Quiz 16: Pain, Temperature Regulation, Sleep, and Sensory Function
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1. Pricking one’s finger with a needle would cause minimal pain, whereas experiencing abdominal surgery would produce more pain. This distinction is an example of which pain theory?
a. Gate control theory c. Specificity theory
b. Intensity theory d. Pattern theory
2. Which pain theory proposes that a balance of impulses conducted from the spinal cord to the higher centers in the central nervous system (CNS) modulates the transmission of pain?
a. GCT c. Specificity theory
b. Pattern theory d. Neuromatrix theory
3. Which type of nerve fibers transmits pain impulses?
a. A-alpha (A) fibers c. A-delta (A) fibers
b. A-beta (A) fibers d. B fibers
4. Where are the primary-order pain transmitting neurons located within the spinal cord?
a. Lateral root ganglia c. Anterior root ganglia
b. Dorsal root ganglia d. Medial root ganglia
5. The gate in the GCT of pain is located in the:
a. Substantia gelatinosa c. Nucleus proprius
b. Marginal layer d. Dorsolateral tract of Lissauer
6. Which spinal tract carries the most nociceptive information?
a. Archeospinothalamic c. Dorsal spinothalamic
b. Paleospinothalamic d. Lateral spinothalamic
7. The major relay station of sensory information is located in the:
a. Basal ganglia c. Thalamus
b. Midbrain d. Hypothalamus
8. Where in the CNS does a person’s learned pain response occur?
a. Cerebral cortex c. Thalamus
b. Frontal lobe d. Limbic system
9. Massage therapy relieves pain by closing the pain gate with the stimulation which fibers?
a. A c. B
b. A d. C
10. What part of the brain provides the emotional response to pain?
a. Limbic system c. Thalamus
b. Parietal lobe d. Hypothalamus
11. Which neurotransmitters inhibit pain in the medulla and pons?
a. Norepinephrine and serotonin
b. Gamma-aminobutyric acid (GABA) and aspartate
c. Glutamate and tumor necrosis factor–alpha
d. Neurokinin A and nitric oxide
12. Which endogenous opioid is located in the hypothalamus and pituitary and is a strong -receptor agonist?
a. Enkephalins c. Dynorphins
b. Endorphins d. Endomorphins
13. What is the term that denotes the duration of time or the intensity of pain that a person will endure before outwardly responding?
a. Tolerance c. Threshold
b. Perception d. Dominance
14. Pain that warns of actual or impending tissue injury is referred to as what?
a. Chronic c. Acute
b. Psychogenic d. Phantom
15. Which description characterizes visceral pain?
a. Is sharp and well-defined when transmitted by A-delta (A) fibers.
b. Is perceived as poorly localized and is transmitted by the sympathetic nervous system.
c. Arises from connective tissue, muscle, bone, or skin.
d. Is perceived as dull, aching, and poorly localized when transmitted by C fibers.
16. When caring for a person who has experienced pain for 3 days, anxiety is likely to produce which physical signs that a nurse would expect to find?
a. Fever and muscle weakness or reports of fatigue
b. Irritability and depression or reports of constipation
c. Decreased blood pressure or reports of fatigue
d. Increased heart rate and respiratory rate with diaphoresis
17. Enkephalins and endorphins act to relieve pain by which process?
a. Inhibiting cells in the substantia gelatinosa
b. Stimulating the descending efferent nerve fibers
c. Attaching to opiate receptor sites
d. Blocking transduction of nociceptors
18. What is a long-term complication of rewarming as a treatment for hypothermia?
a. Acidosis c. Shock
b. Dysrhythmias d. Renal failure
19. How does the release (increase) of epinephrine raise body temperature?
a. The release of epinephrine causes shivering.
b. It affects muscle tone.
c. It raises the metabolic rate.
d. It increases and strengthens the heart rate.
20. Using a fan to reduce body temperature is an example of which mechanism of heat loss?
a. Evaporation c. Convection
b. Radiation d. Conduction
21. Up to how many liters of fluid per hour may be lost by sweating?
a. 2 c. 6
b. 4 d. 8
22. Heat loss from the body via radiation occurs by:
a. Emanations of electromagnetic waves
b. Transfer of heat through currents of liquids or gas
c. Dilation of blood vessels bringing blood to skin surfaces
d. Direct heat loss from molecule-to-molecule transfer
23. Which cytokines are endogenous pyrogens?
a. IL-3, IL-10, and IL-18
b. IL-2, IL-8, and IFN-
c. IL-4, IL-12, colony-stimulating factor, and IFN-
d. IL-1, IL-6, TNF-, and IFN-
24. Which hormones help diminish the febrile response?
a. Arginine vasopressin (AVP), melanocyte-stimulating hormone-alpha (-MSH), and corticotropin-releasing factor
b. Adrenocorticotropic hormone (ACTH), thyroid-stimulating hormone, and thyroxine (T4)
c. Antidiuretic hormone, growth hormone, and aldosterone
d. None; hormones only facilitate the increase of core body temperature.
