NURS 535 EXAM 1 | COMPREHENSIVE NURSING STUDY GUIDE,
PRACTICE QUESTIONS & ANSWERS 2026/2027
Gate control theory - correct answer ✔✔In this theory pain impulses travel through the spinal cord
where cells in the substantia gelatinase (laminae in the dorsal horn of the spinal cord) function as a
"gate". Partial closure of the gate can be cause by non-nociceptive stimulation.
Neuroma Trix theory - correct answer ✔✔This theory suggests that various inputs lead to feeling pain,
including genetic, psychologic, and cognitive experiences. Illustrates the plasticity of the brain.
Nociceptive transmissions - correct answer ✔✔Fibers that open the spinal gate and increase the
perception of pain
Afferent pathway - correct answer ✔✔Begins in the peripheral nervous system (PNS), travel to the spinal
gate in the dorsal horn and then ascend to higher levels in the CNS
Interpretive center - correct answer ✔✔Located in the brainstem, midbrain, diencephalon, and cerebral
cortex
Efferent pathway - correct answer ✔✔Descend from the CNS to the dorsal horn of the spinal cord
modulate pain
Pain transduction - correct answer ✔✔This step of nociception begins when tissue is damaged by
noxious stimuli and is converted to electrophysical activity, which causes activation of nociceptors
A delta fibers - correct answer ✔✔Lightly myelinated, medium sized fibers that rapidly transmit sharp,
well-localized "fast" pain sensations
C fibers - correct answer ✔✔Smaller, unmyelinated that slowly transmit dull, aching, or burning
sensations that are poorly localized and longer lasting
A beta fibers - correct answer ✔✔Large, myelinated fibers that transmit touch and vibration sensations
Pain transmission - correct answer ✔✔The conduction of pain impulses along A delta and C fibers into
the dorsal horn of the spinal cord and the brainstem, thalamus, and cortex.
Dorsal horn - correct answer ✔✔The back of the spinal cord, where the sensory fibers relay pain
transmissions to the brain
Spinothalamic - correct answer ✔✔Pathway that "goes towards the thalamus"
Thalamus - correct answer ✔✔The principle target location for afferent nociceptors is the:
Pain modulation - correct answer ✔✔The physiologic process of suppressing or facilitating pain
Hyperalgesia - correct answer ✔✔Increased sensitivity to pain
, Allodynia - correct answer ✔✔Perception of an ordinarily non-noxious stimulus as pain
Endorphins - correct answer ✔✔Inhibitory neurotransmitter than provides natural pain relief
Pain threshold - correct answer ✔✔The point at which a stimulus is perceived as pain and it does not
vary significantly among people or in the same person over time
Pain tolerance - correct answer ✔✔Intensity of pain that an individual will endure before initiating overt
pain responses and is generally decreased with repeated exposure to pain. Influenced by a person's
cultural perceptions, expectations, physical and mental health, gender, fatigue, etc.
Chronic pain - correct answer ✔✔Pain lasting at least 3 months and lasting well beyond the expected
healing time
Migraine headache - correct answer ✔✔Etiology: unilateral head pain, throbbing pain, pain worsens
with activity, AND n/v, photophobia, or phono phobia; risk factors: women, ages 25-55; clinical
manifestations: repeated, episodic headache lasting 4 to 72 hours
Fibromyalgia - correct answer ✔✔Etiology & patho: related to central sensitization, strong genetic
connections, alterations in genes affecting serotonin, catecholamines, and dopamine, HPA-axis
alterations; risk factors: women, ages 30-50, often seen in combination with lupus and IBS; clinical
manifestations: diffuse, chronic pain, tenderness in 11 out of 18 pain points both above and below the
waist, profound fatigue, anxiety, and depression
Diabetic neuropathy - correct answer ✔✔Etiology & patho: metabolic and vascular factors related to
chronic hyperglycemia with ischemia and demyelination contributing to neural changes, damage to
peripheral nerves; risk factors: 60-70% of persons with diabetes; clinical manifestations: loss of pain,
temperature, and vibration sensations
Postherpetic neuralgia - correct answer ✔✔Etiology & patho: persistent pain that lasts for more than 8
weeks after the onset of skin lesions, approximately 10-15% of patients with herpes zoster (shingles); risk
factors: advanced age and hx of immune compromise; clinical manifestations: burning pain that follows
along a dermatomal pathway and is accompanied by a blistering rash
Genotype - correct answer ✔✔An organism's genetic makeup, or allele combinations.
Phenotype - correct answer ✔✔An organism's physical appearance, or visible traits.
Dominant - correct answer ✔✔The allele whose effects are observable (AA)
Recessive - correct answer ✔✔The allele whose effects are hidden (Aa)
Heterozygote - correct answer ✔✔Organism that inherits two different alleles for a given gene (Aa)
Autosomal dominant - correct answer ✔✔"Autosomal" means the gene in question is located on one of
the numbered, non-sex chromosomes. "Dominant" means that a single copy of the disease-associated
mutation is enough to cause the disease
PRACTICE QUESTIONS & ANSWERS 2026/2027
Gate control theory - correct answer ✔✔In this theory pain impulses travel through the spinal cord
where cells in the substantia gelatinase (laminae in the dorsal horn of the spinal cord) function as a
"gate". Partial closure of the gate can be cause by non-nociceptive stimulation.
