Pain

This term implies that there is an unpleasant sensory and emotional experience with actual or potential tissue damage or described in terms of damage.

A. Pain

B. Trauma

C. Damage

D. Injury

A

Nurse Tuazon is assessing a client with Type 2 Diabetes. While assessing, what is the most accurate indicator or essential component of pain assessment?

A. The watcher’s report

B. The documented pain scale 8 hours ago.

C. Patient’s verbalization of the pain and giving a scale.

D. Physical assessment

C

True or False: Pain is considered to be the 5th vital sign but is highly subjective.

True

Nurse Tuazon is taking care of a post-operative patient and has suddenly developed pain within the abdominal area. He understands that pain within seconds to atleast 6 months are categorized as:

A. Acute pain

B. Chronic Pain

C. Breakthrough pain

D. Neuropathic pain

A

Patient Y has suffered a sudden, recent, and sharp pain as he received a fall in his bedroom This type of pain is categorized as?

A. Acute pain

B. Chronic pain

C. Neuropathic pain

D. Breakthrough pain

A

Nurse Tuazon is taking care of a client with a chronic condition and he still feels pain. What would be the assessment findings that would be considered normal?

A. Normal vital signs

B. Hypertension, diaphoresis, and grimacing

C. Usually localized

D. N/A

A

While Tuazon is studying for the concepts of pain. When a client receives an injury and has the perception of noxious stimuli (tissue injury). This is usual and considered not abnormal in any way.

A. Neuropathic pain

B. Nociceptive pain

C. Breakthrough pain

D. Acute pain

B

Nurse Tuazon is taking care of a patient with cancer symptoms when he immediately shrieked in pain despite multiple pain medications. The nurse identifies this as

A. Acute pain

B. Breakthrough pain

C. Chronic pain

D. Allodyna

B

A patient has a suspected damage to the CNS and PNS. What type or category of pain is expected to this patient under your care?

A. Neuropathic

B. Nociceptive

C. Chronic Pain

D. Acute Pain

A

When a patient has unrelieved pain, the anterior pituitary sends out this hormone to flood the body with cortisol.

A. Cortisol

B. Epinephrine

C. Adrenocorticotropic Hormone

D. Catecholamines

C

When a patient has unrelieved pain, this hormone will cause hyperglycemia by causing gluconeogenesis and lipolysis. It can also cause impaired wound healing and immune system.

A. Adrenocorticotropic Hormone

B. Cortisol

C. Glucagon

D. Epinephrine

B

When a patient has unrelieved pain, his heart rate will increase, vasoconstriction in the vessels, and hypertension will be expected. Knowing the physiology of our endocrine system, what are the hormones primarily responsible for causing these physiological events?

A. Epinephrine/Norepinephrine or Catecholamines

B. Cortisol and ACTH

C. Testosterone and Progesterone

D. Epinephrine and Cortisol

A

The client is experiencing unrelieved pain, what hormone would cause the client to retain most of his fluids due to impaired renal function and oliguria?

A. Vasopressin

B. Angiotensin II

C. Renin

D. Aldosterone

A

The client is experiencing unrelieved pain, this hormone is primarily responsible for the retainment of sodium and water whilst excreting out potassium which increases the chances of hypokalemia.

A. Cortisol

B. Vasopressin

C. Angiotensin II

D. Aldosterone

D

Client A presents to the ER with pain that has been unrelieved for quite some time. He is experiencing fever, altered capillary permeability, and has hyperalgesia. What is this cytokine that is responsible for these effects?

A. IL-3

B. IL-1

C. IL-2

D. IL-5

B

Somatic or Visceral: Bone and Joints

Somatic

Somatic or Visceral: Muscles

Somatic

Somatic or Visceral: Skin

Somatic

Somatic or Visceral: Connective Tissue

Somatic

Somatic or Visceral: GI Tract

Visceral

Somatic or Visceral: Pancreas

Visceral

This type of painful stimuli occurs when a patient receives pain despite the stimulus received is not painful (a blanket touching the person). This nature of pain mostly occurs in neuropathic pain.

A. Breakthrough pain

B. Allodynia

C. Opiod antagonist

D. Hyperalgesia

B

When a client has abnormally high and intense reaction to pain, driven by constant use of opiods or damage to the tissue and nerves. What terminology is used when the client receives an intense reaction despite the stimulus received is mild but hurts more than it should.

A. Hyperalgesia

B. Allodynia

C. Breakthrough Pain

D. Ceiling effect

A

This term is defined as the maximum amount of pain and duration of pain that an individual can endure.

A. Hyperalgesia

B. Allodynia

C. Ceiling effect

D. Dysthesia

D

This phase of nociception occurs when the client pain threshold has been reached and there is signs of tissue injury.

A. Transduction

B. Transmission

C. Modulation

D. Perception

A

These are the nerve fibers that interpret pain during physiological pain.

A. Nociceptors

B. Merkel disks

C. Krause End Bulbs

D. Purkinje Fibers

A

This is the neurotransmitter that acts as a stimulant for nociceptors which can enhance the movement of the impulses across the nerve synapse from the primary afferent neuron to the second order neuron.

A. Acetylcholine

B. Substance P

C. Prostagladins

D. Glutamate

B

This hormone is released during injury (nociception) and allows calcium and sodium to rush in allowing an action potential. This is the reason why some light touches are painful when the surrounding area or nerves are stimulated.

