N4 Pain test

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1.
Pain is considered one of the most important:
a. Protective mechanisms.
b. Regenerative processes.
c. Emotional coordinators.
d. Chemical synthesizers.

2.
The objective measurement of pain:
a. Lets nurses know who is malingering.
b. Provides both quantitative and qualitative data.
c. Is more accurate with infants than adults.
d. Is not possible at the present time.

3.
All but one of the following is true about acute pain. Select the untrue characteristic.
a. Onset may be sudden or slow.
b. It serves no purpose and is nonprotective.
c. Intensity may vary from mild to severe.
d. It subsides as healing takes place.

4.
Pain that results when tissue damage produces stimuli sent as electric impulses by way of nerve fibers to the central nervous system is called:
a. Psychogenic.
b. Neuropathic.
c. Nociceptor.
d. Non-nociceptor.

5.
Typically, when tissue is damaged it releases:
a. Substantia gelatinosa.
b. Electric impulses.
c. Neuromodulators.
d. Excitatory neurotransmitters.

6.
The experience of pain involves a sequence of five biochemical and electrical processes. The one in which the person becomes aware of pain is:
a. Transduction.
b. Perception.
c. Transmission.
d. Modulation.

7.
The significance of the gate-control theory is that it helps explain how:
a. Thoughts and emotions may modify the perception of pain.
b. Spinal cord injury affects pain.
c. Neurotransmitters influence pain perception.
d. Neuromodulators influence pain.

8.
When caring for people in pain, nurses should consider all but one of the following factors. Select the least important factor.
a. Cultural differences
b. Physiologic issues
c. Socioeconomic status
d. Psychological factors

9.
The Joint Commission on Accreditation of Healthcare Organizations:
a. Requires pain management policies of all government agencies.
b. Excludes psychiatric facilities from pain management requirements.
c. Encourages but does not mandate pain policies of accredited facilities.
d. Mandates pain management policies in all of its accredited facilities.

10.
The American Academy of Pediatrics policy statement regarding pain management makes all but one of the following recommendations. Select the one not recommended.
a. Restrict involvement of families in the child’s treatment.
b. Advocate for the effective use of pain medications.
c. Advocate for child-specific research in pain management.
d. Provide a calm environment for procedures designed to reduce distress.

11.
The primary source of information about pain is the:
a. Parent or guardian.
b. Nurse or caregiver.
c. Attending physician.
d. Person in pain.

12.
A pain history interview includes questions about all of the following issues except one. Select the issue that is not included in a pain history.
a. What triggers the pain or makes it worse
b. The intensity of the pain
c. Names of persons who have tried to help
d. The location of the pain

13.
The two primary diagnoses for pain identified by the North American Nursing Diagnosis Association (NANDA) are:
a. Adult and pediatric.
b. Acute and chronic.
c. Short-term and long-term.
d. Physical and psychological.

14.
Adjuvants are drugs that address:
a. Symptoms that accompany pain.
b. Central nervous system pain.
c. Pain caused by tissue damage.
d. Derivatives of opium.

15.
Most nonopioid drugs are potent:
a. Anti-emetics.
b. Antibiotics.
c. Anti-inflammatory agents.
d. Sedatives.

16.
In general, nonsteroidal anti-inflammatory drugs (NSAIDs):
a. Include such drugs as Tylenol.
b. Act on mu and kappa receptors in the brain.
c. Are classified as co-analgesics.
d. Affect peripheral nerve endings at the injury site.

17.
Opioid analgesics that bind to mu receptor sites and block pain impulses are:
a. Antagonists.
b. Full agonists.
c. Partial agonists.
d. Mixed agonist-antagonists.

18.
Many adverse symptoms of opioids are due to their effect on:
a. Body systems other than the CNS.
b. Prostaglandin production capabilities.
c. Glucose metabolism and its byproducts.
d. The complex mind-body interaction.

19.
A need to increase opioid dosages for reasons other than the physical adaptation of continuous use is called:
a. Pseudotolerance.
b. Drug tolerance.
c. Psychological dependency.
d. Addiction.

20.
A placebo violates the ethical principles of honesty because it:
a. Strips individuals of the right to make decisions about themselves.
b. Has been used by hucksters throughout history.
c. Seeks to deceive the person who takes the placebo.
d. Is may be used in research to study the effects of drugs.

21.
Cognitive-behavioral interventions are used for all of the following reasons except one. Select the incorrect reason.
a. Anxiety and fear reduction
b. Greater sense of control
c. Greater insight to psychic conflicts
d. Alter perception of pain

22.
Rhizotomy and cordotomy are:
a. Considered low-risk pain-relieving measures.
b. Indicated for specific types of pain.
c. Both performed in conjunction with a laminectomy.
d. Surgical procedures that involve nerve destruction.

23.
Evaluation is a critical phase of nursing care because it tells us:
a. We need to document more thoroughly.
b. The importance of ethical principles to the practice of nursing.
c. The dangers inherent in opioid dependency.
d. The degree to which an intervention achieved an expected outcome.

24.
The ethical perspective that considers the end result of an act, such as relieving pain regardless of risk, is called:
a. Teleological.
b. Deontological.
c. Analytical.
d. Descriptive.

25.
When the nurse accepts a client’s decision to refuse a pain-relieving intervention, the nurse is honoring the ethical principle of:
a. Beneficence.
b. Honesty.
c. Autonomy.
d. Justice.

