Acute Pain
6. Which of the following statements is true about acute pain?
1. Somatic pain comes from body surfaces and is only sharp and well-localized.
2. Visceral pain comes from the internal organs and is most responsive to
acetaminophen and opiates.
3. Referred pain is present in a distant site for the pain source and is based on
activation of the same spinal segment
as the actual
pain site.
4. Acute neuropathic pain is caused by lack of blood supply to the nerves in a
given area.
7. One of the main drug classes used to treat acute pain is NSAIDs. They are used
because:
1. They have less risk for liver damage than acetaminophen.
2. Inflammation is a common cause of acute pain.
3. They have minimal GI irritation.
4. Regulation of blood flow to the kidney is not affected by these drugs.
10. The goal of treatment of acute pain is:
1. Pain at a tolerable level where the patient may return to activities of daily living
2. Reduction of pain with a minimum of drug adverse effects
3. Reduction or elimination of pain with minimum adverse reactions
4. Adequate pain relief without constipation or nausea from the drugs
13. Pathological similarities and differences between acute pain and chronic pain
include:
1. Both have decreased levels of endorphins.
2. Chronic pain has a predominance of C-neuron stimulation.
3. Acute pain is most commonly associated with irritation of peripheral nerves.
4. Acute pain is diffuse and hard to localize.
,MN 553-Final review
Allopurinol
17. Which antigout medication is used to treat chronic tophaceous gout?
a. Allopurinol (Zyloprim)
b. Colchicine
c. Probenecid (Benemid)
d. Sulfinpyrazone (Anturane)
18. The nurse is assessing a patient who has gout who will begin taking
allopurinol (Zyloprim). The nurse reviews the patient’s medical record and will
be concerned about which laboratory result? a. Elevated BUN and creatinine
b. Increased serum uric acid
c. Slight increase in the white blood count
d. Increased serum glucose
19. The nurse provides teaching for a patient who will begin taking allopurinol.
Which statement by the patient indicates understanding of the teaching?
a. I should increase my vitamin C intake.
b. I will get yearly eye exams.
c. I will increase my protein intake.
d. I will limit fluids to prevent edema.
3. Larry is taking allopurinol to prevent gout. Monitoring of a patient who is taking
allopurinol includes:
1. Complete blood count
2. Blood glucose
3. C-reactive protein
4. BUN, creatinine, and creatinine clearance
Angina
20. Isosorbide dinitrate is prescribed for a patient with chronic stable
angina. This drug is administered twice daily, but the schedule is 7 a.m. and
2 p.m. because:
1. It is a long-acting drug with potential for toxicity.
2. Nitrate tolerance can develop.
,MN 553-Final review
3. Orthostatic hypotension is a common adverse effect.
4. It must be taken with milk or food.
21. Art is a 55-year-old smoker who has been diagnosed with angina and
placed on nitrates. He complains of headaches after using his nitrate. An
appropriate reply might be:
1. This is a parasympathetic response to the vasodilating effects of the drug.
2. Headaches are common side effects with these drugs. How severe are they?
3. This is associated with your smoking. Let’s work on having you stop smoking.
4. This is not related to your medication. Are you under a lot of stress?
20. Elderly patients who are started on levothyroxine for thyroid replacement
should be monitored for:
1. Excessive sedation
2. Tachycardia and angina
3. Weight gain
2. Hypertension ................................................................................................... 4
3. Hyperlipidemia ................................................................................................ 5
4. Atherosclerosis ................................................................................................ 5
1. Angina is produced by an imbalance between myocardial oxygen supply (MOS)
and demand (MOD) in the myocardium. Which of the following drugs help to
correct this imbalance by increasing MOS? 1. Calcium channel blockers
2. Beta blockers
3. Angiotensin-converting-enzyme (ACE) inhibitors
4. Aspirin
3. The New York Heart Association and the Canadian Cardiovascular Society
have described gradingcriteria for levels of angina. Angina that occurs
with unusually strenuous activity or on walking or climbing stair after
meals is class:
4. Patients at high risk for developing significant coronary heart disease are
those with:
1. LDL values between 100 and 130
2. Systolic blood pressure between 120 and 130
, MN 553-Final review
3. ClassIII angina
4. Obesity
5. To reduce mortality, all patients with angina, regardless of class, should be on:
1. Aspirin 81 to 325 mg/d
2. Nitroglycerin sublingually for chest pain
3. ACE inhibitors or angiotensin receptor blockers4. Digoxin
6. Patients who have angina, regardless of class, who are also diabetic, should be
on:
1. Nitrates
2. Beta blockers
3. ACE inhibitors
4. Calcium channel blockers
7. Management of all types and grades of angina includes the use of lifestyle
modification to reduce risk factors. Which of these modifications are appropriate
for which reason? Both the modification and the reason for it must be true for
the answer to be correct.
1. Lose at least 10 pounds of body weight. Excessive weight increases cardiac
workload.
2. Reduce sodium intake to no more than 2,400 mg of sodium. Sodium
increases blood volume and cardiac
workload.
3. Increase potassium intake to at least 100 mEq/d. The heart needs higher levels
of potassium to improve contractility and oxygen supply.
4. Intake a moderate amount of alcohol. Moderate intake has been shown by
research to improve cardiac function.
8. Nitrates are especially helpful for patients with angina who also have:
1. Heart failure
2. Hypertension
3. Both 1 and 2
4. Neither 1 nor 2
9. Beta blockers are especially helpful for patients with exertional angina who also
have:
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