PrepU Questions: Chapter #14:

What can the nurse assume about a child's behavior when faced with the need to repeat a painful procedure?

Children act to avoid pain based on their memory of past painful events.

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

Referred

The nurse is studying sensory systems. She understands that signal transduction of an impulse to the thalamus for processing is accomplished by:

Second-order Neurons

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

An 87 y/o client with vascular dementia and numerous other health problems, such as heart failure

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

Impaired thermoregulatory mechanisms brought on by anesthesia

A client has a fever thath was induced by damage to the hypothalamus due to intercranial bleeding. The nurse plans care for which type of fever?

Neurogenic

Which intervention is usually the first line of therapy when treating moderate pain in the older adult population?

Nonopioids such as acetaminophen

A nurse assesses an older adult client for s/s 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

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

Which client may be experiencing the effects of neuropathic pain?

A man with pain secondary to his poorly controlled diabetes

The nurse is teaching a client about various methods of pain control. Which information will the nurse include when teaching the client about applying heat for pain control?

"Heat promotes more blood flow to the area to improve oxygen supply."

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 chaning positions. The client denies feeling pain. Which response will help the nurse BEST manage the client's pain?

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

A client who has been exercising says to the nurse, "My skin is so hot!" What is the nurse's BEST response?

"Your body is trying to lower your temperature."

A nurse's handoff report states that a client's temperature is 106.6 F. What may have caused the client's temperature to elevate past 105.8 F? Select all that apply.

- Convulsions - Hyperthermic State

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

- Inexpensive - Have minimal adverse effects - Effective

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

Abnormal discrimination pathway function

A client reports general malaise and has a temperature of 103.8 F. 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 rescribed pharmacologic intervention. The medication most likely to be prescribed would be an:

Antiseizure

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

Brown Fat

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

Convection

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

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

A nurse who is providing a staff development in-service determines that the participants understand the information when they state that which bodily function aids heat conservation by reducing surface area for heat loss?

Erection of pilomotor muscles

What is the most common cause of drug fever?

Hypersensitivity reaction to medication

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

Intermittent

The 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 (Intermittent is experienced for part of a day, but the temperatures return to normal at least once during the 24 hours .... sustained or remittent fevers do not return to normal temp. range)

A client reports a sudden intense headache. Which factor would indicate the presence of a possible subarachnoid hemorrhage?

Intractable pain

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

Parethesia 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 stimulus would be used to elicit the withdrawal reflex when testing response to nociceptive stimuli?

Pressure from a sharp object

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

The nurse is conducting a community education course on hyperthermia and heatstroke. The nurse determines that the participants understand the information when they state that which bodily function increases core temperatures?

Shivering

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

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

Tension

A client has recently been diagnosed with chronic back pain that requires the dialy use of hydromorphone, an opioid analgesic. For the first few weeks, the client achieved relief with 4mg every 6 hours. However, the client not requries 6mg doses to achieve the same effect. How should the nurse best interpret this phenomenon/

The client is developing opioid tolerance, which is expected

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 nurse caring for an older adult who has been diagnosed with a urinary tract infection checks the client's temperature on admission and finds that it is 96.9 F. Which statement describes how the nurse should interpret the finding?

The client may be exhibiting a blunted or absent febrile response

The nurse is conducting a neurologic assessment and has greatly poked the pt'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?

This is a normal finding when assessing discrimination at this location

A client is admitted to the acute care facility with severe pain in the abdomen related to inflammatroy 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

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

Visual symptoms such as flickering lights precede the headache