Neuroma Trix theory - correct answer ✔✔This theory suggests that various inputs lead to feeling pain,
including genetic, psychologic, and cognitive experiences. Illustrates the plasticity of the brain.
Nociceptive transmissions - correct answer ✔✔Fibers that open the spinal gate and increase the
perception of pain
Afferent pathway - correct answer ✔✔Begins in the peripheral nervous system (PNS), travel to the spinal
gate in the dorsal horn and then ascend to higher levels in the CNS
Interpretive center - correct answer ✔✔Located in the brainstem, midbrain, diencephalon, and cerebral
cortex
Efferent pathway - correct answer ✔✔Descend from the CNS to the dorsal horn of the spinal cord
modulate pain
Pain transduction - correct answer ✔✔This step of nociception begins when tissue is damaged by
noxious stimuli and is converted to electrophysical activity, which causes activation of nociceptors
A delta fibers - correct answer ✔✔Lightly myelinated, medium sized fibers that rapidly transmit sharp,
well-localized "fast" pain sensations
C fibers - correct answer ✔✔Smaller, unmyelinated that slowly transmit dull, aching, or burning
sensations that are poorly localized and longer lasting
A beta fibers - correct answer ✔✔Large, myelinated fibers that transmit touch and vibration sensations
Pain transmission - correct answer ✔✔The conduction of pain impulses along A delta and C fibers into
the dorsal horn of the spinal cord and the brainstem, thalamus, and cortex.
Dorsal horn - correct answer ✔✔The back of the spinal cord, where the sensory fibers relay pain
transmissions to the brain
Spinothalamic - correct answer ✔✔Pathway that "goes towards the thalamus"
Thalamus - correct answer ✔✔The principle target location for afferent nociceptors is the:
Pain modulation - correct answer ✔✔The physiologic process of suppressing or facilitating pain
Hyperalgesia - correct answer ✔✔Increased sensitivity to pain
, Allodynia - correct answer ✔✔Perception of an ordinarily non-noxious stimulus as pain
Endorphins - correct answer ✔✔Inhibitory neurotransmitter than provides natural pain relief
Pain threshold - correct answer ✔✔The point at which a stimulus is perceived as pain and it does not
vary significantly among people or in the same person over time
Pain tolerance - correct answer ✔✔Intensity of pain that an individual will endure before initiating overt
pain responses and is generally decreased with repeated exposure to pain. Influenced by a person's
cultural perceptions, expectations, physical and mental health, gender, fatigue, etc.
Chronic pain - correct answer ✔✔Pain lasting at least 3 months and lasting well beyond the expected
healing time
Migraine headache - correct answer ✔✔Etiology: unilateral head pain, throbbing pain, pain worsens
with activity, AND n/v, photophobia, or phono phobia; risk factors: women, ages 25-55; clinical
manifestations: repeated, episodic headache lasting 4 to 72 hours
Fibromyalgia - correct answer ✔✔Etiology & patho: related to central sensitization, strong genetic
connections, alterations in genes affecting serotonin, catecholamines, and dopamine, HPA-axis
alterations; risk factors: women, ages 30-50, often seen in combination with lupus and IBS; clinical
manifestations: diffuse, chronic pain, tenderness in 11 out of 18 pain points both above and below the
waist, profound fatigue, anxiety, and depression
Diabetic neuropathy - correct answer ✔✔Etiology & patho: metabolic and vascular factors related to
chronic hyperglycemia with ischemia and demyelination contributing to neural changes, damage to
peripheral nerves; risk factors: 60-70% of persons with diabetes; clinical manifestations: loss of pain,
temperature, and vibration sensations
Postherpetic neuralgia - correct answer ✔✔Etiology & patho: persistent pain that lasts for more than 8
weeks after the onset of skin lesions, approximately 10-15% of patients with herpes zoster (shingles); risk
factors: advanced age and hx of immune compromise; clinical manifestations: burning pain that follows
along a dermatomal pathway and is accompanied by a blistering rash
Genotype - correct answer ✔✔An organism's genetic makeup, or allele combinations.
Phenotype - correct answer ✔✔An organism's physical appearance, or visible traits.
Dominant - correct answer ✔✔The allele whose effects are observable (AA)
Recessive - correct answer ✔✔The allele whose effects are hidden (Aa)
Heterozygote - correct answer ✔✔Organism that inherits two different alleles for a given gene (Aa)
Autosomal dominant - correct answer ✔✔"Autosomal" means the gene in question is located on one of
the numbered, non-sex chromosomes. "Dominant" means that a single copy of the disease-associated
mutation is enough to cause the disease
