Vital Signs and Pain Assessment PDF

Vital Signs and Pain Assessment 1. Body temperature is regulated by the: a. thalamus. b. hypothalamus. c. medulla. d. pons. e. cerebellum. ANS - B: Body temperature is regulated by the hypothalamus. TOP: Discipline: Pathophysiology MSC: Organ System: General 2. Wh...

Vital Signs and Pain Assessment 1. Body temperature is regulated by the: a. thalamus. b. hypothalamus. c. medulla. d. pons. e. cerebellum. ANS - B: Body temperature is regulated by the hypothalamus. TOP: Discipline: Pathophysiology MSC: Organ System: General 2. Which of the following is not involved in increasing body temperature? a. Exogenous pyrogens b. Vasoconstriction c. Shivering d. Vasodilation e. Prostaglandins ANS - D: Body cooling occurs by vasodilation, which increases heat loss through the skin and evaporation of perspiration. TOP: Discipline: Pathophysiology MSC: Organ System: General 3. Which of the following is most closely related to damage or dysfunction of the central or peripheral nervous system? a. Chronic pain b. Neuropathic pain c. Acute pain d. Acute inflammation e. Surgery ANS - B: Neuropathic pain is a long-term pain associated with damage or dysfunction of the central or peripheral nervous system (e.g., amputation, complex pain syndrome). TOP: Discipline: Pathophysiology MSC: Organ System: General 4. Nociceptors transmit pain impulses from the periphery along A-delta and C-polymodal fibers to the: a. posterior horn of the spinal cord. b. hypothalamus. c. cerebellum. d. dorsal horn of the spinal cord. e. pons. ANS - D: Pain impulses travel from the site of injury to the dorsal horn of the spinal cord and then through the ascending spinal tracts to the thalamus and cerebral cortex. TOP: Discipline: Pathophysiology MSC: Organ System: General 5. Which of the following make infants more susceptible to hypothermia? a. Low body surface area for weight b. Thicker skin c. Limited ability to cope with cold stress d. Higher pulse rate e. Lower blood pressure ANS - C: Infants are more susceptible to hypothermia because of their large ratio of body surface area to weight, thinner skin, and limited ability to cope with cold stress. Infants have a higher pulse rate and lower blood pressure than adults, but this is unrelated to hypothermia. TOP: Discipline: Pathophysiology MSC: Organ System: General 6. A 5-year-old is complaining of nondescriptive “belly pain.” Your next action should be to ask him to: a. point a finger to the spot that hurts. b. draw a circle around the area that hurts. c. use a metaphor to describe the pain. d. identify what makes the pain worse. e. allow him to use a “pain-o-meter.” ANS - A: Asking the child to point to the area of pain can help communicate a more precise location. The other choices are not appropriate for the age of the child. TOP: Discipline: Behavioral Science MSC: Organ System: General 7. During pregnancy, all of the following may be related to back pain except: a. lax pelvic ligaments. b. weight gain. c. hyperlordosis. d. anterior tilt of the pelvis. e. lower blood pressure. ANS - E: Blood pressure commonly decreases beginning at about 8 weeks of gestation, gradually falling until a low point is reached at midpregnancy, but this is unrelated to the back pain some women experience during pregnancy. TOP: Discipline: Pathophysiology MSC: Organ System: General 8. The value of the use of scales for patients to rate their pain intensity is that: a. the emotional responses are factored in. b. correlation with others’ expectations is achieved. c. the patient’s response to therapy can be documented. d. subjective responses are eliminated. e. the patient’s perception is minimized. ANS - C: The use of scales permits the very important day-to-day documentation of the response to therapy. Although the patient’s perception is the controlling variable, the patient is still giving a subjective measurable response. TOP: Discipline: Behavioral Science MSC: Organ System: General 9. A pain scale that is reliable and valid for children is the: a. pain-o-meter scale. b. pain-rating instrument scale. c. numeric pain intensity scale. d. Wong/Baker Faces Rating Scale. e. descriptive pain intensity scale. ANS - D: The Wong/Baker Faces Rating Scale and the Oucher Scale are examples of pain scales that are reliable and valid for use with children. TOP: Discipline: Behavioral Science MSC: Organ System: General 10. Which is the most reliable indicator of a patient’s pain? a. Facial grimacing b. Grunting or groaning c. Body movements d. Reluctance to be moved e. Patient’s report of the pain ANS - E: The patient’s report of pain is the most reliable indicator of pain and should be believed