverages
  3. I will take my medication at breakfast
  4. I will use a humidifier at bedtime
A

3.

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13
Q

Which nonpharmcologic intervention is difficult to use with older adults who are cognitively impaired?

  1. Aromatherapy
  2. Distraction
  3. Guided imagery
  4. Heat application
A

3.

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14
Q

An 85 yo male patient with hx of prostate cancer and metastasis to the lumbar spine, is receiving methadone (solo phone), 10mg, three times a day. The patient’s spouse tells the pain management nurse that the patient exhibits a lack of motivation, loss of appetite and inability to get out of bed. Nurse initially focuses on patient’s

  1. Need for antidepressants
  2. Pain assessment
  3. Physical therapy evaluation
  4. Psychological evaluation
A

2.

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15
Q

Biofeedback is a therapy used to:

  1. Develop psycho-physiological self-regulation
  2. Enhance drug delivery
  3. Increased release of serotonin
  4. Promote neuronal regeneration
A

1.

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16
Q

Which question does the pain management nurse ask a patient who is taking chondroitin to prevent potential drug interactions

  1. Are you a smoker?
  2. Do you have a history of anemia?
  3. Do you have diabetes and take insulin?
  4. Do you take prescribed blood thinners or aspirin?
A

4.

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17
Q

A 45yo patient reports pain in the foot that moves up along the calf, saying: My right foot feels like it is on fire”. The patient reports that the pain started yesterday and that he/she has no previous hx of injuries or falls. Which components of pain assessment has the patient reported.

  1. Aggravating and alleviating factors
  2. Exacerbation and associated signs and symptoms
  3. Location, quality and onset
  4. Intensity, temporal characteristics, and functional impact.
A

3.

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18
Q

A 53 yo patient receiving Ibuprofen (Motrin) 400mg Twice a day for chronic low back pain develops lower extremity edema. The pain management nurse suspects that the edema is caused by:

  1. A decrease in renal function
  2. A low creatinine level
  3. An increase in glomerular filtration rate
  4. An increase in plasma proteins
A

1.

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19
Q

A distinguishing feature of a cluster headache is that it occurs:

  1. Bilaterally
  2. Globally
  3. Occipitally
  4. Unilaterally
A

4.

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20
Q

The pain management nurse assesses a patient with complex regional pain syndrome. The nurse is concerned about the patient’s depressed mood, because she/he has said: “I can’t live with this pain.” The nurse further assesses for suicide risk, because:

  1. Decreased pain thresholds lead to suicidal thoughts
  2. Suicidal thoughts are common in patients with chronic pain
  3. Suicidal thoughts are often expressed by patients with acute pain
  4. Verbalization of suicidal thoughts is a way for patients to get attention.
A

2.

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21
Q

A 45 yo dx with lumbar radiculopathy - patient’s pain is not well controlled by opioid medication. Which medication class does pain management nurse identify as being the first-line, adjuvant medication for this diagnosis?

  1. Acetaminophen containing drugs?
  2. Non-steroidal anti-inflammatory drugs
  3. SSRI’s
  4. TCA’s
A

4.

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22
Q

The pain management nurse assesses a 67yo patient for reports of episodic, sudden onset, right sided facial pain. The patient describes the pain as fleeting, electric-like, and triggered by light touch and brushing of the teeth. The nurse suspects:

  1. Facet syndrome
  2. Myofascial pain syndrome
  3. Temporomandibular disorder
  4. Trigeminal neuralgia
A

4.

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23
Q

When assessing an infant for pain, the pain management nurse recognizes that:

  1. A lack of physiologic or behavioral response means lack of pain
  2. If something causes pain in adult, it can cause pain in an infant.
  3. The parents observations should not be included in the patient’s assessment of pain.
  4. Wong-Baker FACES Scale is an appropriate assessment tool
A

2.

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24
Q

Proxy pain ratings are used when the patient

  1. Inconsistently provides pain ratings
  2. Is hearing impaired
  3. Is unable to provide pain ratings
  4. Refuses to give a pain score
A

3.

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25
Q

A patient utilizing a heating pad at home for the treatment of muscle spasm. The pain management nurse notes the patient is on a transdermal fentanyl (Duragesic) patch. What will the nurse include in the patient’s education?

