prepU 14

The nurse is caring for a team of clients with febrile illnesses. For which medication prescription would the nurse seek clarification?

Aspirin 650 mg every 4 hours for a 15-year-old with influenza

A client is admitted to the acute care facility with severe pain in the abdomen related to inflammatory bowel disease. What type of pain will the nurse be administering medication to relieve?

Visceral pain

Which characteristic differentiates a migraine with aura from a migraine without aura?

Visual symptoms such as flickering lights precede the headache

A nurse instructing unlicensed assistive personnel (UAP) on temperature regulation includes as part of the teaching that core body and skin temperatures are sensed by which part of the brain?

hypothalamus

A surgical client is at greatest risk for hypothermia during a surgical procedure related to:

impaired thermoregulatory mechanisms brought on by anesthesia.

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:

stop sponging the client and retake a set of vital signs.

What will the nurse teach a client with trigeminal neuralgia about the condition?

Carbamazepine is a first-line treatment.

How will the nurse explain to a client the changes in blood flow during exercise?

"Heat dilates blood vessels and increases local blood flow to skeletal muscles."

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."

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."

Which core body temperature is within normal range?

37.3°C (99.1°F)

Which client will the nurse be assessing in relation to problems with thermoregulation?

66-year-old client with damage to the hypothalamus secondary to a cerebral vascular accident.

Which client(s) is showing manifestations of infection? Select all that apply.

75-year-old client with temperature 37.3°C (99.2°F), declining mental status, weakness and fatigue 25-year-old client with temperature 40°C (104°F), sweating, shivering, states generalized pain 2-month-old client with temperature 38.3°C (100.4°F), lethargy, poor feeding, and cyanosis

A nurse is working at the medical booth at a marathon on a hot summer day. Which individual is at greatest risk for hyperthermia?

83-year-old spectator with congestive heart failure

A client diagnosed with moderate hypothermia would likely experience the instillation of warmed fluids into the gastrointestinal tract and extracorporeal blood warming. This type of rewarming is referred to as:

Active core

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 preemptively and before pain becomes extreme.

An otherwise healthy client has been referred to a pain clinic because he is experiencing exquisite pain from the friction of his clothes on his torso. This client is likely to be diagnosed with which health problem?

Allodynia

For which older adult client would pain assessment likely be most challenging for the nurse?

An 87-year-old client with vascular dementia and numerous other health problems, such as heart failure

Chronic pain is difficult to treat. Cancer, a common cause of chronic pain, has been especially addressed by the World Health Organization (WHO). What has WHO created to assist clinicians in choosing appropriate analgesics?

An analgesic ladder for pain control

The nurse is performing an assessment for a client with diabetes who has peripheral neuropathy. When the nurse assesses pain response in the lower extremities, the client does not have any reaction. What would the nurse document this response as?

Analgesia

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?

Anterolateral tract

A client reports general malaise and has a temperature is 103.8°F (39.9°C). What is the rationale for administering a prescribed aspirin, an antipyretic, to this client?

Antipyretics protect vulnerable organs, such as the brain, from extreme temperature elevation.

A diabetic client has developed diabetic neuropathy and is prescribed pharmacologic intervention. The medication most likely to be prescribed would be an:

Antiseizure

Which intervention is an appropriate action by a nurse to take in attempting to decrease a client's temperature through conduction?

Apply cooling blanket

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 not indicate fever in an infant?

Avid feeding

A nurse caring for a client with hypothermia anticipates that the client's temperature will be:

Below 35°C (95°F)

Which client/disease process would benefit from surgery to relieve severe, intractable pain?

Block transmission of phantom limb pain

Which factors influence pharmacologic choices for pain management in children? Select all that apply

Body size requires dosage adjustment. Liver function is less efficient in an infant. One goal is to minimize side effects. Premature infants may have reduced renal function.

Nonshivering thermogenesis occurs in which of the following to help the newborn infant fight hypothermia?

Brown fat

The nurse is assessing a client with an elevated temperature. Which additional assessment findings provide the most useful information for the nurse?

Client's heart rate is more rapid than anticipated.

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:

Cluster headache

The client asks the health care provider, "What is the purpose of applying cold to a sprained ankle?" Which response by the health care provider is best?

Cold provides pain relief and suppresses the release of products from tissue damage.

The loss of heat from the body through the circulation of air currents is known as:

Convection

A client experiencing an increased temperature reports weakness and fatigue. Which explanation accurately accounts for these symptoms?

Epinephrine and norepinephrine shift the body metabolism to heat production rather than energy generation.

Which risk factor presents the greatest risk for injury in an older adult who is experiencing a dysfunction in temperature regulator function?