A. Dopamine

B. Oxytocin

C. Serotonin

D. Histamine

C

During your physical assessment, you have noticed that the athlete received an injury in his lower leg. It is swelling and edematous, what is the hormone primarily responsible for the swelling and edema?

A. Histamine

B. Serotonin

C. Oxytocin

D. BRADYKININ

A

This is a powerful vasodilator that is released at the site of an injury which causes the release of histamine.

A. Bradykinin

B. Prostagladin

C. Substance P

D. Histamine

A

During transduction phase, the nurse understands that prostaglandins are released into the blood stream due to an injury. What class of medication or drug class works on this phase which can alleviate the pain and swelling?

A. NSAIDs and corticosteroids

B. Beta blockers

C. Opiods

D. Local anesthetics

A

What class of drug inhibits ions or voltage sodium channels from allowing electrical impulses from traveling up a nerve.

A. NSAIDs

B. Corticosteroids

C. Local anesthetics

D. Opiods

C

Nurse Tuazon is carrying out a order of 500 mg paracetamol orally PRN. The nurse understands that the drug is classified as a antipyretic and analgesic and its MOA is:

A. Paracetamol blocks the production of COX-2 enzymes, therefore reducing prostaglandin synthesis and effectively reducing swelling as it stops vasodilation from occuring.

B. Paracetamol acts primarily in the CNS which inhibits central cox enzymes that can block prostaglandin synthesis centrally but is terminated peripherally due to peroxides.

C. Paracetamol has no effect in pain and therefore must be questioned and challenged. It primarily only handles pyrexia or high temperatures.

D. Paracetamol only works as an antiplatelet.

B

When the nerve impulse travel through the peripheral nerves and enter the brain, this phase is known as?

A. Transduction

B. Transmission

C. Perception

D. Modulation

B

A client is feeling a sharp pain and localized within his left leg. The nurse understands that the nerve that the electrical impulses travelled to is the:

A. A delta fibers

B. C fibers

C. D fibers

D. E fibers

A

When a client is experiencing dull and aching pain. The type of fibers that the pain is traveling to is?

A. A-delta fibers

B. B-delta fibers

C. C-fibers

D. D-delta fibers

C

This drug class interrupts the transmission of stimuli to the dorsal horn before the signal can cross to the spinothalamic tract.

A. Local Anesthetics

B.Gabapentinods

C. Opiods

D. Epidurals & Intrathecal Blocks

D

This order of neuron extends from the peripheral tissues to the dorsal horn of the spinal cord.

A. First order neuron

B. Second order neuron

C. Third order neuron

D. Forth order neuron

A

This type of fiber is fully myelinated and non-nociceptive. This is the primary reason why massages and effleurage is a good way to block pain according to the Gate Control Theory

A. A-delta fibers

B A-beta fibers

C. C fibers

D. C-delta fibers

B

This exogenous drug depletes substance P in the primary afferent C-fibers. Once depleted, pain transmission is no longer enhanced.

A. Lidocaine

B. Acetaminophen

C. Celecoxib

D. Capsaicin

D

Nurse Tuazon is assessing a client and described his pain as burning and shooting. Knowing the anatomy and physiology of the pain pathway, you understand that this involves C-fibers. What is the first-line systemic drug (oral) that will bind to the subunit of the voltage-gated channel calcium at the dorsal horn junction which will help prevent the release of excitatory neurotransmitters caused by overactive c-fibers

A. Gabapentinoids

B. Opiods

C. NSAIDs

D. SNRIs

A

You are assessing a client taking Gabapentinoids as he is experiencing diabetic neuropathy causing excessive of substance P. What clinical sign should you immediately warn the healthcare provider?

A. Peripheral edema, dizziness, somnolence

B. Tinnitus, hepatotoxicity, fall risk

C. Ototoxicity, blindness, edema

D. Tachycardia, pinpointed pupils, seizures

A

This drug class primarily enhances descending inhibitory pathways from the brainstem to block the incoming c-fibers at the spinal cord. It is important to educate clients that it will take 1-2 weeks and must not be stop abruptly.

A. SNRIs (Duloxetine)

B. Gabapentinoids (Gabapentin)

C. Topical Lidocaine

D. Corticsteroids

A

The first order neuron is complete, when does the second order neuron start and stop?

A. Dorsal horn - spinothalamic tract

B. Peripheral nerves - Substatia gelatiosa

C. Dorsal Horn - Spinothalamic Tract - Thalamus

D. Thalamus - Somatosensory Cortex

C

The stimulus coming from our second order neuron decussated and entered the thalamus. The termination organ is?

A. Limbic system

B. Somatosensory cortex

C. Spinothalmaic tract

D. Dorsal horn

B

This drug aims to target the thalamus and cerebral cortex (third order neuron level) which completely stops the perception of pain signals and by depressing the central nervous system.

A. Local anesthetics

B. NSAIDs

C. Gabapentinoids

D. General Anesthesia

D

These drugs albeit originally made for something else, they are used i low doses as adjuvant analgesics specifically for chronic neuropathic pain. This works by blocking the uptake of serotonin and norepinephrine causing reduced perception of pain by handling the dorsal horn in the spinal cord.

A. SNRIs

B. Tricyclic Antidepressants (TCA)

C. TENS

D. Analgesics

B

In the modulation phase, besieds endogenous opiods. This is also released during the inhibatory pathway that will help reduce the pain.

A. Gamma-aminobutyric acid

B. Exogenous opiods

C. Serotonin and Enkephalins

D. Encephalins

A