NUR 355 Exam #2 - Modules 3 & 4 "Pain/Inflammation &
Immunity/Infection"
2026 NEW NUR 355 Exam #2 - Modules 3 & 4 "Pain/Inflammation & Immunity/Infection" (Acute & Chronic Health Disruptions In
Adults I) Arizona College
Pain / Inflammation (Module 3)
General (assessment, priority, evaluation, education, non-pharm etc.) (5 questions)
1. Assess and document pain (5th v/s) according to client condition.
2. Nonopioid analgesics including NSAIDs should be considered first-line therapy, administered
on a standing schedule rather than a prn schedule.
3. Assessing Pain in Older Adults With Cognitive Impairments: (pain is not a part of aging
process)
a. Observational pain was assessed through the Pain Assessment in Advanced Dementia
(PAINAD) tool, and cognition and mood were evaluated with the Mini-Mental State
Examination (MMSE) and the Geriatric Depression Scale (GDS015).
b. Hydromorphone and fentanyl are the preferred opioids in older adults with kidney or
liver impairment, whereas meperidine should be avoided because of the adverse
effects associated with a toxic metabolite, normeperidine.
c. managing pain in cognitively impaired adults includes a tailored plan of physical
activity and cognitive-behavioral therapy (CBT)
4.
1
, NUR 355 Exam #2 - Modules 3 & 4 "Pain/Inflammation &
Immunity/Infection"
5. Refusing food, sign of pain. Chronic pain or elevated HR is not reliable pain measurement.
Pain Assessment (9 questions)
1. Focused Pain Assessment:
a. Location- use anatomical terminology/landmarks to describe location. “where is your
pain?” ask pt to point to location.
b. Quality- how the pain feels (sharp, dull, aching, burning etc). “what does it feel like?”
ask if throbbing, burning, stabbing etc.
c. Measures- intensity, strength, and severity. (use visual analog, #scale). “how much
pain do you have?” “rate your pain 0-10”
d. Timing-onset, duration, and frequency. “when did it start?” “how often does it occur?”
e. Setting- how pain affects daily life or ADLs. “what are you doing when symptoms
occur?” “How does pain affect your ability to work?”
f. Associated Manifestations-document manifestations (fatigue, depression, nausea,
anxiety). “what other symptoms do you have when you are feeling pain?”
g. Aggravating/relieving factors-“What makes the pain better/worse?” “Are you taking
anything OTC/herbals/Rx?”
h.
2. Joint pain and mobility
a. Joint pain and mobility are indicators of treatment efficacy and disease progression.
3. Temperature
2
, NUR 355 Exam #2 - Modules 3 & 4 "Pain/Inflammation &
Immunity/Infection"
a. An increase in temperature is an indicator of infection.
4. Acute pain- Onset and usually of short duration, presenting immediately following noxious
stimuli and tissue damage and continuing for several hours to several weeks
a. responsive to common pain management treatments and predictably resolves as
tissue heals.
6. Chronic pain- Pain that is present for more than 3 to 6 months, with or without an obvious
link to tissue injury, is considered chronic pain.
a. intensity can vary widely; patients describe pain that is achy, dull, stabbing, burning,
and icy hot. (serves no apparent biological purpose.)
5. Nociceptive Pain- stimulation of peripheral nerve fibers by noxious stimuli or conditions in
superficial skin and tissues as well as bones, joints, and muscles or in organs. damage to or
inflammation of tissue other than that of the peripheral and central nervous system. (normal
processing of painful stimuli)
a. Cutaneous- Superficial tissues. (sharp, with intensity varying mild to severe)
b. Somatic-in bones, joints, muscles, skin, or connective tissues. (dull, achy, difficult to
localize mild to severe) Ex. Arthritis, overuse injuries (muscle), trauma, bone
degeneration.
c. Visceral- internal organs, cause referred pain in other body locations. (sharp, dull-
difficult to localize)
d. managed using opioids and nonopioid meds
6. Referred Pain-nerve fibers from high sensory area (superficial tissues) and input from low-
sensory area (visceral organs) all converge at similar levels of spinal cord. (Diagnostic for
serious disorders and should be evaluated thoroughly.)
3
, NUR 355 Exam #2 - Modules 3 & 4 "Pain/Inflammation &
Immunity/Infection"
7. Neuropathic Pain-abnormal or damaged pain nerves. (most challenging type of pain to assess
and manage. last for months to years.) shooting, stinging, or “pins and needles”.
a. Peripherally generated neuropathic pain presents in the peripheral tissues but may
represent injury or dysfunction anywhere along the nerve pathway that supports that
region of the body. Ex. Phantom Limb, diabetic and alcohol-induced neuropathy,
chemotherapy-induced neuropathy, and postherpetic neuralgia
b. Centrally generated neuropathic pain has its origins in injuries to the spinal cord and
brain structures. (stroke, Parkinson’s disease, or multiple sclerosis, damage to neurons,
their supporting myelin, or the nourishing glial cells that surround the brain and spinal
tissue also disrupt pain processing.)
c. Managed using adjuvant meds (antidepressants, antispasmodic, skeletal muscle
relaxants)
8.
