NUR 4125: Chapter 14 Somatosensory Function, Pain, and Temperature

The nurse knows that chronic pain lacks which of the characteristic pain-related reactions? Disturbed sleep patterns Increased heart rate Depression Loss of appetite

b

What will the nurse teach a client with trigeminal neuralgia about the condition? Avoid eating if it triggers the pain. Carbamazepine is a first-line treatment. It is good to spend time alone every day. Surgery will relieve the condition.

b

When assessing neurologic response times, the nurse expects the fastest rate of transmission to be from fibers that have which characteristics? Small diameter, myelinated Large diameter, myelinated Large diameter, unmyelinated Small diameter, unmyelinated

b

The nurse on the pediatric unit is implementing distraction strategies for a child who is experiencing pain. Which strategies would be best for the nurse to implement? Select all that apply. Silence Games Music Television Bubbles Acetaminophen

b c d e

A 33-year-old client is brought into the emergency room with a core temperature of 39°C (102.2°F). The client is red in the face, chest, and back due to significant cutaneous vasodilation. The client is likely in which stage of fever? Third First Fourth Second

A

Children feel pain just as much as adults do. What is the major principle in pain management in the pediatric population? Treat on individual basis and match analgesic agent with cause and level of pain. Always use nonpharmacologic pain management before using pharmacologic pain management. Base treatment of pain on gender and age group. Treat pediatric pain the way the parents want it treated.

A

A nurse is assessing the pain level of a client who has just had surgery. The client tells the nurse he does not think he should take any medication until the pain becomes extreme. The best response would be: "Asking for pain medication with the early onset of pain will cause addiction." "The use of pain medication before the pain becomes extreme will help prevent hyperexcitability of the CNS." "If you wait longer, you will receive stronger medication." "If you wait for a longer period of time, the pain will decrease in intensity."

B

Place the four successive stages of fever in correct order. A. Chill B. Prodromal C. Defervescence D. Flush

B A D C

A client asks if pain threshold and pain tolerance are the same. The best response by the health care provider would be: "Pain threshold is the point at which a stimulus is perceived as painful." "Pain threshold is not varied from person to person." "Pain tolerance is not affected by psychological, familial, cultural, and environmental factors." "Pain tolerance is the minimum intensity of pain a client will endure."

a

A client has been diagnosed with a fever of unknown cause. The nurse recognizes this as: A prolonged fever that does not have an identified source A fever that only occurs in adults A fever that has responded well to several medications A fever of new onset

a

A client has been diagnosed with osteomyelitis and admitted to the hospital. The client's fever persists throughout most of the day but returns to normal at least twice a day. Which pattern of fever is this client displaying? Intermittent Remittent Erratic Relapsing

a

Fever in infants and young children is not an uncommon event. Many trips to the pediatrician's office occur because of fever in children ages 1 day to 3 years. Which sign or symptom does notindicate fever in an infant? Cyanosis Avid feeding Poor tissue oxygenation Hypoventilation

b

A surgical client is at greatest risk for hypothermia during a surgical procedure related to: impaired thermoregulatory mechanisms brought on by anesthesia. the instillation of warmed intravenous fluids that lower the core temperature. the decreased temperature of the surgical suite caused by electrical appliances. negligence of the anesthesiologist in regulating the body temperature.

a

Nonshivering thermogenesis occurs in which of the following to help the newborn infant fight hypothermia? Brown fat Subcutaneous tissue Epidermis Adipose tissue

a

The nurse caring for older adults in an extended care facility suspects one of the clients has an infection. What is the earliest manifestation the client could exhibit? Increased mental confusion Shivering and chills Dehydration Elevated temperature

a

The nurse instructs the unlicensed assistive personnel (UAP) to be sure to turn the client every 2 hours in order to avoid pressure on the skin and avoid a pressure ulcer. What type of stimuli is the nurse encouraging the UAP to avoid? Mechanical stimuli Thermal stimuli Pain stimuli Chemical stimuli

a

The nurse learns that different types of headaches respond to different therapies. Which headache is most responsive to nonpharmacologic therapy? Tension Migraine Sinus Cluster

a

The nurse needs to assess a 1-year-old child for fever. Which approach will produce the mostaccurate reading? Rectal Oral Axillary Forehead

a

A client comes to the clinic for evaluation of a sharp, intermittent, severe, stabbing facial pain that she describes as "like an electric shock." The pain occurs on only one side of her face. It seems to be triggered when she chews, brushes her teeth, or sometimes when she merely touches her face. Often it is accompanied by involuntary grimacing. What diagnosis is most likely? Migraine headache Postherpetic neuralgia Complex regional pain syndrome Trigeminal neuralgia

d

A client is experiencing a cluster headache. The client would most likely manifest: nausea with vomiting. symptoms aggravated by physical activity. sensitivity to light. severe pain behind the eye.

