Deck 14: Managing Pain

Question 1

Clinical pain is pain that:

A) requires some form of medical treatment.
B) is chronic.
C) is recurrent.
D) is idiopathic.

Answer 1

requires some form of medical treatment.

Question 2

When Carla had the flu,every part of her body seemed to hurt and she felt compelled to get extra rest.Carla's condition is an example of:

A) prechronic pain.
B) acute recurrent pain.
C) psychophysiological pain.
D) hyperalgesia.

Answer 2

hyperalgesia.

Question 3

Which of these is NOT true regarding pain measurement?

A) There are many objective measures of pain.
B) The most frequently used measures of pain are based on the patient's verbal or written report.
C) Chronic pain is what patients report fearing most about illness.
D) Almost all people suffering from headaches tend to choose the same pattern of words to describe their pain.

Answer 3

There are many objective measures of pain.

Question 4

The slow pain system serves:

A) the skin.
B) mucous membranes.
C) all body tissues except the brain.
D) the brain.

Question 5

The most widely used pain questionnaire is the:

A) Melzack Pain Questionnaire.
B) McGill Pain Questionnaire.
C) Minnesota Multiphasic Pain Inventory.
D) Nociception Survey.

Question 6

To assess a patient's pain experience,nurses and other health care professionals often use:

A) a pain-rating scale.
B) the Pain Behavior Scale.
C) electromyography (EMG).
D) simple measures of autonomic arousal.

Question 7

Fast (A-delta)nerve fibers are _____,and they conduct neural impulses at about _____ meters per second.

A) myelinated; 15 to 30
B) large; 0.5 to 2
C) unmyelinated; 0.5 to 2
D) small; 15 to 30

Question 8

Because of pain's complex nature,researchers have had to rely on all of these EXCEPT:

A) behavioral measures.
B) physical measures.
C) self-report measures.
D) objective measures.

Question 9

Jerry has an always-present nagging ache in his lower back that is moderate in intensity.Jerry's pain would probably be classified as:

A) acute pain.
B) referred pain.
C) chronic pain.
D) prechronic pain.

Question 10

Researchers believe that opioid-induced _____ occurs because of _____ among nerve cells in the spinal cord.

A) hyperalgesia; long-term potentiation
B) hyperalgesia; inhibition
C) acute pain; damage
D) chronic pain; desensitization

Question 11

Acute pain is often characterized by _____ pain,and chronic pain is often characterized by _____ pain.

A) dull; sharp
B) sharp; dull
C) recurrent; intermittent
D) intermittent; recurrent

Question 12

The simplest sensory receptors for pain are called:

A) fast nerve fibers.
B) slow nerve fibers.
C) free nerve endings.
D) nocebos.

Question 13

The most common reason why people seek medical treatment is for treatment of:

A) heart disease.
B) cancer.
C) diabetes.
D) pain.

Question 14

Slow (C)nerve fibers are _____,and they conduct neural impulses at about _____ meters per second.

A) myelinated; 15 to 30
B) large; 0.5 to 2
C) unmyelinated; 0.5 to 2
D) small; 15 to 30

Question 15

Recurrent pain:

A) involves episodes of discomfort interspersed with periods in which the individual is relatively pain-free.
B) is a sharp,stinging pain localized in an injured area of the body.
C) is a long-lasting,dull,burning pain.
D) occurs when the pain sufferer becomes more sensitive to pain over time.

Question 16

One way to assess pain is by recording changes in _____,among other indicators of _____ arousal.

A) heart rate; autonomic
B) blood pressure; CNS
C) skin temperature; endocrine
D) skin conductance; cortical

Question 17

What are nociceptors?

A) sensory receptors in the skin that respond to painful stimuli
B) motor nerves in the spinal cord that relay pain signals from the periphery of the body to the central nervous system
C) thalamic cells that route pain messages to the appropriate areas of the cortex
D) cortical cells that block pain messages from the spinal cord

Question 18

There are no specialized receptor cells devoted solely to the sense of:

A) touch.
B) vision.
C) hearing.
D) pain.

Question 19

The fast pain system carries pain that is perceived as:

A) coming from the skin.
B) stinging and generalized throughout the body.
C) dull and localized in one area.
D) stinging and localized in one area.

Question 20

Which of these qualities is NOT one of Ronald Melzack's dimensions for categorizing pain?

