The nurse evaluates which of the following drugs not to place the surgical client at risk for perioperative complications? A) acetaminophen B) acetylsalicylic acid C) omeprazole D) diphenhydramine ANSWER: A which of the following should the nurse include when teaching a client about an upcoming outpatient surgery? A) postoperative nursing interventions B) risk for postoperative complications C) risks and benefits of proposed surgical procedure D) risks and benefits of anesthetic choices ANSWER: A In reviewing the chart of a client about to undergo general anesthesia, which of the following is the greatest risk factor?. The client who A) Expresses anxiety about the upcoming procedure. B) Ate snack within the last three hours. C) Smokes and states his last cigarette was 24 hours ago. D) Has a history of hypertension controlled by diet and exercise ANSWER: B Which of the following is a priority in the nursing assessment of a client preoperatively? A) question the client about any known allergies B) verification of client identification C) determination of client's nutritional status D) verification of client's neurological status ANSWER: B The nurse is obtaining a nursing history from a client suspected to be at risk for malignant hyperthermia. Which of the following should the nurse assess first to elicit the most accurate risk assessment? A) previous history of complications associated with surgery B) drug allergies C) over-the-counter medication usage D) history of unexplained fevers ANSWER: A The nurse is concerned about a client's risk for impaired gas exchange related to ineffective airway clearance. Which of the following would be a priority assessment? A) number of respirations per minute B) number of liters of oxygen per minute inspired C) decreased air movement D) capillary refill ANSWER: C the nurse is caring for a postoperative client who has received a general anesthetic. Which Of the following observations is the priority to be immediately reported? A) complaints of nausea B) mild hypertension C) decreased urine output D) rising body temperatures ANSWER: D The nurse is caring for a client who is preoperative. Which of the following is a priority nursing intervention utilized to prevent infection in this client? A) preparation of the skin overlying the surgical site B) maintenance of hemodynamic status C) maintenance of client's temperature D) determination of estimated blood loss ANSWER: A When caring for a client receiving conscious sedation, which of the following should the perioperative nurse routinely monitor? A) temperature B) level of consciousness C) dermatome level D) urine output ANSWER: B Which of the following should the perioperative nurse monitor when evaluating the presence of ineffective thermoregulation in a client? A) cardiac rhythm B) blood pressure C) oxygen saturation level D) temperature ANSWER: D Which of the following is the priority nursing intervention that the nurse should perform for a client in the postoperative period after surgery? A) establish a patent airway B) maintain adequate blood pressure C) establish level of consciousness D) assess level of pain ANSWER: A The nurse is caring for a client postoperatively. Which of the following would indicate that the client has a compromised airway? The client A) Complains of anxiety B) Complains of pain C) Has a pulse oximetry reading of 90percent D) Is slightly cool and clammy ANSWER: A The nurse is caring for a client who developed a compromised airway. Which of the following interventions is the priority to perform first? A) reposition the client in a supine position B) open the airway with a chin lift or jaw thrust C) prepare for reintubation of the client D) notify the surgeon ANSWER: B Which of the following nursing measures should the nurse include in the plan of care to help reduce the clinical manifestations of laryngospasm? A) administer atropine B) reposition the client in a supine position C) administer high-flow oxygen via face mask D) administer succinylcholine [anectine] ANSWER: D The nurse is caring for a client in the immediate postoperative period. Which of the following would indicate that the client is becoming hypovolemic? A) a diastolic blood pressure of 100 mm Hg B) the client complains of excruciating pain C) the client complains of anxiety D) blood loss of 500 ml ANSWER: D The nurse is caring for a client postoperatively who develops sinus tachycardia. Which of the following interventions should the nurse perform? A) apply warmed blankets B) administer atropine sulfate C) position the client in a left lateral position D) manage the client's anxiety ANSWER: D The nurse is caring for a client postoperatively who has become hypothermic. The nurse's best action would be to A) position the client in a left lateral position B) administer an analgesic