Unit 4 Pain Patho Q's

A nurse practitioner is assessing a 7-year-old boy who has been brought to the clinic by his mother, who is concerned about her son's increasingly frequent, severe headaches. Which questions by the nurse are likely to yield data that will allow for a confirmation or ruling out of migraines as the cause of his problem? Select all that apply. a."Does your son have a family history of migraines?" b."When your son has a headache, does he ever have nausea and vomiting as well?" c."Does your son have any food allergies that have been identified?" d."Is your son generally pain free during the intervals between headaches?" e."Are you currently giving your son any herbal supplements?"

a. "Does your son have a family history of migraines?" b. "When your son has a headache, does he ever have nausea and vomiting as well?" d. "Is your son generally pain free during the intervals between headaches?

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

a. "Many people find that maintaining regular eating and sleeping habits is beneficial."

Which hospital client is most likely to be diagnosed with complex regional pain syndrome II (CRPS II)? a.A man who has been admitted for treatment of continuing hyperalgesia after sustaining a nerve injury in a motor vehicle accident. b.A woman who requires analgesia more than 3 months after an episode of shingles. c.A male client with diabetes mellitus who requires analgesia prior to each dressing change on his chronic foot wound. d.A female who has seemingly unprovoked attacks of pain that are accompanied by facial tics and spasms.

a.A man who has been admitted for treatment of continuing hyperalgesia after sustaining a nerve injury in a motor vehicle accident.

The client rings for pain medication from the nurse. Upon assessment, the nurse finds the client sitting up in a chair, watching television with her husband. Vital signs are normal and the client's skin is warm and dry. Which nursing actions are appropriate? a.Ask the client to rate his pain on the pain scale. b.Tell the client that he does not look as if she is in pain. c.Have the client go back to bed and ask the visitor to leave. d.Check to see when the client last received pain medication. e.Have another nurse assess the client.

a.Ask the client to rate his pain on the pain scale. d. Check to see when the client last received pain medication

The nurse is conducting a neurologic assessment and has gently poked the client's forearm with two ends of a paper clip 0.5 cm apart. The client is unable to state that there were two discrete points of contact. Which is the nurse's best interpretation of this finding? a.This is a normal finding when assessing discrimination at this location. b.The nurse should perform further testing of proprioception, even though this finding is normal. c.The nurse should perform the same test on the other forearm to assess for the presence of hemiplegia. d. There is a need to perform further assessments related to possible deficits in nociception.

a.This is a normal finding when assessing discrimination at this location.

A client arrives at the emergency department after experiencing multiple trauma. During the assessment, the client was unable to discern which side of the body was feeling pain or stimulus, was nauseous, and failed the two-point discrimination test. Which spinal pathway is still intact? a.Discriminative tract b.Anterolateral tract c. Spinothalamic tract d.Vestibulospinal tract

b.Anterolateral tract

How is acute pain defined? a.Pain associated with chronic illness b.Pain associated with an injury or surgery c.Pain associated with malignant pain d.Pain associated with nerve injury

b.Pain associated with an injury or surgery

How is pain perception best defined? a. Pain perception is based on the client's culture and previous experience with pain. b.Pain perception is the conscious experience of pain that occurs in the brain. c.Pain perception is the unconscious experience of pain that occurs in the brain. d.Pain perception is the pain score rating for a client before drug therapy begins.

b.Pain perception is the conscious experience of pain that occurs in the brain.

Gate control therapy proposes a mechanism to explain which phenomenon? a.Pain modulation b.Pain transmission c.Pain perception d.Pain transduction

b.Pain transmission

A client lost his right arm at the shoulder. The client often reports pain to his right arm, despite knowing that it is no longer there. Which aspect of physiology best explains this phenomenon? a.The brain still thinks his arm is there, so it induces pain to prompt its use. b.Spinal nerves fire due to loss of sensory input from the lost appendage. c.Spinal nerves are attempting to reinnervate the lost limb, but entangle with scar tissue. d.Spinal nerves allow leakage of Na+ ions at the wound site.

b.Spinal nerves fire due to loss of sensory input from the lost appendage.

While batting, a baseball player is struck in the ribs by a pitch. Which component of the pain pathway will be the first to contribute to the player's sensation of pain? a.Thalamus b.Dorsal root ganglion neurons c.Dorsal root ganglion periphery d.Axon

c.Dorsal root ganglion periphery

Somatic pain is a type of nociceptor pain that is usually experienced in which area? a.Internal organs b.Cancer or tumors c.Muscles and joints d.The nerves

c.Muscles and joints

A client has been admitted to the emergency department after a bicycle accident. When he fell, he landed on his back and has been unable to move since the accident, despite the absence of obvious head injuries. The physician will most likely assess the client's neurologic status by testing: a.each spinal nerve. b.his dermis. c.each dermatome. d.his pupillary reflexes.

c.each dermatome.

A female client with bone metastases secondary to lung cancer is admitted for palliative radiation treatment and pain control. The client is presently experiencing pain that she rates at 9 out of 10. Which non-pharmacologic treatment is most likely to be a useful and appropriate supplement to pharmacologic analgesia at this point? a.Teaching the client guided imagery and meditation b.Initiating neurostimulation c.Heat therapy d.Relaxation and distraction

d.Relaxation and distraction

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? a.Postherpetic neuralgia b.Migraine headache c.Complex regional pain syndrome d.Trigeminal neuralgia

d.Trigeminal neuralgia