A) sensory quality
B) affective quality
C) intrusive quality
D) evaluative quality

Question 21

The area of the brain that,when electrically stimulated,causes an immediate reduction in pain is the:

A) periaqueductal gray area.
B) pituitary gland.
C) substantia gelatinosa.
D) hypothalamus.

Question 22

Which statement regarding pain sensitivity and racial,cultural,and ethnic differences is TRUE?

A) Asian individuals are more likely to report greater pain sensitivity than individuals with Middle Eastern roots.
B) Differences in pain sensitivity have been found in relation to cultural differences,but not for socioeconomic differences.
C) Individuals of Hispanic origin are more likely than individuals with Northern European roots to express pain.
D) Childbirth is construed as equally painful by all cultures of the world.

Question 23

Cultural differences in pain reactions are most likely related to differences in:

A) genetics.
B) pain tolerance.
C) health behaviors.
D) pain receptor locations.

Question 24

The substantia gelatinosa is the area of the spinal cord where:

A) fast fibers synapse with sensory nerves.
B) slow fibers synapse with sensory nerves.
C) fast and slow fibers synapse with sensory nerves.
D) free nerve endings synapse with sensory nerves.

Question 25

According to the gate control theory,the central control mechanism refers to signals from:

A) fast pain fibers that close the gate.
B) slow pain fibers that open the gate.
C) fast or slow pain fibers that open the gate.
D) the brain that can shut the gate.

Question 26

In one study,dental patients who were given a placebo reported increased pain when they were also injected with:

A) substance P.
B) enkephalins.
C) glutamate.
D) naloxone.

Question 27

The neurotransmitter secreted by pain fibers in the spinal cord that increases pain messages is:

A) substance P.
B) enkephalin.
C) cytokine.
D) naloxone.

Question 28

Through their synapses with slow fibers,neurons containing _____ are believed to regulate how much of the slow pain system's message reaches the brain.

A) substance P
B) enkephalins
C) glutamate
D) serotonin

Question 29

The pain in the shoulder that accompanies advanced heart disease is an example of:

A) acute pain.
B) chronic pain.
C) referred pain.
D) chronic intractable benign pain.

Question 30

Before his coronary bypass surgery,Bill used to experience a deep,burning pain in his left shoulder.Bill's pain was an example of _____ pain.

A) referred
B) phantom limb
C) psychophysiological
D) dysfunctional

Question 31

Which of these is an example of phantom limb pain?

A) A patient continues to feel a deep,burning sensation in a wound that has healed.
B) After an accidental fall,Brad can no longer feel any sensations in his left arm.
C) An amputee reports feeling pain in a missing leg.
D) After Sheila bruises her shoulder,her arm goes numb.

Question 32

The gate control theory attempts to explain how:

A) certain nerve cells in the brain respond to specific features of sensory stimuli.
B) the perception of touch is related to the specific nerve endings that are activated.
C) the nervous system blocks or allows pain signals to pass to the brain.
D) the perception of pain is mediated solely by emotional cues from the environment.

Question 33

One study of patients suffering from _____ found that those with one variation of the COMT gene displayed the most severe psychological and functional impact pain scores.

A) chronic fatigue syndrome
B) restless leg syndrome
C) referred pain
D) fibromyalgia

Question 34

Incoming messages to the cerebral cortex from the skin senses are ultimately routed to the:

A) somatosensory cortex.
B) reticular formation.
C) medulla.
D) ventrobasal complex.

Question 35

Which of these is NOT involved in the pathway of pain from the skin to the brain?

A) the pituitary gland
B) the spinal cord
C) the thalamus
D) the cortex

Question 36

Patients with chronic pain are often deficient in self-regulatory skills,which are partly regulated by the area of the brain known as the:

A) periaqueductal gray area.
B) anterior cingulate cortex.
C) reticular formation.
D) substantia gelatinosa.

Question 37

On its way to the _____,the fast pain pathway triggers neural activity in the _____,which is the brain's mechanism for arousing the cortex in response to important messages.

A) medulla; thalamus
B) thalamus; medulla
C) thalamus; reticular formation
D) somatosensory cortex; midbrain

Question 38

The so-called pain gate is believed to exist in the:

A) spinal cord.
B) brainstem.
C) thalamus.
D) cerebral cortex.

Question 39

Which statement regarding gender differences in the experience of pain is NOT true?

