ADVANCED MED-SURG PRINCIPLES JERSEY COLLEGE EXAM
1
QUESTIONS WITH SOLUTIONS
1. What during labor increases the risk of neonate aquiring acute encephali- tis?: active herpes
simplex virus-2
2. How do you administer meds?: starting with the lowest dose and titrating up slowly
3. What is pain is associated with?: actual or potential tissue damage
4. When pain stimulates the sympathetic nervous system, what does it result in?: - increase in BP
- increase in HR
- increase in RR
5. Where are catecholamines released from?: adrenal medulla
6. Where are steroid hormones (cortisol & aldosterone) released from?: adren- al cortex
7. What does unrelieved pain lead to?: - increases glucagon production
- decreases insulin secretion
- depress immune function
- can lead to addictive behaviors
8. What initiates inflammation, contributes to tissue sweeling, and pain?: -
Prostaglandins
9. What can nerve root injury lead to?: allodynia (pain that is associated with non-noxious
stimuli)
10. What is needed for renal blood flow?: Prostaglandin
11. Pain is?: whatever the patient says it is
12. What is the single most reliable indicator of pain?: the patient's self-report
13. How do NSAID's preimarily produce pain relief?: by preventing prostaglandin formation
14. What does acetaminphen not have?: any inflammatory properties
,15. What do you manage nociceptive pain with?: - local anesthetics
,- non-opioids
- opioids
16. What does 0 on the 0 - 10 numeric pain rating scale indicate?: no pain
17. What does the Wong-Baker FACES pain scale consist of?: cartoon faces that the patient (ages
3 and up) selects to report thier pain level
18. What does the visual analog 10cm scale represent?: no pain to the worst pain, the patient
marks a spot somewhere in between indicating their pain level
19. What pain scale helps indiviuals describe the intensity of pain?: verbal descriptor scale
20. What does a comprehensive pain assessment consist of?: - duration (when it started/lasted)
- type (intensity/assoc factors/influencing fators)
- location
21. What patients do we avoid the rectal route for med administration?: throm- bocytopenic
22. What type of effect do topical agents produce?: local
23. What type of effect do transdermal agents produce?: drug absorption into the systemic
circulation
24. What would help reduce complications related to pain for patients?: pro- vide a PCA
25. How do we administer around the clock pain relief for post-op and chronic pain?: provide
analgesics, never wait for chronic pain to reoccur
26. What is provided for mild to moderate pain?: aspirin or acetaminaphen
27. What is provided for moderate pain?: NSAID's
28. What is provided for severe pain?: morphine
29. Why would you wake patients who have chronic pain or who have moder- ate to severe pain
folowing surgery?: to administer prescribed analgcsics
30. What can excessive use of acetaminophen cause?: hepatoxicity
31. What does of acetaminophen could lead to hepatoxicity?: 4,000 mg/day
, 32. What can NSAID's meds result in?: - gastric ulcers
- contribute to CV events (MI or stroke)
33. What can the use of NSAID's lead to in patients with volume depletion or who take it for chronic
pain?: acute renal failure
34. What undesirable effects do opioids produce?: - constipation
- nausea
- pupil constriction
- respiratory distress
35. Physical dependence and tolerance are not the same as what?: addiction
36. Why do you never apply heat over a transdermal patch?: it could increase absorption and
result in lethal complications
37. How should you manage neuropathic pain?: with adjuvant meds such as antidepressants
or anticonvulsants
38. What should not be used in a clincial practice that it would violate the nurse-patient
relationship?: placebos
39. What are some non-pharmacologic pain management strategies?: - physi- cal modalities
- mind-body methods
- biologic and energy-based therapies
40. What are the clinical manifestations of hyponatremia?: - headaches
- seizures
- lethargy
- tachycardia
- decreased BP
- thready pulse
- hyperactive bowel sounds
1
QUESTIONS WITH SOLUTIONS
1. What during labor increases the risk of neonate aquiring acute encephali- tis?: active herpes
simplex virus-2
2. How do you administer meds?: starting with the lowest dose and titrating up slowly
3. What is pain is associated with?: actual or potential tissue damage
4. When pain stimulates the sympathetic nervous system, what does it result in?: - increase in BP
- increase in HR
- increase in RR
5. Where are catecholamines released from?: adrenal medulla
6. Where are steroid hormones (cortisol & aldosterone) released from?: adren- al cortex
7. What does unrelieved pain lead to?: - increases glucagon production
- decreases insulin secretion
- depress immune function
- can lead to addictive behaviors
8. What initiates inflammation, contributes to tissue sweeling, and pain?: -
Prostaglandins
9. What can nerve root injury lead to?: allodynia (pain that is associated with non-noxious
stimuli)
10. What is needed for renal blood flow?: Prostaglandin
11. Pain is?: whatever the patient says it is
12. What is the single most reliable indicator of pain?: the patient's self-report
13. How do NSAID's preimarily produce pain relief?: by preventing prostaglandin formation
14. What does acetaminphen not have?: any inflammatory properties
,15. What do you manage nociceptive pain with?: - local anesthetics
,- non-opioids
- opioids
16. What does 0 on the 0 - 10 numeric pain rating scale indicate?: no pain
17. What does the Wong-Baker FACES pain scale consist of?: cartoon faces that the patient (ages
3 and up) selects to report thier pain level
18. What does the visual analog 10cm scale represent?: no pain to the worst pain, the patient
marks a spot somewhere in between indicating their pain level
19. What pain scale helps indiviuals describe the intensity of pain?: verbal descriptor scale
20. What does a comprehensive pain assessment consist of?: - duration (when it started/lasted)
- type (intensity/assoc factors/influencing fators)
- location
21. What patients do we avoid the rectal route for med administration?: throm- bocytopenic
22. What type of effect do topical agents produce?: local
23. What type of effect do transdermal agents produce?: drug absorption into the systemic
circulation
24. What would help reduce complications related to pain for patients?: pro- vide a PCA
25. How do we administer around the clock pain relief for post-op and chronic pain?: provide
analgesics, never wait for chronic pain to reoccur
26. What is provided for mild to moderate pain?: aspirin or acetaminaphen
27. What is provided for moderate pain?: NSAID's
28. What is provided for severe pain?: morphine
29. Why would you wake patients who have chronic pain or who have moder- ate to severe pain
folowing surgery?: to administer prescribed analgcsics
30. What can excessive use of acetaminophen cause?: hepatoxicity
31. What does of acetaminophen could lead to hepatoxicity?: 4,000 mg/day
, 32. What can NSAID's meds result in?: - gastric ulcers
- contribute to CV events (MI or stroke)
33. What can the use of NSAID's lead to in patients with volume depletion or who take it for chronic
pain?: acute renal failure
34. What undesirable effects do opioids produce?: - constipation
- nausea
- pupil constriction
- respiratory distress
35. Physical dependence and tolerance are not the same as what?: addiction
36. Why do you never apply heat over a transdermal patch?: it could increase absorption and
result in lethal complications
37. How should you manage neuropathic pain?: with adjuvant meds such as antidepressants
or anticonvulsants
38. What should not be used in a clincial practice that it would violate the nurse-patient
relationship?: placebos
39. What are some non-pharmacologic pain management strategies?: - physi- cal modalities
- mind-body methods
- biologic and energy-based therapies
40. What are the clinical manifestations of hyponatremia?: - headaches
- seizures
- lethargy
- tachycardia
- decreased BP
- thready pulse
- hyperactive bowel sounds
