Chapter 6, Pain
Multiple Response
Identify one or more choices that best complete the statement or answer the question.
1. Which are characteristics of afferent neurons? Select all that apply.
1. They are motor nerves.
2. They extend to the muscles of the body.
3. They enter the dorsal horn.
4. They exit through the ventral horns.
5. They carry pressure sensations into the spinal cord.
2. Which features belong to A-delta fibers? Select all that apply.
1. Myelinated
2. Cause persistent, dull pain
3. Small in diameter
4. Cause sharp, long-lasting pain
5. Conduct impulses slowly
3. The nurse is performing a physical assessment on a client. When checking for a patellar reflex, the
nurse notes an expected response. Which additional facts are relevant to this response? Select all that
apply.
1. Impulses cross over at the medulla
2. Sensory impulse exits thNroUuRgS
hIthN
eGveTnBtr.
alChO
orMn
3. Impulse descends downward in the spinal cord
4. The reaction is referred to as a simple reflex arc
5. Sensory neuronal impulses ascend the brain cortex
4. A client visits a primary health-care provider and reports pain. The client is diagnosed with
neuropathic pain. The nurse is aware of which characteristics of neuropathic pain? Select all that
apply.
1. Arises as a result of sustained noxious stimuli
2. Can be described as acute or chronic
3. Is burning, tingling, and shooting in sensation
4. Often in the legs, back, feet, thighs, and toes
5. Can be caused by spinal nerve radiculopathy
5. Which assessment actions does the nurse use to identify the severity of pain in a client? Select all
that apply.
1. Ask for a description of the pain
2. Select a client-appropriate pain scale
3. Ask the client to identify the cause of the pain
4. Inquire about what makes the pain better
5. Have the client point to the area of pain
6. Which clinical criteria does the nurse follow to analyze pain? Select all that apply.
1. Examine the area of pain first
2. Assess the history of the client
, 3. Listen to the client’s account of pain
4. Assess any pain the client reports
5. Ask the client to point to the area of pain
7. The nurse is attending a client who presents with colicky pain. Other symptoms include nausea and
vomiting. Which conditions does the nurse suspect as possible causes of the presenting symptoms?
Select all that apply.
1. Pancreatitis
2. Nephrolithiasis
3. Cholecystitis
4. Appendicitis
5. Duodenum peptic ulcer
8. The nurse is updating the medical history of a client who is 4 weeks postoperative for a total knee
replacement. The client reports pain at a level of 8 on a scale of 0 to 10 and requests “something
stronger” for pain management. For which predictors of possible substance abuse does the nurse
assess? Select all that apply.
1. Occurrence of withdrawal syndrome
2. History or treatment for depression
3. Increased pain level from last visit
4. Recent event requiring use of naloxone
5. Past history of needing extended pain relief
9. A client prefers nonpharmacological treatment for regional complex pain syndrome. Which
treatment options can be offNerUeR
dStoIthNeGcTliB
en.t?CSOeM
lect all that apply.
1. Counseling
2. Alternative medicine
3. Acupuncture
4. Transcutaneous electrical neural stimulation (TENS)
5. Guided imagery
10. Which statements are true regarding intradiscal electrothermal therapy (IDET)? Select all that apply.
1. It uses thoughts and suggestions to guide the imagination.
2. It uses heat to modify the nerve fibers of a spinal disc.
3. It uses electrodes to deliver electrical current through the skin.
4. It uses a wire placed through an incision into the spinal disc.
5. It uses thin, solid, metallic needles.
11. The nurse is educating a client about the cause of bone pain in cancer clients. Which statement by
the client indicates effective learning? Select all that apply.
1. “Metastasis of cancer to the bones is one of the reasons for bone pain.”
2. “Entrapment of the spinal nerve in a herniated disc is a reason for bone pain.”
3. “Excess glucose in the nerves leads to structural breakdown of the nerves.”
4. “A tumor within the bone can cause bone pain.”
5. “Enzyme and inflammatory mediators cause bone pain.”
Multiple Choice
Identify the choice that best completes the statement or answers the question.
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, 12. Which statement is related to a simplex reflex arc?
