Deck 10: The Management of Pain and Discomfort

Question 1

Which of the following is the most common reason for euthanasia?

A)Anxiety in a hospital setting
B)Substantial cost of treatment
C)Inadequate relief from pain
D)Prospect of surgery

Answer 1

Inadequate relief from pain

Question 2

Which of the following statements is true of A-delta fibres?

A)Sensory aspects of pain are heavily determined by activity in the A-delta fibers.
B)A-delta fibers are unmyelinated nerve fibers that are involved in polymodal pain.
C)Dull, aching pain is typically transmitted to the cerebral cortex by A-delta fibers.
D)A-delta fibers typically conduct pain signals at a slower rate than C-fibers.

Answer 2

Sensory aspects of pain are heavily determined by activity in the A-delta fibers.

Question 3

Patients with chronic pain disorders:

A)always present clear tissue damage.
B)are characterized by the deactivation of nociceptors in the peripheral nerves.
C)show significant loss of gray matter in the prefrontal, cingular, and insular cortex.
D)always present psychological profiles which are identical to patients with acute pain.

Answer 3

show significant loss of gray matter in the prefrontal, cingular, and insular cortex.

Question 4

_____ is a functional pain disorder in which there is no clear tissue damage present.

A)Polymyositis
B)Fibromyalgia
C)Hematoma
D)Tumefaction

Question 5

A-delta fibers _____.

A)are small, myelinated fibers.
B)typically transmit dull, aching pain.
C)cannot respond to mechanical pain.
D)transmit pain signals at a slower rate than C-fibers.

Question 6

Neurons in the periductal gray connect to the reticular formation in the medulla which makes connections with the neurons in the _____ of the dorsal horn of the spinal cord.

A)subarachnoid space
B)substantia nigra
C)septomarginal fasciculus
D)substantia gelatinosa

Question 7

____ -fibers are unmyelinated nerve fibers, involved in polymodal pain, which transmit dull, aching pain.

A)C
B)A-delta
C)B
D)A-gamma

Question 8

Athletes who continue to play, despite being injured, experience a reduction in pain sensitivity because of increased:

A)sympathetic arousal.
B)parasympathetic arousal.
C)psychological distress.
D)stimulation of nociceptors.

Question 9

Which of the following statements is true about physical pain and social pain?

A)Psychological distress is a key component of physical pain but not social pain.
B)There are no similarities in the way that social and physical pain are experienced.
C)Social pain relies on the same pain-related neurocircuitry as physical pain.
D)Physical pain and social pain are mutually exclusive.

Question 10

Which of the following statements is true of pain?

A)From a medical practitioner's perspective, pain is never a by-product of a disorder.
B)It is always easy for individuals to describe pain objectively.
C)It is the symptom most likely to lead an individual to seek treatment.
D)Sympathetic arousal that occurs in response to vigorous sports increases pain sensitivity.

Question 11

Identify the true statement about pain from the following.

A)The degree to which pain is felt and how incapacitating it is largely depends on how it is interpreted.
B)Men typically show a greater sensitivity to pain compared to women.
C)Cultural differences have no influence over the interpretation of pain.
D)Unlike acute pain, chronic pain is usually short in duration and decreases with treatment and the passage of time.

Question 12

One barrier to the treatment of pain is that:

A)pain behavior cannot be measured.
B)the psychological profiles for acute and chronic pain are always identical.
C)it is difficult for people to objectively describe pain.
D)physical pain and social pain are mutually exclusive.

Question 13

_____ refers to pain that triggers chemical reactions from tissue damage.

A)Phantom limb sensation
B)Thermal damage
C)Mechanical nociception
D)Polymodal nociception

Question 14

When acute anxiety reduces sensitivity to pain it is known as _____.

A)stress-induced analgesia
B)stimulation-produced analgesia
C)primary hyperalgesia
D)opioid-induced hyperalgesia

Question 15

Which of the following statements is true about chronic pain?

A)Behaviors that arise from chronic pain cannot be measured.
B)Patients with chronic pain disorders show significant loss of gray matter in certain regions of the brain.
C)Unlike acute pain, chronic pain usually decreases with treatment and the passage of time.
D)Most pain control techniques work well to control chronic pain but are less successful with acute pain.

Question 16

The scientific understanding of pain was originally developed by Melzack in the _____ theory of pain.

A)peripheral pattern
B)three dimensions
C)intensive
D)gate-control

Question 17

According to a medical provider, pain:

A)and the severity of an underlying problem are always independent of each other.
B)is a by-product of a disorder and is often considered to be unimportant.
C)can always be easily and objectively described by patients.
D)has no psychological significance.

Question 18

The periductal gray is a structure in the _____ that provides pain relief when stimulated.

A)cerebellum
B)occipital lobe
C)meninges
D)midbrain

Question 19

Nociception is the _____ of pain.

