Ch. 14- Somatosensory Function, Pain, and Headache

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

"Antipyretics help to protect the body."

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

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

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? a) "Are you afraid of becoming addicted if I give you any pain medication?" b) "I can come back in an hour to see if you are having any pain then." c) "You just had surgery. Are you sure you are not having any pain?" d) "You seem to be uncomfortable. Pain is common with surgery. I can bring you pain medication."

"You seem to be uncomfortable. Pain is common with surgery. I can bring you pain medication."

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

A high ratio of surface area to body mass

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

A prolonged fever that does not have an identified source

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? a) Lower temperatures inhibit the protein synthesis of bacteria. b) Most antipyretics have been shown to have little effect on core temperature but alleviate discomforts. c) Antipyretics protect vulnerable organs, such as the brain, from extreme temperature elevation. d) Temperatures in excess of 99.5°F (37.5°C) can result in seizure activity.

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

Which intervention is an appropriate action by a nurse to take in attempting to decrease a client's temperature through conduction? a) Remove the client's blankets b) Give client a warm bath c) Apply cooling blanket d) Lower the room temperature

Apply cooling blanket

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? a) Behavioral signs of pain demonstrated by the client b) The client's verbal perception of pain c) The client's comfort level regarding the discussion of pain d) Cultural beliefs held by the client regarding the cause of pain

Behavioral signs of pain demonstrated by the client

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

Carbamazepine is a first-line treatment. -an anticonvulsant

The loss of heat from the body through the circulation of air currents is known as: a) Conduction b) Evaporation c) Radiation d) Convection

Convection

Which pain disorder is a manifestation of a disruption of cranial nerve function? a) Phantom limb pain b) Postherpetic neuralgia c) Trigeminal neuralgia d) Temporomandibular joint (TMJ) syndrome

Trigeminal neuralgia

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? a) Increased heat loss by evaporation b) Disturbance in the functioning of the thermoregulatory center c) Presence of comorbidities that are associated with lowered core temperature d) Persistent closure of arteriovenous shunts

Disturbance in the functioning of the thermoregulatory center

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

Hypersensitivity reaction to medication

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

Increased heart rate Rationale: Characteristics of chronic pain do not include autonomic responses like increased heart and respiratory rate

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? a) The immature hypothalamus is unable to perform normal thermoregulation. b) Fever in infants is often evidence of a congenital disorder rather than an infection. c) Commonly used antipyretics often have no effect on the core temperature of infants. d) Infants are susceptible to serious infections, because of their decreased immune function.

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

Select the tactile receptors that are sensitive to the movement of very light objects over the surface of the skin. a) Free nerve endings b) Ruffini end-organs c) Merkel disks d) Meissner corpuscles

Meissner corpuscles Rationale: Meissner corpuscles are particularly sensitive to the movement of very light objects over the surface of the skin and low-frequency vibration. -Free nerve endings detect touch and pressure. -Merkel disks allow for continuous determination of touch against the skin. -Ruffini end-organs are involved in heavy and continuous touch and pressure.

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

Referred

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? a) Biofeedback b) Distraction c) A physical agent d) Stimulus-induced analgesia

Stimulus-induced analgesia

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

Tension Tension-type headaches often are more responsive to nonpharmacologic techniques, such as biofeedback, massage, acupuncture, relaxation, imagery, and physical therapy, than other types of headache.

Which of the following is an accurate method of assessing pain in children ages 3 to 8 years? a) Using a word graphic scale b) Using a faces scale c) Using physiologic responses d) Using a numeric 1-10 scale

Using a faces scale

A client with a history of migraine headaches tells the physician that he or she usually experiences an aura before the onset of the headache. The client is most likely experiencing: a) Lethargy b) Visual disturbances c) Dizziness d) Dysphasia

Visual disturbances Migraine aura is associated with visual symptoms, including flickering lights, spots, or loss of vision; sensory symptoms, including feeling of pins or needles, or numbness; and speech disturbances or other neurologic symptoms.

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

Visual symptoms such as flickering lights precede the headache Explanation: An aura is visual (flickering lights, spots, or loss of vision), sensory (feeling of pins and needles, or numbness), and/or speech disturbance that precedes a migraine.

Why does subcutaneous fat affect the body's ability to insulate itself? Select all that apply. a) It adds thickness to the body's outer shell b) The tendency of its blood vessels to vasodilate c) Its poor ability to conduct body heat d) Its ability to produce body heat e) It decreases the body's need to shiver to produce heat.

a) It adds thickness to the body's outer shell c) Its poor ability to conduct body heat

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. a) decreased mental status b) change in functional capacity c) depression d) weight gain e) fatigue

a) decreased mental status b) change in functional capacity c) depression

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

a) severe pain behind the eye.

Clinical manifestations of hypothermia include which signs/symptoms? Select all that apply. a) Constricted pupils b) Impaired coordination c) Decreased respirations d) Slurred speech e) Strong bounding pulse

b) Impaired coordination c) Decreased respirations d) Slurred speech

The health care provider will likely prescribe which medication to a client who is experiencing severe nausea and vomiting with a migraine? a) oral ondansetron, an antiemetic b) sumatriptan intranasal spray c) dihydroergotamine, an ergotamine derivative d) caffeine injection

b) sumatriptan intranasal spray

A client is being taught how to use a TENS unit. The nurse determines that teaching was effective when the client states: a) "Anytime that the setting on my TENS unit needs to be changed I will have to return it to the company and wait for them to deliver a new one." b) "The TENS unit is the easiest and most cost-effective way to manage my pain at home." c) "I should take my medication and apply the TENS unit to the painful area as soon as I feel the pain." d) "I will need to return to the doctor's office to have this TENS unit surgically implanted under my skin for the best pain relief."

c) "I should take my medication and apply the TENS unit to the painful area as soon as I feel the pain."

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

c) "Pain threshold is the point at which a stimulus is perceived as painful." -Pain threshold is closely associated with the point at which a nociceptive stimulus is perceived as painful. -Pain tolerance relates more to the total pain experience; it is defined as the maximum intensity or duration of pain

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

c) Treat on individual basis and match analgesic agent with cause and level of pain.

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: a) Verifying the intensity of the pin's force of compression. b) Saying "Ouch" when the pin is pressed. c) No response when the pin is pressed. d) The withdrawal reflex is activated.

d) The withdrawal reflex is activated.

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? a) recurrent fever b) intermittent fever c) sustained fever d) remittent fever

intermittent fever

A client reports frequent severe migraines upon waking with frequent nausea and vomiting. Which treatment will the health care provider offer the client as most appropriate? a) sumatriptan intranasal spray b) nonpharmacologic treatment c) ibuprofen d) oral ondansetron, an antiemetic

a) sumatriptan intranasal spray Because the client develops severe pain upon awakening with severe nausea and vomiting, a nonoral preparation may be most appropriate. Sumatriptan is administered intranasally, making it most appropriate.

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

b) impaired thermoregulatory mechanisms brought on by anesthesia.