1. Interpretation of the brain is necessary when it occurs in the body.
2. An efferent neuron connects with an interneuron in the substantia gelatinosa.
3. An interneuron connects to an afferent neuron that exits through the ventral horn.
4. An afferent neuron carries sensory impulses into the dorsal horn of the spinal cord.
13. Pain that is dull or aching and that occurs in certain parts of the body is referred to as deep somatic
pain. How is somatic pain different from other types of pain?
1. It occurs in ligaments, tendons, and bones.
2. It originates in an amputated part of the body.
3. It occurs in deep organs due to disease processes.
4. It originates from the chest and left arm.
14. Pain is an unpleasant sensation that is associated with disease. The process by which people
experience pain occurs in four phases. Which is the first phase that converts painful stimuli into
neuronal impulses?
1. Perception
2. Modulation
3. Transduction
4. Transmission
15. Which statement is related to gate control theory?
1. The first neuron is an interneuron.
2. The second neuron is anNaU ffR
erSeI
ntNnG
euTrB
on.. COM
3. Sensation travels both to and from the brain.
4. The interneuron is influenced by ascending nerve tracts.
16. An adult client experiences problems such as sleeplessness, fear, irritability, anxiety, and stress. The
client has pain lasting longer than 6 months. Which type of pain can be diagnosed from the
symptoms?
1. Acute pain
2. Chronic pain
3. Neuropathic pain
4. Phantom limb pain
17. The nurse is providing care for a client experiencing pain who wishes to manage the pain without
medication. Which explanation of the process by which the body responds to nonpharmacological
treatments does the nurse provide?
1. The body responds by secreting inflammatory mediators.
2. The body responds by secreting endothelin-1.
3. Nonpharmacological treatments activate the body’s prostaglandins.
4. Nonpharmacological treatments activate the body’s own endorphins and
enkephalins.
18. A client presents with a greater-than-3-month history of widespread aches and pains. The client also
points to several tender locations. On further questioning, the client mentions disturbed sleep and
feeling fatigued. Which diagnosis does the nurse suspect for the client?
1. Complex regional pain syndrome
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Multiple Response
Identify one or more choices that best complete the statement or answer the question.
1. Which are characteristics of afferent neurons? Select all that apply.
1. They are motor nerves.
2. They extend to the muscles of the body.
3. They enter the dorsal horn.
4. They exit through the ventral horns.
5. They carry pressure sensations into the spinal cord.
2. Which features belong to A-delta fibers? Select all that apply.
1. Myelinated
2. Cause persistent, dull pain
3. Small in diameter
4. Cause sharp, long-lasting pain
5. Conduct impulses slowly
3. The nurse is performing a physical assessment on a client. When checking for a patellar reflex, the
nurse notes an expected response. Which additional facts are relevant to this response? Select all that
apply.
1. Impulses cross over at the medulla
2. Sensory impulse exits thNroUuRgS
hIthN
eGveTnBtr.
alChO
orMn
3. Impulse descends downward in the spinal cord
4. The reaction is referred to as a simple reflex arc
5. Sensory neuronal impulses ascend the brain cortex
4. A client visits a primary health-care provider and reports pain. The client is diagnosed with
neuropathic pain. The nurse is aware of which characteristics of neuropathic pain? Select all that
apply.
1. Arises as a result of sustained noxious stimuli
2. Can be described as acute or chronic
3. Is burning, tingling, and shooting in sensation
4. Often in the legs, back, feet, thighs, and toes
5. Can be caused by spinal nerve radiculopathy
5. Which assessment actions does the nurse use to identify the severity of pain in a client? Select all
that apply.
1. Ask for a description of the pain
2. Select a client-appropriate pain scale
3. Ask the client to identify the cause of the pain
4. Inquire about what makes the pain better
5. Have the client point to the area of pain
6. Which clinical criteria does the nurse follow to analyze pain? Select all that apply.
1. Examine the area of pain first
2. Assess the history of the client
, 3. Listen to the client’s account of pain
4. Assess any pain the client reports
5. Ask the client to point to the area of pain
7. The nurse is attending a client who presents with colicky pain. Other symptoms include nausea and
vomiting. Which conditions does the nurse suspect as possible causes of the presenting symptoms?