26.
An ethical dilemma requires a choice between:
a. Belief systems and religious doctrines.
b. Ethical principles and theories proposed by philosophers.
c. Ethical behaviors and illegal behaviors.
d. Two or more ethical principles and actions they support.

27.
The American Nurses Association Code of Ethics states that the nurse’s primary commitment is to the:
a. Profession of nursing.
b. Client.
c. Healthcare environment.
d. Employer.

28.
The International Council of Nurses Code of Ethics says nurses have four fundamental responsibilities. Select the responsibility not included in their list:
a. Promote health
b. control overpopulation
c. Prevent illness
d. Restore health
e. Alleviate suffering

29.
The critical issue affecting schedule C-I to C-V drugs is their:
a. Pain-relieving capacity.
b. Interaction with other drugs.
c. Potential for abuse.
d. Ease of administration.

30.
Drugs for which there is no approved medical use are classified as schedule:

a. C-I.
b. C-II.
c. C-III.
d. C-IV.
e. C-V.

31.
States have a constitutionally derived right to create laws concerning the manufacture and distribution of drugs because of the:
a. Controlled Substance Act of 1971.
b. Pure Food and Drug Act of 1906.
c. Kefauver-Harris Amendment.
d. Tenth Amendment to the U.S. Constitution.

32.
The generic name for tetrahydrocannabinol (THC) is:
a. Chloral hydrate.
b. Cannabis sativa.
c. Dronabinol.
d. Cannabinol.

33.
Oregon’s medical marijuana laws:
a. Permit unrestricted cultivation of marijuana.
b. Have become increasingly restrictive.
c. Require an honest effort by police to keep confiscated plants alive.
d. Exempt physicians from responsibility for marijuana use by their patients.

34.
The age group of children in whom imagination merges with the real world is:
a. Infants.
b. Toddlers.
c. Preschoolers.
d. Adolescents.

35.
Vital signs are not reliable indicators of pain in children because:
a. Children are growing and developing.
b. Their bodies adapt to pain.
c. Children tend to exaggerate pain.
d. Hyperglycemia may mask signs of pain.

36.
The most commonly measured variable of pain is:
a. Precipitating factors.
b. Location.
c. Quality.
d. Intensity.

37.
Continuous infusion analgesia:
a. Eliminates the highs and lows of pain control.
b. Is not recommended for children.
c. Requires greater levels of medication to control pain.
d. Is directly related to risk of future addiction.

38.
Failure to thrive may result in infants who lack sufficient:
a. Nutrition.
b. Pain control.
c. Touching.
d. Space to move about.

39.
Barriers to effective pain management in older adults include all but one of the following. Select the one that is not a barrier.
a. Financial constraints
b. Inappropriate or incorrect route analgesics
c. Fear of addiction
d. Uncaring healthcare professionals

40.
A nonverbal behavior that indicates pain in an older adult is:
a. Squirming.
b. Clenched fists.
c. Placid facial expression.
d. Stern, frightened look.

41.
Old-old adults are described as:
a. 65 to 74 years of age.
b. 75 to 84 years of age.
c. 85 years of age and older.
d. Any age, if an adult is frail.

42.
The adverse effects of analgesics are of specific concern in older adults because of:
a. Cultural biases that influence adverse effects.
b. Age-related changes in body anatomy and physiology.
c. Effects of alcohol on analgesic drug potency.
d. The exaggerated reports of pain by elders.

43.
JCAHO recommends all but one of the following actions healthcare providers should take when they care for seniors. Select the inappropriate action.
a. Assume cognitive impairment in older adults.
b. Assess all older adults for chronic pain.
c. Seek information about impaired older adults from caregivers.
d. Instruct older adults to create a “pain diary.”

44.
Addiction is characterized by all but one of the following behaviors. Select the one noncharacteristic behavior of drug dependency.
a. Craving for drug(s) of choice
b. Behaving in a morally depraved manner
c. Continuing to use despite the harm it brings
d. Compulsive use of drug(s) of choice

45.
Migraine headaches are believed to occur because of:
a. A shift in male-female hormones.
b. Stimulation of the limbic system.
c. Activation of the trigeminal-vascular system.
d. Interaction of the hypothalamus and adrenal gland.

46.
Brain tumors in adults cause headaches because they:
a. Increase psychological tension.
b. Stimulate peripheral nerves.
c. Increase intracranial pressure.
d. Initiate neuromodulator production.

47.
Cancer pain:
a. Comes from cancer itself and its treatment.
b. Follows a predictable pattern.
c. Is primarily neuropathic.
d. Derives from psychogenic sources.

48.
The percent of pain experienced by cancer clients due to treatment is:
a. 10% to 15%.
b. 20% to 25%.
c. 30% to 35%.
d. 40% to 45%.

49.
Treatment modalities for cancer include all but one of the following. Select the nontherapeutic intervention for cancer.
a. Surgical removal of tumor
b. Radiation
c. Selective 5-HT antagonist
d. Cell-destroying chemicals

50.
The American Pain Society recommends the use of placebos to treat pain:
a. On a regular basis.
b. For individuals who abuse drugs.
c. For infants and children.
d. Under no circumstances.

51.
The goal of palliative care is to:
a. Enhance the quality of life of dying clients.
b. Prolong life under any circumstances.
c. Comfort, cure, and prolong the life of sufferers.
d. Help people face the realities of death.

52.
Partnership for Care recommends the following healthcare directive(s):
a. Living will only.
b. Healthcare proxy and living will.
c. Living trust only.
d. Healthcare proxy and living trust.