Answer to Question 1
D
Modulation is a protective reflex response also occurs with pain. When a person is injured, a noxious stimulus from the skin travels along sensory neurons to the dorsal horn of the spinal cord where it synapses with spinal motor neurons. The impulse continues to travel along the spinal nerve to the skeletal muscle, causing the person to withdraw from the source of the pain. Perception occurs when the pain impulse ascends to the brain, the central nervous system extracts information such as location, duration, and quality of the pain impulse. Transmission is the cellular damage from thermal, mechanical, or chemical injury results in the release of excitatory neurotransmitters such as prostaglandins, histamine, bradykinin, and substance P. These pain-sensitizing substances surround the pain fibers in the extracellular fluid, spreading the pain message and causing an inflammatory response. The pain stimulus enters the spinal cord via the dorsal horn and travels one of several routes until ending within the gray matter of the spinal cord. At the dorsal horn substance P is released, causing a synaptic transmission from the afferent (sensory) nerve to spinothalamic tract nerves, which cross to the opposite side. Transduction converts energy produced by these stimuli into electrical energy. The process begins in the periphery when a pain-producing stimulus sends an impulse across a sensory peripheral pain nerve fiber (nociceptor), initiating an action potential. Once transduction is complete, transmission of a pain impulse begins.
Answer to Question 2
A, B, D, E
Priority setting, time management, delegation, and team communication are all leadership skills. Student nurses do not perform case management and case management is not a leadership skill but an approach to delivery of patient care.