C) remove clothing saturated with blood D) monitor the intake and output ANSWER: C A client is experiencing confusion in the immediate postoperative period. Which of the following assessments is essential to determine the reason for the confusion? A) airway status B) cardiac rhythm C) level of consciousness D) level of anxiety ANSWER: A The nurse admits a client scheduled for surgery. Which of the following findings should the nurse report as a risk factor for aspiration? A) obesity B) cigarette smoking C) an elevated serum sodium level D) a history of sleep apnea ANSWER: A Which of the following is a priority in the plan of care for a client who has had abdominal surgery and complains of pain in the immediate postoperative period? A) monitor the client's blood pressure B) teach the client to splint the abdomen C) reposition the client for comfort D) ask the client to describe the pain ANSWER: D A 16-year-old client has a medical history of anexia nervosa. The nurse is preparing the client for abdominal surgery. The nurse is most concerned about the client's risk for A) aspiration B) infection C) hypovolemia D) tissue perfusion ANSWER: B A client is scheduled for and operative procedure to rule out cancer. When the nurse assesses the client, the nurse observes tears in the client's eyes. Which of the following would be the most therapeutic nursing intervention? A) contact the surgeon the alleviate the clients concerned B) ask the client to describe his or her feelings C) medicate the client with a preoperative analgesic D) reassure the client that there is nothing to be concerned about ANSWER: B A client is admitted for emergency surgery for a bowel obstruction. The perioperative nurse understands that the client is at greatest risk during the perioperatve period for A) infection B) Electrolyte imbalances. C) Aspiration D) Airway obstruction. ANSWER: C A client admitted to the postanesthesia care unit [PACU] after abdominal surgery complains of "feeling a pop" and a gush of warm fluid at the incision site. The nurse concludes that the client has experienced a wound dehiscence. The priority nursing interventions would be all of the following except to A) position the client in a supine position B) cover the incision with a sterile dressing C) apply oxygen via nasal cannula at 8 L per minute D) contact the surgical team ANSWER: c A client has a PCA [patient-controlled analgesia] machine ordered to manage postoperative pain. The PACU (postanesthesia care unit) nurse determines that the best time to initiate the PCA machine is A) when the client complains of pain B) when the client arrives at the PACU C) just prior to transfer of the client to the floor D) When the client shows evidence of nonverbal signs of pain. ANSWER: B The registered nurse is preparing the clinical assignments for the day. Which of the following may the nurse delegate to a licensed practical nurse? A) inform a client scheduled for surgery on the surgical procedure B) instruct a client scheduled for surgery on the preoperative preparation C) obtain an informed consent from a client D) Administer the preoperative intramuscular medication. ANSWER: D A client with cholycystitis is receiving propantheline bromide. This medication is given because A) Reduces gastric solution production and hypermotility B) Slows emptying of the stomach and reduces chime in the duodenum C) Inhibits contraction of the bile duct and gallbladder D) Decreases bile secretions ANSWER: C The nurse is caring for a client who underwent a subtotal gastrectomy. To manage dumping syndrome, the nurse should advice the client to A) Restrict fluid to 1000 ml /day B) Drink liquids only with meals C) Don't drink liquids 2 hours before meals D) Drink liquids only between meals ANSWER: D A client is diagnosed with hiatal hernia. Which statement indicates effective client teaching about hiatal hernia and its treatment? A) I'll drink only three large meals every day without any fluid restrictions B) I'll lie down immediately after a meal C) I'll gradually increase the heavy lifting that I do D) I'll eat frequent small bland meals that are high in fiber ANSWER: D A client undergoes total gastrectomy. Several hours after surgery, the nurse notes that the client's NGT has stopped draining.How should the nurse respond? A) Notify the physician B) Reposition the tube C) Irrigate the tube D) Increase the suction level ANSWER A The nurse is developing a plan of care for a client with hepatitis A. What is the route of transmission of this virus? A) Sputum B) Feces C) Blood D) Urine ANSWER: B To prevent gastroesophageal reflux in a client with hiatal hernia, the nurse should provide which discharge instruction? A) Lie down after meals to provide digestion B) Avoid coffee and alcoholic beverages C) Take antacid with meals D) Limit fluid intake