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MN 553-Final review

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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. 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. 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 4. Cold intolerance

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