d

A client is experiencing anorexia, myalgia, arthralgia, headache, and fatigue. The nurse should assess for: Urinary output Respirations Hypothermia Temperature

d

Infants are at greater risk of hypothermia than children because of which of the following? An increased thickness of subcutaneous fat at birth Their inability to remove clothing A high ratio of surface area to body mass The inability of infants to state that they are cold

c

A client was skating on the lake when the ice broke and he was submerged for 15 minutes. When rescuers were able to retrieve him from the water, his core temperature was 31° C (87.8°F). Into which classification does this temperature fit? Mildly hypothermic Moderately hypothermic Severely hypothermic Lethally hypothermic

a

A nurse is planning care for a client coming into the emergency department via ambulance on a hot summer day with the following symptoms: temperature of 105°F (40.5°C), absence of sweating, and loss of consciousness. The nurse anticipates that the client has which condition? Heatstroke Blunted febrile response Heat exhaustion Hyperthermia

a

A nurse teaching a client about the cervical mucus basal body temperature (CMBBT) method of birth control says that during the postovulation time frame, the core body temperature does which of the following? Increases 0.5°C to 1.0°C Decreases 0.5°C-1.0°C Increases 1.0°F-1.5°F Decreases 1.0°F-1.5°F

a

A student is feeling inside her backpack to find her mobile phone. There are a number of other items in the backpack. Which component of somatosensory conduction is most likely to provide the detailed sensory information that will help her distinguish her phone from other items? The primary dorsal root ganglion neuron, dorsal column neuron, and the thalamic neuron The opposite anterolateral pathway that travels to the reticular activating system A slow-conducting pathway that projects into the intralaminar nuclei of the thalamus A bilateral, multisynaptic, slow-conducting tract

a

What can the nurse tell a client about antipyretic drugs during fever? "Antipyretics help to protect the body." "They are not recommended." "Antipyretics are ineffective in most cases." "They usually have little effect."

a

When conducting a health assessment that focuses on the pain experienced by an older client diagnosed with early dementia, the nurse will pay particular attention to which of the following? Behavioral signs of pain demonstrated by the client The client's comfort level regarding the discussion of pain The client's verbal perception of pain Cultural beliefs held by the client regarding the cause of pain

a

Which client is exhibiting headache symptoms that indicate a need for further evaluation? Pregnant mother with drowsiness and unrelenting headache College student with unilateral headache after eating a chocolate bar Parent with general head pain after a night caring for an ill child Older adult with a headache after missing the evening meal

a

In addition to medication efficacy, what should the nurse consider when assessing the appropriateness of a pain medication prescribed to an older adult client? Select all that apply. The cost of the medication The availability of nonpharmacologic therapies The effects of normal aging on metabolism The existence of chronic illnesses The possibility of drug interaction

a c d e

A client has a mild headache and fatigue. He also states he has some aches and pains. Which stage of fever does the nurse determine the client is experiencing? Chill Prodrome Flush Defervescence

b

A recovery room nurse monitoring a client for adverse effects of cold cardiplegia assesses for: Postoperative anxiety Ventricular dysrhythmia Postoperative migraine Increased intercranial pressure

b

An older adult tells the nurse, "My friend just developed shingles and has a lot of pain. Is there a way for me to protect myself from it?" Which of the following is an appropriate response from the nurse? "Apply a topical anesthetic agent." "Get a Zostavax vaccination." "Use antiviral drugs as soon as you are exposed." "Avoid children and people with shingles."

b

The loss of heat from the body through the circulation of air currents is known as: Radiation Convection Evaporation Conduction

b

Which interventions are appropriate for a client with acute pain following abdominal surgery? Select all that apply. Amitriptyline Ibuprofen Hydrocodone Cold therapy Guided imagery

b c d e

In describing the ideal analgesic, what factors would be included? Select all that apply. Decrease the level of consciousness Have minimal adverse effects Effective Addictive Inexpensive

b c e

A client presents with a temperature of 38.8°C (101.8°F), a racing heart, fatigue, and an upset stomach after working outside in a hot day. Which assessment findings suggest fever rather than hyperthermia as a cause of the elevation in the man's temperature? Select all that apply. Dizziness Moist skin Shivering Cognitive changes Pallor

b e

A client who is being treated for chronic low back pain is using a TENS unit for relief of pain. The nurse is aware that the use of this device is considered what type of pain relief? Biofeedback Distraction Stimulus-induced analgesia A physical agent

c

A severe type of headache that occurs more frequently in men than women and is described as having unrelenting, unilateral pain located most frequently in the orbit is called: Chronic daily headache Migraine headache Cluster headache Tension headache

c

Antipyretic drugs, such as aspirin, ibuprofen, and acetaminophen, are often used to alleviate the discomforts of fever and protect vulnerable organs, such as the brain, from extreme elevations in body temperature. The use of aspirin is limited in children, however, because it can sometimes cause which disease? Angelman syndrome Münchausen syndrome Reye syndrome Guillain-Barré syndrome

c

The nurse is caring for a client who has returned from surgery after having a colon resection. What is the best method for the nurse to use when administering an opioid for pain in order to optimize pain control? Administer the opioid if the client is becoming restless. If the client is asleep, wait until she awakens to administer an opioid, because sleeping clients are not in pain. Administer the opioid preemptively and before pain becomes extreme. Administer the opioid each time the client asks for it.