A) Women report more frequent episodes of pain than men do.
B) Women suffer more than men from migraines and tension headaches.
C) Men receive 5% to 10% more prescription drugs for common pain complaints than women do.
D) Lesbian and bisexual women report a higher pain threshold than heterosexual women.

Question 40

Acute,stinging pain is transmitted in which type of nerve fibers?

A) slow
B) fast
C) periaqueductal
D) substantia gelatinosa

Question 41

One research study of catastrophizing among rheumatoid arthritis patients found that _____ was associated with elevated levels of _____.

A) poor emotional regulation; substance P
B) helplessness; C-reactive protein
C) rumination; prostaglandin
D) cognitive distraction; inflammation

Question 42

Which neurotransmitter is activated during the phenomenon of stress-induced analgesia?

A) naloxone
B) substance P
C) glutamate
D) endorphin

Question 43

Pain sufferers may experience social reinforcement for _____ from the attention they receive from others.

A) long-term potentiation
B) deferred imitation
C) primary gains
D) pain behaviors

Question 44

Aspirin,acetaminophen,and ibuprofen are classified as:

A) nonsteroidal anti-inflammatory drugs.
B) prostaglandins.
C) COX-2 inhibitors.
D) opioids.

Question 45

_____ is an opioid analgesic,whereas _____ is a nonopioid analgesic.

A) Morphine; aspirin
B) Ibuprofen; morphine
C) Acetaminophen; naproxen
D) Aspirin; acetaminophen

Question 46

Kennedy has burned her hand,but she does not have an emotional response to the pain-even though she feels the pain,can judge the severity of the pain,and rationally seeks immediate medical attention for the injury.She has damage to the _____,the area of the brain that regulates her emotional response to a stimulus such as heat.

A) prefrontal cortex
B) anterior cingulate cortex
C) anterior insula
D) primary somatosensory cortex

Question 47

Which statement is an example of cognitive distraction?

A) While rescuing an unconscious victim from a burning building,a seriously injured firefighter was able to ignore her own pain.
B) By mentally rehearsing a difficult medical treatment,a patient is able to keep his emotions under control.
C) By ignoring a chronic pain sufferer's excessive complaining,dependence,and request for painkillers,the staff at a pain clinic aim to increase more positive ways of coping.
D) A chronic pain patient wears a battery-powered device that emits an audible tone whenever his muscle tension increases.

Question 48

Giancarlo is about to undergo an uncomfortable medical procedure,and he wants help in reducing his level of anxiety and in reducing the postprocedural pain.The hospital health psychologist suggests a form of self-hypnosis that involves focused concentration and attention.What intervention has the health psychologist suggested that Giancarlo use?

A) cognitive reappraisal
B) sensory focus
C) guided imagery
D) meditation

Question 49

Generally speaking,surgery to relieve pain:

A) yields excellent local pain relief,but only for certain types of injuries.
B) has unpredictable results.
C) is the most effective biomedical treatment for pain.
D) yields excellent central pain relief.

Question 50

After being injured in a football game,David is certain that his hoped-for career as a professional athlete is doomed and that the rest of his life will be miserable.A health psychologist would probably characterize David's pattern of thinking as an example of:

A) catastrophizing.
B) victimization.
C) self-blame.
D) dwelling on the pain.

Question 51

Which of these is NOT true of transcutaneous electrical nerve stimulation?

A) It is a form of counterirritation.
B) It involves applying impulses of electricity to nerve endings under the skin near the painful area.
C) It yields excellent local pain relief for some chronic pain patients.
D) It is a form of behavioral therapy.

Question 52

Like _____,guided imagery is based on the concept that our attention and awareness have _____.

A) relaxation training; unlimited capacity
B) cognitive distraction; a limited capacity
C) reflex training; an optimal level of arousal
D) visualization; multiple dimensions

Question 53

Jian,who is doing research on cognitive-behavioral interventions,is fascinated by a line of research on the neurobiology of distraction and how a particular set of pain-coping strategies is associated with reduced activation of key regions of the pain-processing areas of the brain.What is the collective name of that set of pain-coping strategies?

A) cognitive reappraisal
B) sensory focus
C) guided imagery
D) meditation

Question 54

Which form of therapy vigorously challenges clients' illogical and self-defeating beliefs?

A) psychoanalysis
B) systematic desensitization
C) aversive conditioning
D) cognitive restructuring

Question 55

A key component of cognitive-behavioral therapy is _____,which focuses on helping individuals reinterpret and redistribute pain-related sensations.

