Porth's PrepU- Chapter 18: Somatosensory Function, Pain, and Headache

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?

"Get a Zostavax vaccination."

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

Increased heart rate

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."

A nurse assessing an older adult 3 hours postoperative notes guarding, grimacing, and stiff body movement when changing positions. The patient denies feeling pain. Which of the following responses will help the nurse best manage this patient's pain?

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

The nurse on the pediatric unit is implementing distraction strategies for a child who is experiencing pain. The best strategies for the nurse to implement would be: Select all that apply.

-Bubbles -Music -Television -Games

Which of the following sensations will be impaired in a patient who has an injury to the primary somatosensory cortex? Select all that apply.

-Fine touch in the thumb -Pressure sense in lips -Sense of hot and cold

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

-Inexpensive -Effective -Minimal adverse effects

A nurse is caring for a 30-year-old patient who experiences intense one-sided headaches. Which of the following additional characteristics would support a diagnosis of cluster headaches? Select all that apply.

-Pain behind the eye -Rhinorrhea on the same side as the headache

Which of the following clients may be experiencing the effects of neuropathic pain?

A man with pain secondary to his poorly controlled diabetes

A nurse who is testing a patient's response to passive movement of the fingers with the patient's eyes closed, notes that the patient cannot accurately identify on which side the movement occurred or in what position the finger was placed. Which of the following is an appropriate interpretation of this result?

Abnormal discrimination pathway function

A client fell from a ladder and broke his ankle and is being seen in the emergency department for severe ankle pain with swelling and limited range of motion. What type of pain does the nurse recognize the client experiencing?

Acute pain

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

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

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

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 what?

Cluster headache

Select the most appropriate pain assessment tool for a health care provider to use when caring for children between the ages of 3 to 7 years old.

Faces pain scale

In contrast to acute pain, persistent chronic pain indicates which of the following?

Imposes physiologic stress

In contrast to acute pain, persistent chronic pain indicates which of the following?

Imposes physiologic stresses

Which of the following statements is true of migraine headaches?

Migraines may have a hormonal etiology in some patients

A client on an acute medicine unit with a diagnosis of small bowel obstruction is reporting intense, diffuse abdominal pain. Which physiologic phenomenon is most likely contributing to the client's pain?

Nociceptive afferents are conducting along the cranial and spinal nerve pathways of the ANS

Which of the following will conduct injurious stimuli to alert the body of potential damage?

Nociceptors

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

Paresthesia from temporary nerve compression

Which of the following patients is exhibiting headache symptoms that indicate a need for further evaluation?

Pregnant mother with drowsiness and unrelenting headache

When testing nociceptive stimuli to elicit a withdrawal reflex in the body, what stimuli are commonly used?

Pressure from a sharp object

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

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?

Stimulus-induced analgesia

A client is experiencing acute pain. The nurse would anticipate the client to manifest:

Tachycardia

A client who works in a high stress job presents with facial pain and severe headache. She reports that she sometimes feels the pain in her neck or ear and that it is particularly bad during very busy times at work. Which diagnosis is most likely?

Temporomandibular joint syndrome

The nurse learns that different types of headaches respond to different therapies. Which headache is most responsive to non-medication centered therapy?

Tension

The nurse working in the neurological intensive care unit is performing a neurological assessment of somatosensory function for a client who was involved in a motor vehicle accident with suspected spinal cord injury. What should the nurse be sure to include in this assessment?

Testing the integrity of spinal segmental nerves

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 client is developing opioid tolerance, which is expected

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

Children feel pain just as much as adults do. What is the major principle in pain management in the pediatric population?

Treat on an individual basis and match analgesic agent with cause and level of pain

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?

Trigeminal neuralgia

Nonopioids, such as acetaminophen (Tylenol), are the first line of therapy for managing mild to moderate pain in the elderly because they are safe.

True

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

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:

Visual disturbances