with meals ANSWER B A client is recovering from a small bowel obstruction. To relieve the pain, the physician prescribes meperidine 75 mg IM every 4 hours.How soon after administration should meperidine's onset of action occur? A) 5-10 minutes B) 15-30 minutes C) 30-60 minutes D) 2-4 hours ANSWER: B A client with severe pain is being evaluated for appendicitis. What is the most common cause of appendicitis? A) Rupture of the appendix B) Obstruction of the appendix C) A high fat diet D) A duodenal ulcer ANSWER: B For a client with cirrhosis,deterioration of heapatic function is best indicated by A) Fatigue and muscle weakness B) Difficulty in arousal C) Nausea and anorexia D) Weight gain ANSWER: B When preparing a client age 50, for surgery to treat appendicitis,the nurse formulates a nursing diagnosis of risk for infections related to inflammation, perforation and surgery. What is the rationale for choosing this nursing diagnosis? A) Obstruction of appendix may increase venous drainage and cause the appendix to rupture. B) Obstruction of the appendix reduce arterial flow, leading to ischemia, inflammation and rupture of the appendix C) The appendix may develop gangrene and rupture especially in a middle aged client D) Infection of the appendix diminishes necrotic arterial blood flow and increases venous drainage ANSWER: B A client comes to the emergency department complaining of acute GI distress.When obtaining the client's history, the nurse inquires about the family history. Which disorder has a familial basis? A) Hepatitis B) Iron deficiency anemia C) Ulcerative colitis D) Chronic peritonitis ANSWER: C One year ago, a friend was diagnose with cirrhosis of the liver caused by alcohol abuse was admitted to the hospital for hepatic encephalopathy. The physician prescribes latulose.For which other condition is lactulose given? A) Hyperkalemia B) Lactic acidosis C) Hypoglycemia D) Constipation ANSWER: D After undergoing a liver biopsy, the client would be placed in which position? A) Semi-Fowler's position B) Right lateral decubitus position C) Supine position D) Prone position ANSWER: B Which condition is most likely to have a nursing diagnosis of fluid volume deficit? A) Appendicitis B) Pancreatitis C) Cholycystitis D) Gastric ulcer ANSWER: A A client who must undergo colon surgery, the physician orders preoperative cleansing enema and neomycin sulfate.The rationale for using neomycin sulfate in this client is to A) Control postoperative nausea and vomiting B) Decrease the intestinal bacteria count C) Increase the intestinal bacteria count D) Prevent the development of megacolon ANSWER: B The nurse is teaching a client how to irrigate the stoma. Which action indicates that the client needs more teaching? A) Hanging the irrigation bag 34"-36" above the stoma B) Filling the irrigation bag with 500 – 1000 ml of lukewarm water C) Stopping irrigation for cramps and clamping the tubing until cramps pass D) Washing hands with soap and water when finished ANSWER: A To prevent gastroesophageal reflux in a client with hiatal hernia, the nurse should provide which discharge instruction? A) Lie down after meals to promote digestion B) Avoid coffee and alcoholic beverages C) Take antacids with meals D) Limit fluid intake with meals ANSWER: B Which age related changes in the GI tract increases the risk for anemia? A) Atrophy of the gastric mucosa B) Decrease in intestinal mucosa C) Increase in bile secretion D) Dulling of nerve impulses ANSWER: A Which of the following factors can cause hepatitis A? A) Contact with infected blood B) Blood transfusions with infected blood C) Eating contaminated shellfish D) Sexual contact with an infected person ANSWER: C A client with peptic ulcer is about to be discharged, the nurse should provide which instruction? A) Eat three balance meals a day B) Stop taking the drugs when your symptoms subside C) Avoid aspirin and products that contain aspirin D) Increase your intake of fluids containing caffeine ANSWER C A client has been diagnosed with hepatitis A. On assessment the nurse expects to note A) severe abdominal pain radiating to the shouldet B) Anorexia, nausea and vomiting C) Eructation and constipation D) Abdominal ascites ANSWER: B A client has new created colostomy after participating in counseling with the nurse and receiving support from the spouse, the client decides to change the colostomy pouch unaided. Which behavior suggest that the client beginning to accept the change in body image? A) the client close the eyes when the abdomen is exposed. B) The client avoid talking about the recent surgery. C) The client asks the spouse to leave the room. D) The client touches the altered body part. ANSWER: D The physician prescribed the lactulose[Cephulac], 30 ml three times daily, when a client with cirrhosis develops in increased