A)symptom
B)management
C)suppression
D)perception

Question 20

C-fibers:

A)are small, myelinated fibers that transmit sharp pain.
B)strongly influence the affective and motivational elements of pain.
C)respond to mechanical or thermal pain but not to polymodal pain.
D)typically transmit pain signals more rapidly than A-delta fibers.

Question 21

Typically, chronic progressive pain:

A)involves intermittent episodes of pain that are acute in character but chronic inasmuch as the condition repeats for more than 6 months.
B)involves constant pain that varies in severity, persists for 6 months or longer, and is relatively unresponsive to treatment.
C)is associated with degenerative disorders, involves constant pain that increases in severity over time, and lasts longer than 6 months.
D)goes on for 6 months or less and disappears when the tissue damage is repaired.

Question 22

Which of the following best describes a pain-prone personality?

A)Societal factors that force an individual to experience pain more intensely
B)A constellation of personality traits that predispose a person to experience chronic pain
C)An individual's congenital traits that make him or her more vulnerable to pain
D)Individuals with personality traits that predispose them to deliberate self-injury

Question 23

According to the Minnesota Multiphasic Personality Inventory, which of the following is commonly referred to as the neurotic triad?

A)Social introversion, anxiety, and schizophrenia
B)Depression, delusion, and paranoia
C)Anxiety, stress, and hysteria
D)Hypochondriasis, hysteria, and depression

Question 24

Which of the following statements is a characteristic of acute pain?

A)Unlike chronic pain, acute pain usually goes on for 6 months or more.
B)Acute pain is usually short in duration compared to chronic pain.
C)Acute pain usually presents psychological profiles that are identical to chronic pain.
D)Unlike chronic pain, acute pain is usually unresponsive to treatment.

Question 25

Which of the following is a difference between acute pain and chronic pain?

A)Unlike acute pain, chronic pain has no psychological significance.
B)Unlike acute pain, chronic pain does not require individualized techniques for its management.
C)Acute pain involves a more complex interaction of physiological, psychological, social, and behavioral components than chronic pain.
D)Most pain control techniques work well to control acute pain, but are less successful with chronic pain.

Question 26

_____ pain is due to an unidentifiable physical cause.

A)Nociceptive
B)Phantom
C)Neurogenic
D)Psychogenic

Question 27

_____ is a personality attribute that is associated with chronic pain.

A)Openness to experience
B)Agreeableness
C)Increased self-esteem
D)Introversion

Question 28

Typically, endogenous opioid peptides:

A)are pain control drugs manufactured from plants.
B)require additional factors to trigger their arousal.
C)exacerbate the transmission of pain signals.
D)increase sensitivity to pain.

Question 29

Which of the following statements best describes recurrent acute pain?

A)The pain is constant and varies in severity, typically persists for 6 months or longer, and is relatively unresponsive to treatment.
B)The pain typically goes on for 6 months or less and disappears when the tissue damage is repaired.
C)It involves constant pain that increases in severity over time, due to a malignant condition, and typically lasts longer than 6 months.
D)It involves intermittent episodes of pain that are acute in character but chronic inasmuch as the condition repeats for more than 6 months.

Question 30

Migraine headache is an example of _____ pain.

A)acute
B)chronic benign
C)recurrent acute
D)chronic progressive

Question 31

_____ pain varies in severity, persists for 6 months or longer, and is relatively unresponsive to treatment.

A)Acute
B)Chronic benign
C)Recurrent acute
D)Chronic progressive

Question 32

_____ means that a patient no longer feels anything in an area of the body that once hurt.

A)Pain threshold
B)Pain sensitivity
C)Pain behavior
D)Pain control

Question 33

Which of the following is an important feature of chronic pain?

A)It typically disappears with the passage of time.
B)It typically begins with an acute pain episode.
C)It typically presents psychological profiles that are identical to acute pain.
D)It typically lasts for 6 months or less.

Question 34

Temporomandibular disorder and trigeminal neuralgia are examples of _____ pain.

A)acute
B)recurrent acute
C)chronic benign
D)chronic progressive

Question 35

Unlike acute pain, chronic pain does not:

A)decrease with treatment and the passage of time.
B)carry an overlay of psychological distress.
C)require individualized techniques for its management.
D)increase in severity over time.

Question 36

How does compensation provide an incentive for being in pain?

A)By increasing the ability of patients to continue with life activities uninterrupted
B)By increasing the perceived severity of pain
C)By reducing the amount of disability experienced
D)By reducing the amount of distress that is reported

Question 37

Which of the following is a reason for chronic pain to get exacerbated?

A)Inappropriate prior treatments
B)Increased sympathetic arousal
C)Appropriate prescription of medications
D)Decreased stimulation of nociceptors

Question 38

Typically, acute pain:

A)does not decrease with treatment and the passage of time.
B)persists for 6 months or longer and increases in severity over time.
C)results from a specific injury that produces tissue damage.
D)always requires individualized pain control techniques for its management.