4
Immunity/Infection"
2026 NEW NUR 355 Exam #2 - Modules 3 & 4 "Pain/Inflammation & Immunity/Infection" (Acute & Chronic Health Disruptions In
Adults I) Arizona College
Pain / Inflammation (Module 3)
General (assessment, priority, evaluation, education, non-pharm etc.) (5 questions)
1. Assess and document pain (5th v/s) according to client condition.
2. Nonopioid analgesics including NSAIDs should be considered first-line therapy, administered
on a standing schedule rather than a prn schedule.
3. Assessing Pain in Older Adults With Cognitive Impairments: (pain is not a part of aging
process)
a. Observational pain was assessed through the Pain Assessment in Advanced Dementia
(PAINAD) tool, and cognition and mood were evaluated with the Mini-Mental State
Examination (MMSE) and the Geriatric Depression Scale (GDS015).
b. Hydromorphone and fentanyl are the preferred opioids in older adults with kidney or
liver impairment, whereas meperidine should be avoided because of the adverse
effects associated with a toxic metabolite, normeperidine.
c. managing pain in cognitively impaired adults includes a tailored plan of physical
activity and cognitive-behavioral therapy (CBT)
4.
1
, NUR 355 Exam #2 - Modules 3 & 4 "Pain/Inflammation &
Immunity/Infection"
5. Refusing food, sign of pain. Chronic pain or elevated HR is not reliable pain measurement.
Pain Assessment (9 questions)
1. Focused Pain Assessment:
a. Location- use anatomical terminology/landmarks to describe location. “where is your
pain?” ask pt to point to location.
b. Quality- how the pain feels (sharp, dull, aching, burning etc). “what does it feel like?”
ask if throbbing, burning, stabbing etc.
c. Measures- intensity, strength, and severity. (use visual analog, #scale). “how much
pain do you have?” “rate your pain 0-10”
d. Timing-onset, duration, and frequency. “when did it start?” “how often does it occur?”
e. Setting- how pain affects daily life or ADLs. “what are you doing when symptoms
occur?” “How does pain affect your ability to work?”
f. Associated Manifestations-document manifestations (fatigue, depression, nausea,
anxiety). “what other symptoms do you have when you are feeling pain?”
g. Aggravating/relieving factors-“What makes the pain better/worse?” “Are you taking
anything OTC/herbals/Rx?”
h.
2. Joint pain and mobility
a. Joint pain and mobility are indicators of treatment efficacy and disease progression.
3. Temperature
2
, NUR 355 Exam #2 - Modules 3 & 4 "Pain/Inflammation &
Immunity/Infection"
a. An increase in temperature is an indicator of infection.
4. Acute pain- Onset and usually of short duration, presenting immediately following noxious
stimuli and tissue damage and continuing for several hours to several weeks
a. responsive to common pain management treatments and predictably resolves as
tissue heals.
6. Chronic pain- Pain that is present for more than 3 to 6 months, with or without an obvious
link to tissue injury, is considered chronic pain.
a. intensity can vary widely; patients describe pain that is achy, dull, stabbing, burning,
and icy hot. (serves no apparent biological purpose.)
5. Nociceptive Pain- stimulation of peripheral nerve fibers by noxious stimuli or conditions in
superficial skin and tissues as well as bones, joints, and muscles or in organs. damage to or
inflammation of tissue other than that of the peripheral and central nervous system. (normal
processing of painful stimuli)
a. Cutaneous- Superficial tissues. (sharp, with intensity varying mild to severe)
b. Somatic-in bones, joints, muscles, skin, or connective tissues. (dull, achy, difficult to
localize mild to severe) Ex. Arthritis, overuse injuries (muscle), trauma, bone
degeneration.
c. Visceral- internal organs, cause referred pain in other body locations. (sharp, dull-
difficult to localize)
d. managed using opioids and nonopioid meds
6. Referred Pain-nerve fibers from high sensory area (superficial tissues) and input from low-
sensory area (visceral organs) all converge at similar levels of spinal cord. (Diagnostic for
serious disorders and should be evaluated thoroughly.)
3
, NUR 355 Exam #2 - Modules 3 & 4 "Pain/Inflammation &
Immunity/Infection"
7. Neuropathic Pain-abnormal or damaged pain nerves. (most challenging type of pain to assess
and manage. last for months to years.) shooting, stinging, or “pins and needles”.
a. Peripherally generated neuropathic pain presents in the peripheral tissues but may
represent injury or dysfunction anywhere along the nerve pathway that supports that
region of the body. Ex. Phantom Limb, diabetic and alcohol-induced neuropathy,
chemotherapy-induced neuropathy, and postherpetic neuralgia
b. Centrally generated neuropathic pain has its origins in injuries to the spinal cord and
brain structures. (stroke, Parkinson’s disease, or multiple sclerosis, damage to neurons,
their supporting myelin, or the nourishing glial cells that surround the brain and spinal
tissue also disrupt pain processing.)
c. Managed using adjuvant meds (antidepressants, antispasmodic, skeletal muscle
relaxants)
8.
4