serum ammonia level. To evaluate the effectiveness of lactulose the nurse should maonitor. A) A urine output B) Abdominal Girth C) Stool frequency D) Level of consciousness [LOC] ANSWER: D Which of the following is a warning sign of colon cancer? A) Hoarseness B) Indigestion C) Rectal Bleeding D) Sore that doesn't heal After undergoing a liver biopsy, the client would be place in what position? A) Semi Fowler's position B) Right lateral decubitus position C) Supine Position D) Prone position ANSWER: B Which medication should the nurse expect to administer to a client with constipation? A) Lorazepam [Antivan] B) Loperamide [Imodium] C) Flurbiprofen [Ansaid] D) Ducosate Sodium [Colace] ANSWER: D A client admitted for treatment of a gastric ulcer is being prepared for discharge on antacid therapy. Discharge teaching should include which instruction? A) Continue to take antacid even if your symptoms subside B) You may take antacid with other medication C) Avoid taking magnesium-containing antacids if you develop a heart problem D) Be sure to take antacid with meal” ANSWER: A A client with acute liver failure exhibits confusion, a declining level of consciousness and slowed respiration. The nurse finds him very difficult to arouse. The diagnostic information which best explains the clients behavior is: A) elevated liver enzymes and low serum protein level. B) Subnormal serum glucose and elevated serum ammonia level. C) subnormal clotting factor and platelet count. D) elevated blood urea nitrogen and creatinine levels and hyperglycemia. ANSWER: B A client with severe inflammatory bowel disease is receiving total parenteral nutrition TPN. When administering TPN, the nurse must take care to maintain the prescribe the flow rate because giving TPN too rapidly may cause: A) Hyperglycemia B) Air Embolism C) Constipation D) dumping syndrome ANSWER: A a client take 30 ml of magnesium hydroxide and aluminum hydroxide with simethicone ( Maalox TP) P.O. 1 hour and 3 hours after each meal and at bedtime for treatment of a duodenal ulcer. Why does the client take this antacid so frequently? A) it has a slow onset of action. B) It has a short duration of action. C) It has prolonged half-life. D) It's highly metabolized. ANSWER: B The physician orders a Bernstein test (which is performed by inserting a nasogastric [NG] tube and aspirating gastric contents) for a client who complains of chest pain. When teaching the client about this test, the nurse explains that it's done to: A) Locate an esophagus mass B) Evaluate competency of the lower esophageal sphincter C) Assess for acid perfusion of the gastric mucosa D) Detect esophageal inflammation ANSWER: C Apthous stomatitis is best described A) A canker sore of the oral soft tissues B) An acute stomach infection C) Acid indigestion D) An early sign of peptic ulcer disease ANSWER: A Which blood type is also a risk factor for duodenal ulcer? A) Type A B) Type B C) Type AB D) Type O ANSWER: D A client who received an inhalation anesthesia during GI surgery experiences severe shivering postoperatively. In addition to providing blankets, the nurse should A) Notify the physician immediately B) Increase the IV infusion rate C) Provide oxygen as prescribed D) Monitor fluid intake and output ANSWER: C The client asks which part of the GI tract absorbed mainly the nutrients in the A) Stomach B) Small intestine C) Large intestine D) Rectum ANSWER: B One hour before a client is to undergo abdominal surgery, the physician orders Atropine .3mg IM.The client asks why this drug must be administered.How should the nurse respond? A) Atropine decreases salivation and gastric secretions. B) Atropine controls the heart rate and blood pressure”. C) Atropine improves ventilation by increasing the respiratory rate. D) Atropine enhances the effect of anesthetic agent”. ANSWER: A During a client teaching session, which instruction should the nurse give to a client receiving a kaolin and pectin [Kaopectate] for treatment of diarrhea? A) Take the medication after every other loose bowel movement, up to five doses per day. B) Avoid taking this medication for more than 4 days. C) Consult the physician if you have more than six bowel movements in 1 day. D) Drink 8 to 13 8oz glasses [2-3L] of fluid daily. ANSWER: D A client is diagnosed with shigellosis. The nurse teaches the client and family how the disease is transmitted and treated and discusses the need for enteric precautions. The nurse should explain the enteric precautions must be maintained: A) During the acute decease stage and up to 48 hours after diarrhea stops. B) During the acute decease stage and as long as the virus is shed [up to 30 days] C) for 24 to 48 hours after anti- infective therapy begins. D) Until three fecal cultures are negative for shigellia. ANSWER: D A client is scheduled to undergo