  1. Avoid using the heating pad directly over the patch
  2. Cover the patch with a cloth while using the heating pad
  3. Remove the patch while using the heating pad
  4. Stop the use of the heating pad until the patch is discontinued
A

1.

26
Q

The pain management nurse is assessing a trauma patient’s readiness for discharge, by determining the level of comfort the patient prefers. The nurse completes the portion of the pain assessment by asking about the patients.

  1. Aggravating and alleviating factors
  2. Intensity of pain
  3. Onset of pain
  4. Pain goal
A

4.

27
Q

A patient with fibromyalgia reports symptoms of unrelieved pain. To determine whether the patient is also experiencing other conditions, the pain management nurse will ask the patient about:

  1. Constipation, dizziness and pruritus
  2. Evening pain and stiffness
  3. Hyperactivity, followed by periods of heavy sleep
  4. Loss of appetite and increased feelings of anxiety
A

4.

28
Q

A patient refuses to take acetaminophen statin that it is like a sugar pill. The pain management nurse explains that taking tylenol 650mg orally is equivalent to taking:

  1. Hydrocodone (Vicodin) 5mg orally
  2. Ibuprofen (Motrin) 800mg orally
  3. Morphine (MSIR) 1mg orally
  4. Naproxen (Aleve) 500mg orally
A

1.

29
Q

The pain management nurse, concerned with metabolite accumulation in a patient with decreased creatinine clearance, decides to utilize:

  1. Fentanyl
  2. Meperidine
  3. Morphine
  4. Oxycodone
A

1.

30
Q

A patient is receiving a continuous, upper extremity, peripheral nerve block, following surgery to the left elbow. The pain management nurse immediately notifies the anesthesia provider of:

  1. A change in level of sensory or motor function to the left hand
  2. A new complaint of left great toe pain with a reported history of gout
  3. New orders written by surgeon to increase frequency of oral opioid
  4. Patient refusal to participate in physical therapy.
A

1.

31
Q

A 12 yo oncology patient is in home care without IV access and needs medication for breakthrough pain. The pain management nurse’s most effective route of administration to recommend is:

  1. Intranasal
  2. Nebulized
  3. Oral transmucosal
  4. Transdermal
A

3.

32
Q

Identify the impact of research to the practice of pain management nursing:

  1. Research provides a better understanding of the medical model of healthcare
  2. Research builds professionalism that defines the parameters of the practice
  3. Research facilitates and awareness of the differences between qualitative and quantitative research
  4. Research distinguishes moral and ethical constraints
A

2.

33
Q

The neuropathic pain of multiple sclerosis (MS) is caused by the demyelination of neurons of the spinal cord and the brain, which causes ectopic nerve impulses. Another characteristic of MS is that:
1. It affects more men that women proportionally
2. The pain depends on age at onset, length of time with MS, or degree of disability
3. The pain may be described as burning, aching, prickly, or “pins and needles”
4. Location of pain is dependent upon the spinal cord level involvement of the MS

A

C.

34
Q

Facet syndrome is defined as degeneration of the facet joints caused by:

  1. A degenerative process of the intervertebral disc
  2. An inflammatory process secondary to infection
  3. A forced twisting sprain of the joint
  4. Bulging of the nucleus pulposus
A

3.

35
Q

The genitourinary system may be affected by unrelieved pain. The resulting effects are:

  1. Increased excretion of potassium, water and sodium retention, fluid overload and decrease UOP
  2. Increased UOP, fluid depletion and hyperkalemia
  3. Increased blood pressure and shifts of fluid to the extracellular departments
  4. Decreased release of aldosterone, cortisol and catecholamines and increased release of angiotensin II and prostaglandins
A

1.

36
Q

Which statement indicates the development of opiod tolerance?

  1. Larger doses of opioids are needed to control pain, as compared to several weeks earlier.
  2. Stimulants are needed to counteract the sedating effects of opioids.
  3. The patient becomes anxious about knowing the exact time of the next dose of opioid
  4. The patient no longer experiences constipation from the usual dose of opioid
A
  1. Larger doses of opioids are needed to control pain, as compared to several weeks earlier.
37
Q

The pain management nurse observes a patient with complex regional pain syndrome who is not wearing the right side jacket sleeve. The patient reports intense, right arm pain upon light touch. The nurse recognizes this pain as:
A. Allodynia
B. Hypoalgesia
C. Neuritis
D. parenthesis

A

A

38
Q

A 45 year old patient who reports pain in the foot that moves up along the calf says “my right foot feels like it is on fire”. The patient reports that the pain started yesterday, and he or she has no prior history of injury or falls. Which components of pain assessment has the patient reported?