Delayed initiation of appropriate treatment

The provider is testing the client's ability to identify the specific location of skin touch in two different areas. This ability is communicated through which pathway?

Discriminative

An older adult's blood cultures have come back positive, despite the fact that the client's oral temperature remains within normal range. Which phenomena underlies the alterations in fever response that occur in older adults?

Disturbance in the functioning of the thermoregulatory center

Which principles should underlie the pain control strategy in the care of a child with a diagnosis of cancer?

Dosing and timing should aim for a steady serum level of the prescribed drug.

Drug fever is a fever that can occur with the administration of a specific drug and then disappear when the drug is discontinued. Which method indicates a way that drugs can induce fever? Select all that apply.

Drugs can act as direct pyrogens. Drugs can induce an autoimmune response. Drugs can injure tissues directly.

Sometimes recurrent fevers occur but do not follow a strictly periodic pattern. Causes of these recurrent fevers include genetic disorders such as familial Mediterranean fever. What are the characteristics of familial Mediterranean fever?

Early age of onset (<20 years) and high fever

A client tells the nurse that she was treated at a local urgent care center for a bacterial infection that caused a temperature of 102.5°F (39.1°C). The nurse documents:

Exogenous pyrogen

Which assessment finding correlates to the prodromal stage of a fever?

Fatigue

A nurse is providing care for a 44-year-old male client who is admitted with a diagnosis of fever of unknown origin (FUO). Which characteristic of the client's history is most likely to have a bearing on his current diagnosis?

HIV positive and homeless

In assessing a client with a cerebral infarct for sensation, which results would a nurse find that would indicate that third-order neurons are intact?

Identifying a scent

Clinical manifestations of hypothermia include which signs/symptoms? Select all that apply.

Impaired coordination Decreased respirations Slurred speech

The nurse knows that chronic pain lacks which of the characteristic pain-related reactions?

Increased heart rate

A 20-year-old female has been brought to the emergency department from a rave party where she collapsed on the dance floor. Her friends acknowledge that the woman took ecstasy early in the evening. Her heart rate is regular at 89 beats/minute; temperature 39.8°C (103.6°F) orally. The emergency team would recognize that which phenomenon, related to the drug, is a likely contributor to the woman's status?

Increased peripheral vasoconstriction

In describing the ideal analgesic, what factors would be included? Select all that apply.

Inexpensive Have minimal adverse effects Effective

Which of the following types of pain is characterized by severe, brief, often repetitive pain?

Neuralgia

A febrile, 3-week-old infant is currently undergoing a diagnostic workup to determine the cause of the fever. Which statement conveys the rationale for this careful examination?

Infants are susceptible to serious infections, because of their decreased immune function.

In which client with a transecting spinal cord injury should the nurse anticipate an impaired ability for temperature regulation?

Injury at T2

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

Large diameter, myelinated

The health care provider is obtaining a pain history from a client. Which information is most important to obtain? Select all that apply.

Localization Quality Self-report Intensity Pain onset

Most febrile illnesses are due to common infections and are relatively easy to diagnose. In certain instances, however, it is difficult to establish the cause of a fever. In these instances, the elevation in temperature is referred to as a fever of unknown origin (FUO). What is a common cause of FUO?

Malignancies

Select the tactile receptors that are sensitive to the movement of very light objects over the surface of the skin.

Meissner corpuscles

A nurse is assessing a client for manifestations of chronic pain. Which finding is characteristic of chronic pain? Select all that apply.

Mental depression Loss of appetite Withdrawal from activities

Which statement explains how nonsteroidal anti-inflammatory drugs (NSAIDs) control pain?

NSAIDs block the enzyme that synthesizes prostaglandins.

Migraine headaches affect millions of people worldwide. What are first-line agents for the treatment of migraine headaches?

Naproxen sodium and metoclopramide

A client experiencing phantom limb pain after a traumatic amputation finds that opioids, biofeedback, a transcutaneous electrical nerve stimulation unit, and relaxation therapy are all needed to reduce the pain to a tolerable level. Which pain theory is best supported by this event?

Neuromatrix

What will conduct injurious stimuli to alert the body to potential damage?

Nociceptors

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?

Notify the physician.

When a peripheral nerve is irritated enough, it becomes hypersensitive to the noxious stimuli, which results in increased painfulness or hyperalgesia. Health care professionals recognize both primary and secondary forms of hyperalgesia. What is primary hyperalgesia?

Pain sensitivity that occurs directly in damaged tissues

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

Referred

A client reports feeling a tingling sensation in the last two fingers of one hand after hitting the inner surface of the elbow on a desk. What is the cause of this symptom?