a left hemicolectomy for corolectal cancer. The physician prescribed phenobartibal [Luminal], 100 mg I.M 60 minutes surgery, for sedation. Which statement accurately describes administration of phenobartibal? A) The preferred route of administration for this drug is I.M. B) This drug can be mixed and given with other medications. C) This drug should be used within 24 hours after opening D) This drug should be injected into a large muscle mass. ANSWER: D The nurse is caring for a client who underwent a subtotal gastrectomy 24 hours ago. The client has a nasogastric [NG] tube. The nurse should: A) Apply sunction to the NG tube every hour B) Clamp the NG tube if the client complaint with nausea. C) Irrigate the NG tube gently with normal saline solution. D) Reposition the NG tube if pulled out. ANSWER: C The nurse is teaching an elderly client about good bowel habit. Which statement by the client would indicate to the nurse that additional teaching is required .Which statement by the client would indicate to the nurse that an additional teaching is required A) I should not eat a fiber rich diet with raw, leafy vegetable B) I need to use laxative regularly to prevent constipation C) I need to drink 2 to 3 liters of fluid every day D) I should exercise four times per week ANSWER: B To verify the placement of a gastric feeding tube, the nurse should perform at least two test. One test required instilling air into the tube with a syringe and listening with a stethoscope for air passing into the stomach. What is another test method? A) Aspiration of gastric content and testing for a pH less than six. B) Instillation for 30 ml of water while listening with a stethoscope C) Cessation of reflex gagging D) Ensuring proper measurement of the tube before insertion. ANSWER A A client with recent onset of epigastric discomfort is scheduled for an upper GI series [barium swallow]. When teaching the client how to prepare the test, which instruction should the nurse to provide? A) Eat a low residue diet for 2 days before the test B) Eat a clear liquid diet for 2 days before the test. C) Take a potent laxative the day before the test. D) Avoid eating or drinking anything for 6 to 8 hours before the test. ANSWER: D As a result of viral infection, a client develops gastroenteritis. The physician prescribed kaolin and pectin mixture ( Kaopectate), 60 ml by mouth after each loose bowel movement, up to eight doses daily. The client asks the nurse how soon the medication will take effect. How should the nurse respond? A) In 5 to 10 minutes B) Within 30 minutes C) Within 1 hour D) Within 2 hours ANSWER: B A client with cholecystitis is receiving propantheline bromide. The client is given this medication because it: A) Reduces gastric solution production and hypermobility B) Slows emptying of the stomach and reduces chime in the duodenum. C) Inhibits contraction of the bile duck and gull bladder. D) Decreases bile secretions. ANSWER: C A client is admitted to the health care facility with a diagnosis of bleeding gastric ulcer. The nurse expects this clients stool to be: A) Coffee ground like B) clay colored C) black and tarry D) bright red ANSWER: C A client with a history of rectal bleeding is being prepared for a colonoscopy. How should the nurse position the client for this test initially? A. Lying on the right side with leg straight B. Lying on the left side with knees legs C. Prone with the torso elevated D. Bent over with hands touching the floor ANSWER B A client is admitted to the health care facility with nausea, vomiting, and abdominal cramps and distention. Which test is most significant? A) Blood urea nitrogen ( BUN) level of 29 [mg/dl] B) Serum sodium level of 132 [mEq/L] C) Urine specific gravity of 1.025 D) Serum potassium level of 3 [mEq/L] ANSWER: D For a client who must undergo colon surgery, the physician orders preoperative cleansing enemas and neomycin sulfate ( Mycifradin). The rationale for neomycin use in this client is to: A) control postoperative nausea and vomiting B) decrease the intestinal bacteria count C) Increase the intestinal bacteria count D) Prevent the development of megacolon. ANSWER: B A client who can't tolerate oral feedings begins receiving intermittent enteral feedings. When monitoring for evidence if intolerance to these feedings, the nurse must stay alert for: A) diaphoresis, vomiting, and diarrhea B) manifestations of electrolyte disturbances C) manifestations of hypoglycemia D) Constipation, Dehydration, and hypercapnia ANSWER: A Alterations in hepatic blood flow resulting from a drug interaction also can affect: A) Onset and duration B) distribution and excretion C) absorption and metabolism D) metabolism and excretion ANSWER: D A 68 year old male is being admitted to the hospital with abdominal pain, anemia and bloody stools. He complains