25. Prolonged high environmental temperatures that produce dehydration, decreased plasma volumes, hypotension, decreased cardiac output, and tachycardia cause which disorder of temperature regulation?
a. Heat cramps c. Malignant hyperthermia
b. Heat stroke d. Heat exhaustion
26. In acute hypothermia, what physiologic change shunts blood away from the colder skin to the body core in an effort to decrease heat loss?
a. Hypotension c. Voluntary muscle movements
b. Peripheral vasoconstriction d. Shivering
27. A heat stroke is characterized by:
a. Core temperatures usually reaching approximately 39.9° C (103.9° F)
b. Sweat production on the face occurring even during dehydration
c. A rapidly decreasing core temperature as heat loss from the evaporation of sweat ceases
d. Symptoms caused by the loss of sodium and prolonged sweating
28. Which medication is used to reverse the effects of malignant hyperthermia?
a. Propranolol c. Dantrolene sodium
b. Diazepam d. Sodium carbonate
29. The major sleep center is located in which section of the brain?
a. Thalamus c. Frontal lobe
b. Brainstem d. Hypothalamus
30. Which neuropeptide promotes wakefulness?
a. Prostaglandin D2 c. Hypocretins
b. L-tryptophan d. Growth factors
31. Which term is also used to refer to paradoxic sleep?
a. Non-REM c. REM
b. Light d. Delta wave
32. The sudden apparent arousal in which a child expresses intense fear or another strong emotion while still in a sleep state characterizes which sleep disorder?
a. Night terrors c. Somnambulism
b. Insomnia d. Enuresis
33. Coronary artery disease is most affected by which component of sleep?
a. Non-REM c. REM
b. Light d. Delta wave
34. Rapid eye movement (REM) sleep occurs in cycles approximately every:
a. 45 minutes c. 120 minutes
b. 90 minutes d. 150 minutes
35. Loud snoring, a decrease in oxygen saturation, fragmented sleep, chronic daytime sleepiness, and fatigue are clinical manifestations of which sleep disorder?
a. Obstructive sleep apnea c. Somnambulism
b. Upper airway resistance syndrome d. Narcolepsy
36. What are the expected changes in sleep patterns of older adults?
a. Older adults experience difficulty falling asleep with less time spent in REM sleep.
b. They experience sound sleep during the night with approximately 50% of the time spent in REM sleep and dreaming.
c. Older men commonly experience interrupted sleep patterns later in life than do older women.
d. Older adults awaken often but with a rapid return to sleep; they awaken refreshed but often later in the morning.
37. Pinkeye is characterized by inflammation of which structure?
a. Eyelids c. Meibomian glands
b. Sebaceous glands d. Conjunctiva
38. Open-angle glaucoma occurs because of:
a. Decreased production of aqueous humor
b. Increased production of vitreous humor
c. Obstructed outflow of aqueous humor
d. Excessive destruction of vitreous humor
39. How can glaucoma cause blindness?
a. Infection of the cornea
b. Pressure on the optic nerve
c. Opacity of the lens
d. Obstruction of the venous return from the retina
40. When comparing the effects of acute and chronic pain on an individual, chronic pain is more often:
a. The external event that results in a sense of fear
b. Viewed as being meaningful but undesirable
c. A factor that contributes to depression
d. A sense of internal unease
41. When considering the risk factors for the development of phantom limb pain, the nurse recognizes which as a primary contributing factor?
a. Age, with adolescent patients being at a higher risk than adults
b. Presence of pain in the limb before amputation
c. Patient’s previous experience with managing pain
d. Cultural views regarding the acceptance of pain
42. Based on an understanding of the physiologic process of nociceptors, the nurse expects which surgical procedure to create more pain?
a. Repair of several crushed fingers
b. External fixation of a dislocated shoulder
c. Cyst removal on the internal surface of an ovary
d. Repair of a ruptured spleen
43. The basis of the specificity theory of pain is that:
a. Injury to specific organs results in specific types of pain.
b. Chronic pain is generally less intense than acute pain.
c. The greater the tissue injury, the greater the pain.
d. Acute pain is specific only to certain injuries.
44. Which statement is true regarding the gate control theory (GCT) of pain?
a. The pain gate is located in the brain.
b. A closed gate increases pain perception.
c. The brain primarily controls the pain gate.
d. An open gate facilitates the brain in processing the pain.
45. Which factors contribute to sensorineural hearing loss? (Select all that apply.)
a. Ménière disease
c. Diabetes mellitus
d. Noise exposure
e. Outer ear trauma
46. Why are children more susceptible to heat stroke than are adults? (Select all that apply.)
a. Children produce more metabolic heat when exercising.
b. They have more surface area–to-mass ratio.
c. Children have less sweating capacity.
d. They an underdeveloped hypothalamus.
e. Children have an overdeveloped ability to perceive heat.
47. Heat exhaustion results in: (Select all that apply.)
a. Profuse sweating
b. Profound vasodilation
c. A need to ingest warm liquids
d. Permanent damage to the hypothalamus
e. An increased risk for future heat exhaustion
48. It is true that a fever: (Select all that apply.)
a. Is a complex cascade involving several different systems.
b. Can be a result of a dysfunctional hypothalamus.
c. Should be eliminated as quickly as possible.
d. Triggers endocrine responses.
e. Is in response to a pyrogen.
Match the types of chronic pain with its description. Types of pain may be used more than once.
______ A. Myofascial pain syndrome
______ B. Neuropathic pain
______ C. Deafferentation pain
______ D. Sympathetically maintained pain
49. Pain that results from tumor infiltration of nerve tissue, from trauma or chemical injury to the nerve, or from damage from radiation, chemotherapy, or surgical sectioning of the nerve
50. Pain that is thought to be caused by trauma or disease of nerves and leads to abnormal processing of sensory information by the peripheral and central nervous systems
51. Pain that occurs after peripheral nerve injury and is described as continuous with severe sensations and a burning quality
52. Pain that is the result of muscle spasms, tenderness, and stiffness and leads to muscle guarding that limits muscle motion