Unrelieved acute pain has several negative physiological consequences. A significant increase in heart rate and blood pressure is primarily caused by which of the following?
Parasympathetic nervous system activation.
The release of endorphins.
Sympathetic nervous system activation.
A reduction in cardiac output.
The Correct Answer is C
Unrelieved acute pain stimulates the body’s stress response, activating the sympathetic nervous system. This leads to the release of catecholamines such as epinephrine and norepinephrine, which cause increased heart rate, elevated blood pressure, and heightened myocardial oxygen demand. These physiological changes are part of the "fight-or-flight" response, preparing the body to react to perceived danger but potentially harmful when prolonged, especially in patients with cardiovascular disease.
Rationale for correct answer:
C. Sympathetic nervous system activation: Acute pain signals trigger the hypothalamus, which activates the sympathetic nervous system. This results in vasoconstriction, increased cardiac contractility, and elevated heart rate and blood pressure — all aimed at improving perfusion during stress, but potentially detrimental if sustained.
Rationale for incorrect answers:
A. Parasympathetic nervous system activation: This system slows the heart rate and lowers blood pressure, the opposite of what occurs with unrelieved acute pain.
B. The release of endorphins: Endorphins are natural pain-relieving peptides that reduce the perception of pain and can lower sympathetic activity, not increase it.
D. A reduction in cardiac output: Unrelieved acute pain generally increases cardiac output due to sympathetic stimulation, not decreases it — unless pain is severe enough to cause decompensation in a compromised heart.
Take home points
- Acute pain activates the sympathetic nervous system, increasing HR and BP.
- Catecholamine release is a key mechanism in this physiological stress response.
- Prolonged sympathetic activation can have harmful effects, especially in patients with cardiac conditions.
- Effective pain control can help stabilize vital signs and prevent cardiovascular complications.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
The statement reflects the affective dimension of pain, which encompasses the emotional responses and feelings associated with pain. Fear, anxiety, frustration, and hopelessness are common affective reactions that can amplify the perception of pain and affect a patient’s overall well-being.
Rationale for correct answer:
D. The affective dimension: This relates to the emotional aspects of the pain experience, including fear, anger, sadness, or distress. Fear about pain persistence is a classic affective response that can worsen pain perception and hinder coping strategies.
Rationale for incorrect answers:
- The sensory dimension: Focuses on the physical qualities of pain such as location, intensity, and quality (e.g., burning, throbbing), not emotions.
- The behavioral dimension: Involves observable actions taken in response to pain, such as grimacing, restlessness, or avoidance of activity.
- The cognitive dimension: Pertains to beliefs, attitudes, and expectations about pain, such as thoughts about its cause or meaning, but does not directly capture emotional fear.
Take home points
- Pain is multidimensional; sensory, affective, cognitive, and behavioral aspects all interact.
- The affective dimension captures the emotional toll of pain, such as fear, anxiety, or depression.
- Addressing emotional responses is crucial for effective pain management.
Correct Answer is B
Explanation
The IASP defines pain as a subjective, unpleasant sensory and emotional experience linked to actual or potential tissue damage, or described in such terms. This emphasizes that pain is not only a physical sensation but also an emotional experience, making patient self-report the gold standard in pain assessment.
Rationale for correct answer:
B. A subjective, unpleasant sensory and emotional experience associated with actual or potential tissue damage: This definition recognizes that pain has both sensory and emotional components and may occur even in the absence of visible injury. It also underlines that only the patient can truly describe their pain.
Rationale for incorrect answers:
A. Purely physical sensation: This oversimplifies pain by ignoring its emotional and subjective aspects.
C. Objective measure of tissue injury: Pain cannot be objectively quantified by the extent of injury; mild injuries can cause severe pain and vice versa.
D. Psychological symptom with no physiological basis: This dismisses the legitimate physical basis of many types of pain and stigmatizes the patient’s experience.
Take home points:
- Pain is a complex, multifaceted experience involving sensory and emotional factors.
- Self-report remains the most reliable method for pain assessment.
- Understanding the IASP definition helps guide holistic pain management.
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