Select all that apply.
1. Pancreatitis
2. Nephrolithiasis
3. Cholecystitis
4. Appendicitis
5. Duodenum peptic ulcer
8. The nurse is updating the medical history of a client who is 4 weeks postoperative for a total knee
replacement. The client reports pain at a level of 8 on a scale of 0 to 10 and requests “something
stronger” for pain management. For which predictors of possible substance abuse does the nurse
assess? Select all that apply.
1. Occurrence of withdrawal syndrome
2. History or treatment for depression
3. Increased pain level from last visit
4. Recent event requiring use of naloxone
5. Past history of needing extended pain relief
9. A client prefers nonpharmacological treatment for regional complex pain syndrome. Which
treatment options can be offNerUeR
dStoIthNeGcTliB
en.t?CSOeM
lect all that apply.
1. Counseling
2. Alternative medicine
3. Acupuncture
4. Transcutaneous electrical neural stimulation (TENS)
5. Guided imagery
10. Which statements are true regarding intradiscal electrothermal therapy (IDET)? Select all that apply.
1. It uses thoughts and suggestions to guide the imagination.
2. It uses heat to modify the nerve fibers of a spinal disc.
3. It uses electrodes to deliver electrical current through the skin.
4. It uses a wire placed through an incision into the spinal disc.
5. It uses thin, solid, metallic needles.
11. The nurse is educating a client about the cause of bone pain in cancer clients. Which statement by
the client indicates effective learning? Select all that apply.
1. “Metastasis of cancer to the bones is one of the reasons for bone pain.”
2. “Entrapment of the spinal nerve in a herniated disc is a reason for bone pain.”
3. “Excess glucose in the nerves leads to structural breakdown of the nerves.”
4. “A tumor within the bone can cause bone pain.”
5. “Enzyme and inflammatory mediators cause bone pain.”
Multiple Choice
Identify the choice that best completes the statement or answers the question.
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, 12. Which statement is related to a simplex reflex arc?
1. Interpretation of the brain is necessary when it occurs in the body.
2. An efferent neuron connects with an interneuron in the substantia gelatinosa.
3. An interneuron connects to an afferent neuron that exits through the ventral horn.
4. An afferent neuron carries sensory impulses into the dorsal horn of the spinal cord.
13. Pain that is dull or aching and that occurs in certain parts of the body is referred to as deep somatic
pain. How is somatic pain different from other types of pain?
1. It occurs in ligaments, tendons, and bones.
2. It originates in an amputated part of the body.
3. It occurs in deep organs due to disease processes.
4. It originates from the chest and left arm.
14. Pain is an unpleasant sensation that is associated with disease. The process by which people
experience pain occurs in four phases. Which is the first phase that converts painful stimuli into
neuronal impulses?
1. Perception
2. Modulation
3. Transduction
4. Transmission
15. Which statement is related to gate control theory?
1. The first neuron is an interneuron.
2. The second neuron is anNaU ffR
erSeI
ntNnG
euTrB
on.. COM
3. Sensation travels both to and from the brain.
4. The interneuron is influenced by ascending nerve tracts.
16. An adult client experiences problems such as sleeplessness, fear, irritability, anxiety, and stress. The
client has pain lasting longer than 6 months. Which type of pain can be diagnosed from the
symptoms?
1. Acute pain
2. Chronic pain
3. Neuropathic pain
4. Phantom limb pain
17. The nurse is providing care for a client experiencing pain who wishes to manage the pain without
medication. Which explanation of the process by which the body responds to nonpharmacological
treatments does the nurse provide?
1. The body responds by secreting inflammatory mediators.
2. The body responds by secreting endothelin-1.
3. Nonpharmacological treatments activate the body’s prostaglandins.
4. Nonpharmacological treatments activate the body’s own endorphins and
enkephalins.
18. A client presents with a greater-than-3-month history of widespread aches and pains. The client also
points to several tender locations. On further questioning, the client mentions disturbed sleep and
feeling fatigued. Which diagnosis does the nurse suspect for the client?
1. Complex regional pain syndrome
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