Deck 14: Managing Pain

Question 1

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.

Answer 1

involves episodes of discomfort interspersed with periods in which the individual is relatively pain free.

Question 2

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

Answer 2

sharp; dull

Question 3

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 3

hyperalgesia.

Question 4

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 5

Identify, and describe with illustrative examples, the features of effective pain-management programs.

Question 6

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

Question 7

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 8

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

A) behavioral measures.
B) pain diaries.
C) rating scales.
D) objective measures.

Question 9

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 10

Clinical pain is pain that:

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

Question 11

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 12

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

Question 13

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

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

Question 14

The most common reason for people seeking medical treatment is:

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

Question 15

One way to asses 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 16

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 your discussion, explain why pain is difficult to accurately measure, and describe various measures that have been developed.

Question 17

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) People suffering from headaches tend to choose the same pattern of words to describe their pain.

Question 18

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 19

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

Question 20

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 21

Slow nerve fibers are ______ and 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 22

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 23

An opioid antagonist that binds to opioid receptors in the body and blocks the effects of natural opiates is:

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

Question 24

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

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

Question 25

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

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

Question 26

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 27

The slow pain system services:

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

Question 28

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

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

Question 29

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 30

Fast nerve fibers are ______ and 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 31

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 32

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 33

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 34

The simplest sensory receptors for pain are called:

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

Question 35

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 36

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 37

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

A) the pituitary gland
B) the amygdala
C) the thalamus
D) the cortex

Question 38

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 matter.
B) anterior cingulate cortex.
C) reticular formation.
D) substantia gelatinosa.

Question 39

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 40

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 41

Pain sufferers may experience ______ from the social reinforcement they receive in response to pain behaviors.

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

Question 42

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 43

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

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

Question 44

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 45

Aspirin, acetaminophen, and ibuprofen are classified as:

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

Question 46

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 percent more prescription drugs for common pain complaints than do women.
D) Certain analgesics provide longer-lasting relief for women than they do for men.

Question 47

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

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

Question 48

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 solely mediated by emotional cues from the environment.

Question 49

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

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

Question 50

______ is an opioid analgesic, whereas ______ is a nonopioid-acting analgesic.

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

Question 51

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 52

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 53

The dominant model for treating chronic pain is:

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

Question 54

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 55

Which statement 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 56

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 57

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

A) African-Americans report significantly greater pain sensitivity than Hispanic-Americans.
B) Differences in pain sensitivity have been found in relation to pain tolerance levels and not for pain threshold.
C) Hispanic-Americans who express the strongest ethnic identity also report greater pain sensitivity.
D) European-Americans report higher levels of lower back pain than African-Americans and Hispanic-Americans

Question 58

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 59

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

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

Question 60

Brad's psychologist 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 61

In one study comparing the effectiveness of different treatments in relieving the pain of tension headaches, the greatest relief occurred with:

A) biofeedback.
B) relaxation training.
C) a combination of biofeedback and relaxation.
D) a placebo.

Question 62

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

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

Question 63

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 64

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 65

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 66

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 67

Giancarlo is about to undergo an uncomfortable medical procedure, and he wants help in both reducing his level of anxiety and 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 utilize?

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

Question 68

As demonstrated by Mrs. Y, 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 69

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 70

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 are 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 71

Which approach 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 72

Like ______, 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