of feeling weak and dizzy. He has a rectal pressure and needs to urinate and move his bowels. The nurse should help him. A) to the bathroom B) to the bedside commode C) on to the bedpan D) to the standing position so he can urinate. ANSWER: C A client with advance cirrhosis has a prothrombin time [PT] of 15 seconds compare with a control time of 11 seconds. The nurse expected to administer. A) spironolactone [aldactone] B) phytonadione [mephytone) C) furosemide [larix] D) warfarin [coumadine] ANSWER: B During a preparation for bowel surgery, a client receives antibiotic to reduce intestinal bacteria. Antibiotic therapy may interfere with synthesis of which vitamin and may lead to hypoprothrombinemia. A) Vitamin A B) vitamin D C) vitamin E D) vitamin K ANSWER: D a client had a nephrectomy 2 days ago, is now complaining abdominal pressure and nausea. The first nursing action should be: A) auscultate bowel sounds B) palpate the abdomen C) change the client position D) insert a rectal tube ANSWER: A Why are antacids administered, regularly, rather than as needed, to treat peptic ulcer disease. A) to keep gastric pH 3.0 to 3.5 B) to promote client compliance C) to maintain regular bowel pattern D) to increase pepsin activity. ANSWER A Which of the following nursing interventions should the nurse perform for a client receiving enteral feedings through gastrostomy tube? A) change the tube feeding solutions and tubing at least every 24 hours. B) maintain the head of the bed at a 15degree elevation continuously C) Check the gastrostomy for position every 2 days. D) maintain the client on bed rest during the feedings. ANSWER: A After checking the clients chart for possible contraindicators, the nurse is administering meperidine [Demerol] ,50 mg I.M to a client pain after an appendectomy. Which type of drug therapy would contraindicate the use of meperidine. A. an antibiotic B. an antimetic C. A monoamine oxidase [MAO] inhibators D. a loop diuretic ANSWER: C The nurse is caring a client with active upper G.I bleeding. What is the appropriate diet for this client during the first 24 hours after admission? A) a regular diet B) skim milk C) nothing by mouth D) clear liquids. ANSWER: C for a client with cirrhosis deterioration of hepatic function is the best indicated by: A) a fatigue and weak muscles B) difficulty in arousal C) anorexia and nausea D) weight gain. ANSWER: B After an exploratory laparotomy, a client develops a subhepatic abcess. After the abcess is incised and the drainage, the affecting organism is identified as bacteroides fragilis. The physician prescribes clyndamicine (cleoline),300 mg. I.V energy 6 hours. Before administering the antibiotic. The nurse reviews the clients medication history because clindamycin may enhance the action of. A) neuromuscular blocking agents B) antiarrythmitic agents C) anticonvulsant agents D) beta-adrenergic blocking agents. ANSWER: A A client is evaluated for severe pain in the right upper abdominal quadrant, which accompanied by nausea and vomiting. The physician diagnosis acute cholecystitis and colelithiasis. For this client, which nursing diagnosis takes top priority? A) pain related to biliary spasms. B) knowledge deficit related to prevention of disease recurrence C) anxiety related to unknown outcome of hospitalization D) altered nutrition: less than body requirements related to biliary inflammation ANSWER: A Pain A) is directly related to the severity of physical symptoms. B) has an important survival function. C) has little medical significance outside of motivating most patients to seek treatment. D) is an important component of most medical school curricula. ANSWER: B Athletes who continue to play, despite being injured, may be experiencing a short-term reduction of pain sensitivity due to A) sympathetic arousal. B) parasympathetic arousal. C) effective training and coaching. D) activities that focus their attention on the pain. ANSWER: A 6.Cross-cultural differences have been found in the A) discrimination of painful stimuli. B) reporting and intensity of reactions to pain. C) sensory aspect of pain. D) all of the above. ANSWER: B The perception of pain may be influenced by A) context B) socialization C) attention D) all of the above ANSWER: D Self report measures such as the McGill Pain Questionnaire typically measure A) pain threshold. B) the nature and intensity of pain. C) pain tolerance. D) pain and encouraged tolerance level. ANSWER: B Pain behaviors A) are observable, measurable behaviors that are manifestations of chronic pain. B) have proven useful in identifying the dynamics of different pain syndromes. C) are used in assessing the impact of pain on quality of life. D) all of the above. ANSWER: D The sensory aspect of pain seems to be determined primarily by A) [A-]delta fibers. B) [C-]fibers. C) the