even when observed behaviors do not seem to correspond. TOP: Discipline: Pathophysiology MSC: Organ System: General 11. Which of the following groups has the greatest variation in pulse rate? a. Toddlers b. Premature infants c. Neonates d. Adolescents e. Older adults ANS - B: The newborn’s pulse rate is more variable than that of toddlers, adolescents, and older adults. The variation is greatest around the time of birth and is even more marked in premature infants. TOP: Discipline: Pathophysiology MSC: Organ System: General 12. The heart rate of a pregnant woman may increase to a level at term that is _____ higher than normal. a. 5% to 10% b. 10% to 30% c. 40% to 60% d. 60% to 80% e. 80% to 100% ANS - B: The heart rate of a pregnant woman gradually increases throughout pregnancy until it is 10% to 30% higher at term. TOP: Discipline: Pathophysiology MSC: Organ System: General 13. Hypertension in a pregnant woman (blood pressure reading greater than or equal to 160 mm Hg systolic or 110 mm Hg diastolic) is one sign of: a. a normal pregnancy. b. a nulliparous woman. c. preeclampsia. d. a multiparous woman. e. Braxton Hicks contractions. ANS - C: A gradual increase in blood pressure is common from the second to the third trimester. However, hypertension in this range may be a sign of preeclampsia. Braxton Hicks contractions are sporadic uterine contractions that start at around 6 weeks of pregnancy and are not associated with gestational hypertension or preeclampsia. TOP: Discipline: Pathophysiology MSC: Organ System: General 14. Blood pressure may increase during the process of aging caused by: a. increasing vagal tone. b. decreasing cardiac output. c. diminished tolerance to pain. d. increasing stiffness of the blood vessels. e. decreasing vascular resistance. ANS - D: During the process of aging the systolic blood pressure often increases because of increasing stiffness of the blood vessels and increased vascular resistance. Increasing vagal tone may decrease the pulse rate. TOP: Discipline: Pathophysiology MSC: Organ System: General 15. The difference in blood pressure readings between the right and left arms is considered normal up to _____ mm Hg. a. 5 b. 10 c. 20 d. 25 e. 30 ANS - B: Blood pressure readings between the left and right arms may vary by as much as 10 mm Hg and tends to be higher in the right arm. TOP: Discipline: Physiology MSC: Organ System: Cardiovascular 16. Postural hypotension is defined as which of the following when the patient stands compared with a sitting or supine reading? a. Blood pressure drop of more than 20 mm Hg in systolic and 10 mm Hg drop in diastolic b. Pulse rate decrease with a systolic pressure increase of at least 15 mm Hg c. Diastolic pressure increase of more than 5 mm Hg and no pulse rate changes d. Pulse rate decrease and diastolic pressure decrease of more than 5 mm Hg e. Decrease in pulse pressure ANS - A: Postural hypotension (orthostatic hypotension) represents a significant decrease in systolic pressure (greater than 20 mm Hg) and a 10 mm Hg drop in diastolic pressure as a patient changes from a sitting to a standing position. An increase in heart rate often occurs as well. TOP: Discipline: Pathophysiology MSC: Organ System: Cardiovascular 17. The most frequent cause of serious hypertension in children is: a. malnutrition. b. liver failure. c. renal disease. d. rheumatic fever. e. heart disease. ANS - C: Do not make the diagnosis of hypertension based on one reading. If the systolic blood pressure is elevated and the diastolic is not, anxiety may be responsible. Most children with a diagnosis of hypertension have an identifiable cause, usually renal disease. TOP: Discipline: Pathophysiology MSC: Organ System: Cardiovascular 18. Systolic hypertension in the adult less than 60 years of age is generally defined as pressure in excess of: a. 120 + the patient’s age. b. 140. c. 160. d. 180. e. 200. ANS - B: Hypertension continues to be defined as a blood pressure consistently at 140/90 mm Hg or higher. The equation that systolic blood pressure should be less than 120 + the patient’s age is no longer the acceptable definition. TOP: Discipline: Pathophysiology MSC: Organ System: Cardiovascular 19. The risk of hypertension in children is about four times higher for those with BMI (body mass index) more than: a. 50% b. 65% c. 75% d. 85% e. 95% ANS - D: Because of the increase in numbers of children and adolescents who are obese, primary or essential hypertension is becoming more common. The risk of hypertension is about four times higher in children at more than 85th percentile of body mass index (BMI). TOP: Discipline: Pathophysiology MSC: Organ System: Cardiovascular