Deck 11: Mechanisms of Pain and Use of Therapeutic Modalities

Question 1

Which of the following best describes the evidence regarding concurrent use of caffeine and TENS for pain modulation?

A) Caffeine consumption may decrease the effectiveness of TENS.
B) Caffeine consumption increases the analgesic effect of TENS.
C) Concurrent use of caffeine and TENS may result in analgesic tolerance.
D) Caffeine acts as a competitive agonist on the opioid receptors, thereby increasing the analgesic effect of TENS.

Answer 1

A

Question 2

Which of the following best describes the evidence-supported level of stimulation amplitude, or intensity, to be used when administering TENS?

A) The amplitude should be just above the sensory threshold.
B) Current amplitude should never rise beyond the motor threshold.
C) Current amplitude should be increased to noxious levels for best effectiveness.
D) Current amplitude should be as strong as is tolerated while still comfortable.

Answer 2

D

Question 3

All of the following are generally accepted as contraindications to TENS except which one?

A) Over an implanted electrical device, such as a pacemaker
B) Over an epiphyseal plate
C) Over the carotid sinus
D) Over an area of active malignancy

Answer 3

B

Question 4

Stimulation of large-diameter A-beta afferents to activate local inhibitory circuits in the dorsal horn best describes what analgesic mechanism of TENS?

A) The gate theory of pain control
B) Descending inhibition
C) Analgesic hyperstimulation
D) Analgesic potentiation

Question 5

Which of the following best describes why application of TENS near or over a pregnant uterus is considered a contraindication?

A) Because the effect of stimulation in these areas is not clearly understood
B) Because the stimulation will induce labor
C) Because the stimulation will increase fetal heart rate and blood pressure
D) Because the stimulation will cause analgesic tolerance in the fetus

Question 6

Which of the following may occur with the co-administration of opioid medication and TENS?

A) Analgesic tolerance
B) Central inhibition
C) Pain gating
D) Descending facilitation

Question 7

Modulation of the beat frequency when using interferential current is known as which of the following?

A) Swing
B) Sweep
C) Scan
D) Swift

Question 8

Which of the following types of pain is the result of real tissue damage caused by infection, trauma, or the progression of a metabolic disorder or degenerative disease?

A) Referred
B) Acute
C) Chronic
D) Intractable

Question 9

What is the correct term for the amplification of neural signaling within the central nervous system resulting in an increased perception of pain?

A) Peripheral summation
B) Temporal aggregation
C) Central sensitization
D) Nociceptive downregulation

Question 10

When selecting small electrodes to administer TENS, which of the following must be considered in regard to the patient's perception and tolerance of the stimulation?

A) Hypersensitivity reactions
B) Inter-electrode distance
C) Current density
D) The electrode polarity

Question 11

Which mode of TENS is best described as eliciting strong sensory paresthesia but without motor activation?

A) Acupuncture TENS
B) Brief-intense TENS
C) Burst-train TENS
D) Conventional TENS

Question 12

Which of the following modes of TENS is administered with a pulse frequency of 100 Hz and a pulse duration of 100 µsec?

A) Acupuncture TENS
B) Brief-intense TENS
C) Burst-train TENS
D) Conventional TENS

Question 13

Modulation of the temporal characteristics of interferential current is best known as what?

A) Swing
B) Sweep
C) Scan
D) Swift

Question 14

Which of the following best describes the recommended increase in current amplitude when using TENS?

A) 10% per day
B) 10% per week
C) 25% each treatment
D) 50% each day

Question 15

Analgesic tolerance is most likely to occur with what type of opioid receptor?

A) Kappa
B) Mu
C) Delta
D) Gamma

Question 16

Electrode placement for TENS should be selected based on which of the following?

A) Chronicity of pain
B) The mode of TENS used
C) In accordance with the painful area or over the peripheral nerve responsible for the pain
D) The cost of the electrodes

Question 17

Which of the following modes of TENS is best described as using a low-pulse frequency, high intensity to evoke visible muscle contractions?

A) Conventional TENS
B) Burst-train TENS
C) Acupuncture TENS
D) Brief-intense TENS

Question 18

What are the three most common parameters used to provide the different modes of TENS?

A) Current waveform, pulse frequency, and fall time
B) Pulse frequency, pulse duration, and current amplitude
C) Current amplitude, pulse duration, and carrier frequency
D) Pulse duration, pulse frequency, and waveform shape

Question 19

___________ is a form of amplitude modulated alternating current and __________ is a form of burst modulated alternating current.

A) Interferential; Aussie
B) Interferential; brief intense
C) Russian; Aussie
D) Russian; interferential

Question 20

Which of the following best reflects the evidence-based recommendations for the duration of a TENS treatment when used for knee osteoarthritis?

A) Less than 15 minutes
B) 40 minutes
C) 1 hour
D) Several hours of continuous stimulation