A) aversive conditioning
B) stimulus control training
C) cognitive restructuring
D) negative reinforcement

Question 56

Which personality trait has NOT been linked with patients who have chronic pain?

A) hysteria
B) hypochondriasis
C) depression
D) emotional dependence

Question 57

The chemical substance responsible for localized pain and inflammation,such as the pain of sunburn,is:

A) substance P.
B) glutamate.
C) prostaglandin.
D) NSAID.

Question 58

Analgesia created by triggering another,mildly painful stimulus is called:

A) counterirritation.
B) referred pain.
C) phantom pain.
D) stress-induced analgesia.

Question 59

Which of these statements is NOT a stated reason why cross-cultural studies of pain can be difficult to conduct and generalize?

A) Pain is a phenomenon that does not have a common universal language.
B) Individual personal history,perceptions,and experiences with pain make generalizability difficult.
C) There appears to be greater inter-group variation than intra-group variation.
D) Cross-cultural studies are typically correlational in nature.

Question 60

The dominant model for treating chronic pain is:

A) behavior modification.
B) dissociation training.
C) cognitive-behavioral therapy.
D) rational-emotive therapy.

Question 61

Noemi is a Hispanic woman who works long shifts in a factory,making a small living to support her family.Her boss,Adam,is of Northern European descent.His salary is significantly larger than Noemi's.How are Noemi's and Adam's pain responses likely to differ?

Question 62

Pain is the most variant sensation from one person to another person.Discuss in detail the various types of pain and types of pain receptors.In the discussion,explain why pain is difficult to accurately measure,and describe various measures that have been developed.

Question 63

Discuss the influence of psychosocial factors in the experience of pain,and critically evaluate the empirical evidence for the proposed existence of a pain-prone personality.

Question 64

Describe and explain in detail the major biomedical treatments for pain.

Question 65

Your friend experiences chronic pain and is reviewing different treatment options.He was told he qualifies for CBT combined with either biofeedback or a surgical procedure.What treatment option do you believe your friend should pursue?

Question 66

Yuri's left leg was amputated a couple years ago,but Yuri reports feeling pain in his left leg.His family thinks he is delusional.What would you tell Yuri's family about his condition and how to treat it?

Question 67

Compare and contrast the different groups of nerve fibers and neural pathways that are involved in pain.Be sure to include specifics related to reception speed,types of pain sensation,and location of nerve fibers in the body.

Question 68

According to Nestoriuc,Rief,and Martin,(2008),meta-analyses provide evidence for the effectiveness of _____ in relieving the pain of tension headaches.

A) biofeedback
B) exercise
C) surgery
D) a placebo

Question 69

Brad's therapist believes that he is not progressing in his treatment because adhering to the role of a pain patient is bringing him a lot of attention from others.Because she wants to reshape Brad's pain behavior,the therapist is advocating:

A) cognitive therapy.
B) guided imagery.
C) distraction.
D) an intervention based on a conditioning model.

Question 70

Provide illustrative examples that identify and describe the features of effective pain management programs.

Question 71

The most effective pain-management programs:

A) focus only on controlling a patient's pain.
B) combine cognitive-behavior therapy with the judicious use of analgesic drugs.
C) are based on operant conditioning.
D) are based on classical conditioning.

Question 72

The mainstay of the behavioral aspect of cognitive-behavioral therapy related to pain is to modify specific targeted pain behaviors that are associated with continued pain and disability.This targeted approach includes all of these interventions EXCEPT:

A) identification of events that act as stimuli,responses,and reinforcers.
B) an increase in reinforcing consequences.
C) an increase in adaptive coping strategies.
D) the maintenance of reinforcing contingencies in response to maladaptive pain behaviors.

Question 73

Use an illustrative example to explain the gate control theory of pain,and discuss in detail the evidence that supports the validity of this theory.

Question 74

_____ is an opioid antagonist that binds to opioid receptors in the body and blocks the effects of natural opiates.

A) Substance P
B) Enkephalin
C) Naloxone
D) Prostaglandin

Question 75

Which of these approaches to pain control works BEST?

A) Physical therapy works best for pain control.
B) Behavioral therapy works best for pain control.
C) Biomedical therapy works best for pain control.
D) It depends on the patient and the nature of the pain.

Question 76

Compare and contrast guided imagery with cognitive reappraisal.