NURS 549 Final Review Questions and answers 2025.

NURS 549 Final Review Questions and
answers 2025




4 .steps .of .pain .pathway .- .CORRECT .ANSWER-transduction, .transmission,
.perception, .modulation


Transduction .- .CORRECT .ANSWER-Stimulus .converted .to .nerve .impulse
Travels .from .most .distal .nerve .ending .toward .CNS

Transmission .- .CORRECT .ANSWER-Impulse .carried .to .brain/CNS
Through .Neospinothalamic .tract .(fast) .or .Paleospinothalamic .tract .(slow)

Perception .- .CORRECT .ANSWER-message .from .periphery .interpreted .by .brain
Alterations .in .neural .circuitry .in .brain .can .cause .change .in .pain .perception
--> .Mood, .stress, .rest

Modulation .- .CORRECT .ANSWER-Brain .sends .signals .that .cause .pain .signals
.from .periphery .to .be .suppressed .or .amplified


Fast .pain .receptors .- .CORRECT .ANSWER-Type .A-delta .fibers
Felt .<0.1 .second .of .stimulus: .sharp, .acute
Mechanical, .acute .thermal .pain
Not .in .deep .tissues

Slow .pain .receptors .- .CORRECT .ANSWER-Type .C .fibers
Felt .1+ .second .of .stimulus: .aching, .throbbing, .burning
Chemical .pain

Neospinothalamic .tract .- .CORRECT .ANSWER-Type .A-delta .fibers
Mechanical .and .thermal .pain
Spine .--> .Thalamus .fibers, .pain .localized .precisely

Paleospinothalamic .tract .- .CORRECT .ANSWER-Type .C .fibers
Chemical .pain
Terminates .in .brain .stem, .only .10-25% .terminate .in .thalamus, .cannot .localize
.pain


Endogenous .pain .modulation/suppression .- .CORRECT .ANSWER-Serotonergic
.and .enkephalin .neurons .BLOCK .pain

, Analgesia .signals .can .block .pain .from .peripheral .neurons .- .from .both .Type .A-
delta .and .C .fibers

NSAIDS: .COX .inhibitors .- .CORRECT .ANSWER-Inhibit .transduction .of .TYPE .C
.pain .fibers
COX-1: .constitutive .(occurs .all .the .time) .
COX-2: .induced .by .cytokines .in .presence .of .inflammation .--> .localized .to .pain

NSAIDS .Side .Effects .- .CORRECT .ANSWER-GI .ulceration .and .bleeding .d/t
.decreased .platelet .aggregation
Decreased .renal .function, .not .good .for .CKD .or .ARF .pts

Acetaminophen .- .CORRECT .ANSWER-COX .inhibitor .(COX-3?), .better .for .fever
.than .inflammation .or .pain


Opioids .- .CORRECT .ANSWER-Block .transmission .of .pain, .binds .to .Mu
.receptors
S/S: .suppresses .respiratory .center .of .brain .stem, .Chemoreceptor .Trigger .Zone
.(CTZ) .- .N/V, .constipation, .urinary .retention


Tramadol .(Ultram) .- .CORRECT .ANSWER-Selective, .weak .mu-opioid .receptor
.agonist
Increases .risk .of .SEIZURE

Antidepressants .for .pain .- .CORRECT .ANSWER-SNRIs .(Duloxetine/Cymbalta) .or
.tricyclics
Good .for .chronic .neuropathy .or .chronic .musculoskeletal .pain

Antiepileptics .for .pain .- .CORRECT .ANSWER-Pregablin/Lyrica, .Gabapentin
Often .need .increased .dose .for .pain .management
Good .for .chronic .neuropathy .or .chronic .musculoskeletal .pain

Goals .of .pulmonary .meds .- .CORRECT .ANSWER-Reduce .inflammation
Stimulate .bronchodilation
Block .bronchoconstriction
Control .cough .(may .be .more .than .one .goal)

Cough .- .CORRECT .ANSWER-Protective .mechanism, .not .always .safe .to .stop
.cough
Cough .receptors .in .trachea

Smoking .and .alveoli .damage .- .CORRECT .ANSWER-Alveoli .sense .foreign .body,
.macrophages .destroy .it
If .happens .repeatedly, .alveoli .become .distended .by .progressive .macrophage
.activity
Alveoli .permanently .inflated, .unable .to .perform .gas .exchange

Sympathetic .NS .- .CORRECT .ANSWER-Causes .bronchoDILATION
activated .by .epinephrine