limbic system. D) the cerebral cortex ANSWER: A Endogenous opioids are A) substances produced by the substantia gelatinosa that help regulate pain. B) substances produced by the brain and glands that help regulate pain. C) specialized receptor sites that play an active role in the regulation of pain. D) drugs, such as heroin and morphine, that help control pain. ANSWER: B Endogenous opioids appear to play a role in the A) inhibition of pain. B) stress response. C) functioning of the immune system. D) all of the above. ANSWER: D Chronic pain A) decreases with the passage of time. B) begins with an acute pain episode. C) readily responds to treatment. D) unlike acute pain, has no subcategories. ANSWER: B Chronic low back pain and myofascial pain syndrome are examples of A) acute pain. B) chronic benign pain. C) recurrent acute pain. D) chronic progressive pain ANSWER: B A migraine headache is an example of A) acute pain. B) chronic benign pain. C) recurrent acute pain. D) chronic progressive pain. ANSWER: D In comparison with acute pain patients, chronic pain patients A) share a similar psychological profile. B) experience higher levels of pain. C) are more responsive to pain management techniques. D) suffer from a syndrome involving physiological, psychological, social and behavioral components. ANSWER: D Compensation for pain resulting from an injury may _______________ the perceived severity of the pain. A) increase B) decrease C) both a and b D) neither a nor b ANSWERA Chronic pain patients whose spouses provide support and positive attention A) experience good marital and sexual functioning. B) may inadvertently maintain or increase the expression of pain. C) restrict their social contact to members of their immediate family. D) take smaller amounts of pain killers than patients who do not receive such support. ANSWER: B According to research investigating personality variables observed in chronic pain patients, A) there is a pain-prone personality, which, like the disease-prone personality, is characterized by negative affectivity. B) a significant proportion of the population appears to be predisposed to experience pain. C) personality change is often a consequence of pain, but personality variables are seldom involved as causes. D) different personality factors may be involved in different types of pain. ANSWER: D Pain control means A) only that the patient no longer feels any pain. B) only that the patient is no longer concerned about the pain. C) only that the patient no longer feels any sensation in the area that once hurt. D) none of the above. ANSWER: D Pharmacological control of pain A) is dangerous in that it usually leads to addiction to prescription drugs. B) is of no concern to researchers and practitioners. C) has a low probability of leading to addiction to prescription drugs. D) is the treatment of last resort. ANSWER: C Biofeedback training A) is an inexpensive pain control method. B) shows robust evidence for pain control. C) probably is no more effective for controlling pain than are relaxation techniques. D) effects are clearly understood. ANSWER: C Relaxation training strategies are A) seldom effective by themselves and need to be combined with other methods of pain control. B) generally less effective in reducing chronic pain than are meditation techniques. C) effective in alleviating chronic but not acute pain. D) all of the above. ANSWER: A Hypnosis relies on A) physiological relaxation. B) distraction. C) reinterpretation of sensations. D) all of the above. ANSWER: D Acupuncture may A) function as a sensory method of controlling pain. B) be effective because patients believe it will work. C) trigger the release of endorphins. D) all of the above. ANSWER: D The results of a study of the use of coping techniques in pain management [Holmes & Stevenson, 1990] suggested that A) avoidant coping was more effective in managing chronic pain. B) attentiona coping strategies were more effective in managing acute pain. C) patient should be trained in avoidant or attentive coping strategies depending on the nature of their pain. D) none of the above. ANSWER: C In contrast to aggressive imagery, relaxation imagery A) is more frequently used to combat pain. B) induces a positive mood state. C) focuses attention. D) all of the above. ANSWER: A Cognitive-behavioral pain interventions A) encourage patients to entrust the management of their pain to the treatment team. B) attempt to modify maladaptive cognitions but not overt and covert behaviors. C) encourage clients to attribute their success to the treatment intervention. D) none of the above ANSWER: D Relapse following initial successful treatment of pain is directly related to A) lack of social support. B) coping styles. C) nonadherence to treatment regimen. D) all of the above. ANSWER: C