  1. Aggravating and alleviating factors
  2. Exacerbation, with associated signs and symptoms
  3. Intensity, temporal characteristics, and functional impact.
  4. Location, quality, and onset.
A

4

39
Q

A 53 year old patient who is receiving ibuprofen 400mg twice a day, for chronic, low back pain develops lower extremity edema. The pain management nurse suspects the edema is caused by:

A. A decrease in renal function.
B. A low creatinine level.
C. An increase in glomerular filtration rate
D. An increased in plasma proteins

A

A

40
Q

Distinguishing feature of a cluster headache is that it occurs:

  1. Bilaterally
  2. Globally
  3. Occipitally
  4. Unilaterally
A

4

41
Q

A 73 year old patient with cancer is in the hospital for pain control and rates pain as a “12” on the Numeric Rating Scale of 0-10. Thirty minutes after receiving IV pain medication, the patient reports no pain relief. The pain management nurse calls the physician for additional orders for pain medication. The nurses actions demonstrate:

  1. Analgesic titration
  2. Empathy
  3. Independence
  4. Patient advocacy
A

4

42
Q

Which behavioral therapy works best to relieve pain with muscle tension and spasms in patients who are anxious about their pain?

  1. Distraction
  2. Hypnosis
  3. Relaxation
  4. Stress management
A

3

43
Q

The pain management nurse follows the recommended protocol for preventing constipation when starting a patient on opioids by:

  1. Adding bulk fiber to the diet
  2. Giving the patient enemas as needed
  3. Increasing fluids and exercise
  4. Using a bowel stimulant and stool softener
A

4.

44
Q

A 35 year old male patient with testicular cancer is joking and playing cards with his roommate. When assessed by the pain management nurse, the patient rates his pain as a 7 on a Numeric Rating Scale of 0-10. The nurse concludes that the patient’s behavior.

  1. Is an emotional reaction to having cancer
  2. Is in anticipation of future pain
  3. Is more indicative of the need for pain medication that the pain rating.
  4. May be in conflict with the pain rating, and accepts the report of pain.
A

4.

45
Q

An older adult patient is discharged from the hospital with nortriptyline (Pamelor) for neuropathic pain. Which statement indicates the patient’s need for additional education?

  1. “I will chew sugarless gum and mints”
  2. “I will drink carbonated beverages”
  3. “I will take my medication at breakfast”
  4. “I will use a humidifier at bedtime”
A

3

46
Q

Which nonpharmacologic intervention is difficult to use with older adults who are cognitively impaired?

  1. Aromatherapy
  2. Distraction
  3. Guided imagery
  4. Heat application
A

3.

47
Q

An 85 year old, male patient with a history of prostrate cancer and metastasis to the lumbar spine, is receiving methadone (dolophine), 10mg, three times day. The patient’s spouse tells the pain management nurse that the patient exhibits a lack of motivation, loss of appetite, and an inability to get out of bed. The nurse initially focuses on:

  1. Need for antidepressants
  2. Physical therapy evaluation
  3. Psychological evaluation
  4. The patient’s pain assessment
A

4.

48
Q

The pain management nurse assesses a patient with complex regional pain syndrome. The nurse is concerned about the patient’s depressed mood, because she or he said: “I can’t live with this pain”. The nurse further assesses for suicide risk, because:

  1. Decreased pain threshold lead to suicidal thoughts
  2. Suicidal thoughts are common in patients with chronic pain
  3. Suicidal thoughts are often expressed by patients with acute pain
  4. Verbalization of suicidal thoughts is a way for patients to get attention
A

2

49
Q

A 45-year old patient is diagnosed with lumbar radiculopathy. The patient’s pain is not well controlled by an opioid medication. Which medication class does the pain management nurse identify as being the first-line, adjuvant medication for this diagnosis?

  1. Acetaminophen containing drugs
  2. Nonsteroidal anti-inflammatory drugs
  3. Serotonin reputake inhibitor antidepressants
  4. Tricyclic antidepressants
A

4.