Paresthesia from temporary nerve compression

A nurse assesses a client with a cerebral infarct for sensation. Which result indicates that second-order neurons are intact?

Patellar reflex +2

Which client is exhibiting headache symptoms that indicate a need for further evaluation?

Pregnant mother with drowsiness and unrelenting headache

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?

Prodrome

A client in the intensive care unit has been having rapidly changing core body temperatures that requires close monitoring. The client is intubated and has a pulmonary artery catheter and a Foley catheter. The nurse should obtain and/or record the temperature from which of the following?

Pulmonary artery catheter

The nurse needs to assess a 1-year-old child for fever. Which approach will produce the most accurate reading?

Rectal

When assessing a newborn (7 days old), which finding indicates the infant may have a bacterial infection?

Rectal temperature of 100.4°F (38°C).

An older adult client with a history of chronic obstructive pulmonary disease (COPD) develops a fever of 38.3ºC (101ºF). What is the primary reason for the nurse to implement temperature-lowering measures?

Reduce oxygen demand

A nurse reading a client's history and physical notes that the client has had a remitting fever. The nurse interprets this to mean that the client's temperature has done what?

Remained elevated but varied a few degrees

The nurse is caring for a client with acute pain from broken humerus. Which direction will the nurse provide the client related to pain management?

Requesting pain medication before the pain is severe can reduce how much medication is needed.

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?

Reye syndrome

A nurse is conducting a health promotion education program on heat cramps that cause painful muscle cramps. What is the likely cause of these cramps?

Salt depletion from heavy sweating

Which intervention would be an appropriate action for a nurse to take in attempting to decrease a client's temperature through radiation heat loss?

Set the room to a lower temperature

The nurse is providing nonpharmacologic pain relief for a client who has a pain level of 2 in the leg. What intervention provided by the nurse would be considered distraction?

Sitting with the client and having a conversation

A client is brought to the emergency department after being lost in the wilderness. What manifestations indicate hypothermia? Select all that apply.

Slurred speech Dehydration Hyperglycemia

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?

Stimulus-induced analgesia

Which client is most likely to be susceptible to developing a neurogenic fever?

Sustained a head injury in a bicycle crash

A client is experiencing anorexia, myalgia, arthralgia, headache, and fatigue. The nurse should assess for:

Temperature

A nurse conducting a community education program on hyperthermia determines that the participants understand the information when they identify that the heat index is which of the following?

Temperature sensed when temperature and humidity are combined

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

Tension

A client who has been exercising for a few weeks begins to sweat as soon as he exercises. What will the nurse determine from this assessment?

The client is reacting normally.

A recovery room nurse monitoring a client for adverse effects of cold cardioplegia assesses for:

Ventricular dysrhythmia

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 medical team is assessing a newly admitted client who is hypothermic following a night spent lost on a ski slope. The health care professionals would recognize that which phenomenon most likely contributed to minimizing the client's heat loss in a cold environment?

The tissue thickness of the outer shell increased and preserved heat.

The health care provider is assessing the functional integrity of all spinal nerves utilizing a pinpoint pressed against the skin. A normal response would be interpreted as:

The withdrawal reflex is activated.

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

Which pain disorder is a manifestation of a disruption of cranial nerve function?

Trigeminal neuralgia

Which is considered the most accurate method of assessing pain in children ages 8 years and older?

Using a numeric 1-10 scale

Fever and hyperthermia describe conditions in which body temperature is higher than the normal range. When does hyperthermia occur?

When the body's set point is unchanged, but the temperature goes up

A nurse assess an older adult client for signs and symptoms of infection. In the absence of a fever, for which will the nurse assess? Select all that apply.

decreased mental status change in functional capacity fatigue

Stretch-sensitive receptors in the skin (Ruffini end organs, Pacinian corpuscles, and Merkel cells) help signal postural information and are processed through the:

dorsal column-medial lemniscus pathway.

Which neuron transmits sensory information from the periphery to the central nervous system (CNS)?

first-order neurons

A client has sought care because of recent malaise and fever. Upon assessment, the client states that for the past week there has been a cycle of high fever in the evening but normal temperature in the mornings. Which fever pattern will the nurse document?

intermittent fever

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

mechanical stimuli

A client is said to be in the chill stage of the fever process when the nurse:

observes piloerection on the skin.

A hospital client who is being treated for acute kidney injury has developed an oral temperature of 39.1°C (102.4°F) despite the absence of other signs and symptoms of infection. When attempting to determine the etiology of the client's fever, the nurse should:

review the client's recent medication history.

A client is experiencing a cluster headache. The client would most likely manifest:

severe pain behind the eye.