c

The nurse is taking the history of a client scheduled for surgery with general anesthesia. What is the best response by the nurse to the client's statement that an uncle died after receiving general anesthesia? Request that a chaplain visit. Give emotional reassurance. Inform the anesthesiologist. Document the statement.

c

Which symptom indicates the next stage of a fever after a prodrome? Predrome A flush A chill Defervescence

c

A nurse assessing an older adult for signs and symptoms of infection in the absence of a fever should assess for which of the following? Select all that apply. Weight gain Depression Fatigue Decreased mental status Change in fuctional capacity

c d e

A client has recently been diagnosed with chronic back pain that requires the daily use of hydromorphone, an opioid analgesic. For the first few weeks, the client achieved relief with 4 mg every 6 hours. However, the client now requires 6 mg doses to achieve the same effect. How should the nurse best interpret this phenomenon? The opioid should likely be replaced with a nonsteroidal anti-inflammatory drug (NSAID) The client is exhibiting the early signs of opioid addiction The client's medication should be replaced with nonpharmacologic interventions The client is developing opioid tolerance, which is expected

d

A client is experiencing chest pain that radiates to the left arm and neck. The nurse would interpret this pain as: Referred Somatic Cutaneous Visceral

d

A nurse assessing an older adult 3 hours postoperative notes guarding, grimacing, and stiff body movement when changing positions. The client denies feeling pain. Which response will help the nurse best manage this client's pain? "Are you afraid of becoming addicted if I give you any pain medication?" "You just had surgery. Are you sure you are not having any pain?" "I can come back in an hour to see if you are having any pain then." "You seem to be uncomfortable. Pain is common with surgery. I can bring you pain medication."

d

A nurse caring for a client with hypothermia anticipates that the client's temperature will be: Above 40°C (104°F) Below 100°F (37.7°C) Below 97°F (36.1°C) Below 35°C (95°F)

d

A nurse is assessing the pain level of an adult with the use of a visual analog scale. Select the response that best indicates the client's rating using this tool. "My pain level looks like the smiley face." "My pain level is moderate." "My pain level is at 6 out of 10." "My pain level falls above the 5-cm mark."

d

A two-day postoperative client's temperature was 98.5°F (36.9°C) at 3:00 pm. At 6:00 pm, the unlicensed assistant (UAP) notifies the nurse that the client's temperature is 102°F (38.9°C). Which action should the nurse take? Offer the client a cold drink. Document the temperature. Increase intravenous fluid rate. Notify the physican.

d

In which client with a transecting spinal cord injury should the nurse anticipate an impaired ability for temperature regulation? Injury at L4 Injury at T9 Injury at L1 Injury at T2

d

The nurse is working with a client who has been diagnosed with recurring migraine headaches. Which advice by the nurse is most appropriate? "Migraines are poorly understood and are generally considered unavoidable, so always have your medication with you." "Migraine headaches usually respond poorly to medication, so I can help you explore nonpharmacologic options." "It's likely in your best interest to move to a rural setting and explore getting a less stressful job." "Many people find that maintaining regular eating and sleeping habits is beneficial."

d

The parents of a premature newborn infant ask why their child needs to remain under a warming light. On what information does the nurse base the answer? All newborns have difficulty maintaining thermoregulation. Lack of insulin delays carbohydrate metabolism in newborns. Newborn hypothermia comes from conduction to the bedding materials. Full-term newborns have brown fat, which is used to generate heat.

d

What can the nurse assume about a child's behavior when faced with the need to repeat a painful procedure? A child will resist any intervention that involves contact with his or her body. A child will benefit from a matter-of-fact approach on the part of the nurse. Pain causes similar responses in people regardless of their age. Children act to avoid pain based on their memory of past painful events.

d

What is the most common cause of drug fever? Increased heat production from PTU Serotonin syndrome Impaired peripheral heat dissipation by atropine Hypersensitivity reaction to medication

d

What will conduct injurious stimuli to alert the body to potential damage? Proprioceptors Thermoreceptors Odorant Nociceptors

d

While sponging a client who has a high temperature, the nurse observes the client begins to shiver. At this point, the priority nursing intervention would be to: administer an extra dose of aspirin. place a heated electric blanket on the client's bed. increase the room temperature by turning off the air conditioner and continue sponging the client with warmer water. stop sponging the client and retake a set of vital signs.

d