50
Q

Biofeedback is a therapy used to:

  1. Develop psycho-physiologic self regulation
  2. Enhance drug delivery
  3. Increased release of serotonin
  4. Promote neuronal regeneration
A

1.

51
Q

The pain management nurse notices a male patient grimacing as he moves from the bed to a chair. The patient tells the nurse that he is not experiencing any pain. The nurses response is to:

  1. Clarify the patient’s report by reviewing the patient’s nonverbal behavior.
  2. Confronting the patient’s denial of pain
  3. Obtaining an order for pain medication
  4. Supporting the patient’s stoic behavior.
A

1.

52
Q

The pain management nurse assesses a 67-year old patient for reports of episodic, sudden-onset, right-sided facial pain. The patient describes the pain as fleeting, electric-like and triggered by light touch and brushing of the teeth. The nurse suspects:

  1. Facet syndrome
  2. Myofascial pain syndrome
  3. Temporomandibular disorder
  4. Trigeminal neuralgia
A

4.

53
Q

When assessing an infant for pain, the pain management nurse recognizes that:

  1. A lack of physiological or behavioral response means a lack of pain
  2. If something causes pain in an adult, it can cause pain in an infant.
  3. The parent’s observations should not be included in the patients’ assessment of pain.
  4. Wong-baker FACES scale is an appropriate assessment tool
A

2.

54
Q

A patient is utilizing a heating pad at home for the treatment of a muscle spasm. The pain management nurse notes the patient is on a transdermal fentanyl (Duragesic) patch. What will the nurse include in the patient’s education?

  1. Avoid using the heating pad directly over the patch
  2. Cover the patch with a cloth while using the heating pad.
  3. Remove the patch while using the heating pad
  4. Stop the use of the heating pad until the patch is discontinued
A

1.

55
Q

The main responsibilities of the nurse on the interdisciplinary, chronic pain management team are to:

  1. Assess level of function; design a therapeutic exercise plan, and monitor functional progress
  2. Provide a comprehensive, psychosocial evaluation; implement cognitive behavior interventions; and teach problem solving techniques.
  3. Provide ergonomic training; develop pain management strategies to apply in the workplace; and facilitate the return to work.
  4. Review the medical history; monitor medications; and provide education to the patient and family
A

4.

56
Q

The pain management nurse is assessing a trauma patients readiness for discharge, by determining the level of comfort the patient prefers. The nurses completes this portion of the pain assessment by asking about the patient’s:

  1. Aggravating and alleviating factors
  2. Functional pain goal
  3. Intensity of pain
  4. Onset of pain
A

2.

57
Q

A patient with fibromyalgia reports symptoms of unrelieved pain. To determine whether the patient is also experiencing other conditions, the pain management nurse will ask the patient about:

  1. Constipation, dizziness, and pruritis
  2. Evening pain and stiffness
  3. Hyperactivity, followed by periods of heavy sleep
  4. Loss of appetite and increased feelings of anxiety.
A

4.

58
Q

The pain management nurse, concerned with metabolite accumulation in a patient with decreased creatinine clearance, decides to utilize:

  1. Fentanyl transdermal patch (duragesic).
  2. Methadone (dolophine)
  3. Morphine (MS-IR)
  4. Oxycodone (roxicodone)
A

Fentanyl patch

59
Q

Following surgery to the left elbow, a patient is receiving a continuous upper-extremity, peripheral nerve block. The pain management nurse immediately notifies the anesthesia provider of:

  1. A change in level of sensory or motor function to the left hand
  2. A new complaint of left great toe pain with a reported history of gout
  3. New orders written by the surgeon to increase frequency of oral oxycodone from every six hours as needed, to every four hours as needed.
  4. Patient refusal to participate in physical therapy.
A

1.

60
Q

A 12 year old oncology patient who is receiving in home care without IV access needs medication for breakthrough pain. The pain management nurse’s most effective route of administration to recommend is:

  1. Intranasal
  2. Nebulized
  3. Oral transmucosal
  4. Transdermal
A

3.

61
Q

Five key elements in pain assessment WILDA

A
  1. Words
  2. Intensity
  3. Location
  4. Duration
  5. Aggravating/alleviating factors

Pain Test (12 decks)

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