Question 39

Cancer and rheumatoid arthritis are degenerative disorders that are typically associated with _____.

A)recurrent acute pain
B)chronic benign pain
C)chronic progressive pain
D)acute pain

Question 40

Which of the following characteristics is most likely to be displayed by patients suffering from chronic pain?

A)Increased communication with family members
B)Preference for loud noises
C)Reduced pain behavior
D)Discomfort against bright lights

Question 41

_____ involves a mindful distancing from the pain experience where patients are trained to control their emotional responses to pain.

A)Acceptance and commitment therapy
B)Counterirritation technique
C)Relaxation technique
D)Biofeedback training

Question 42

Which of the following is a goal of an individualized pain management program?

A)Reducing physical activity
B)Increasing reliance on medication
C)Reducing perception of disability
D)Increasing the use of health care services

Question 43

Which of the following is a traditionally used pain management method?

A)Counterirritation
B)Hypnosis
C)Relaxation
D)Biofeedback

Question 44

Jay fractures his left leg while playing football and now suffers from chronic post-surgical pain.His doctor recommends a psychological technique for pain management.Hence, whenever Jay experiences pain, he listens to his favorite music while trying out new recipes.This helps him deal more effectively with the pain and also helps in reducing the intensity of pain.Which of the following techniques is Jay using to control his pain?

A)Counterirritation
B)Biofeedback
C)Hypnosis
D)Distraction

Question 45

Distraction is most effective in coping with:

A)high-intensity pain.
B)low-level pain.
C)chronic progressive pain.
D)severe pain.

Question 46

The childbirth experience and the perception of pain associated with it is uniform for all women across different cultures.

Question 47

Which of the following is a disadvantage of using morphine as a painkiller?

A)It can be addictive.
B)It is ineffective in relieving chronic progressive pain.
C)It is effective only when used in conjunction with other painkillers.
D)It cannot be administered to women.

Question 48

_____ is a psychological technique for the management of pain and can be thought of as an operant learning process.

A)Counterirritation
B)Distraction
C)Biofeedback
D)Spinal cord stimulation

Question 49

_____ is a psychological pain management technique in which a patient turns his or her attention away from pain by focusing attention on an irrelevant and attention-getting stimulus.

A)Distraction
B)Biofeedback
C)Acupuncture
D)Counterirritation

Question 50

Which of the following is a psychological technique for managing pain?

A)Counterirritation
B)Spinal cord stimulation
C)Spinal block
D)Biofeedback

Question 51

Emotional factors have no effect on the experience of pain.

Question 52

_____ is a sensory technique of inhibiting pain where a set of small electrodes is placed near the point at which the nerve fibers from the painful area enter the spinal cord.When the patient experiences pain, he or she activates a radio signal, which delivers a mild electrical stimulus to that area of the spine.

A)Spinal block
B)Spinal cord stimulation
C)Acupuncture
D)Biofeedback

Question 53

The brain controls the amount of pain an individual experiences by transmitting messages down the spinal cord to block the transmission of pain signals.

Question 54

_____ is a pain control technique that completely eliminates the feeling of pain.

A)Counterirritation
B)Spinal block
C)Distraction
D)Relaxation

Question 55

Nociceptors in the peripheral nerves first sense injury and, in response, release chemical messengers, which are conducted to the spinal cord.

Question 56

Pain is easy to treat because patients are comfortable describing it objectively.

Question 57

Surgical techniques to control pain involve:

A)inhibiting pain in one part of the body by stimulating or mildly irritating another area.
B)using spinal blocking agents to decrease the transmission of pain impulses from the peripheral receptors to the spinal cord.
C)providing biophysiological feedback to a patient about some bodily process of which the patient is usually unaware.
D)creating lesions in pain fibers at various points in the body so that pain sensations can no longer be conducted.

Question 58

Cognitive behavioral techniques are helpful in the treatment of pain because it helps to instill _____ in a patient.

A)drug dependency
B)neuroticism
C)introversion
D)self-efficacy

Question 59

_____ is defined as a disorder in which the small arteries in the extremities constrict, limiting blood flow and producing a cold, numb aching.

A)Alzheimer's disease
B)Raynaud's disease
C)Parkinson's disease
D)Hodgkin's disease

Question 60

Pain has social causes and consequences.

Question 61

In cognitive behavioral therapy, patients are taught how and when to employ overt and covert behaviors in order to make adaptive responses to a pain problem.

Question 62

Chronic pain is not necessarily present every moment, but the fact that it is chronic forces sufferers to organize their lives around it.

Question 63

Explain biofeedback and relaxation techniques for pain management.

Question 64

Typically, catastrophic thinking reduces the pain experience.

Question 65

Explain the importance of social and psychological components of pain.

Question 66

What is pain control? Briefly explain the traditional methods of controlling pain.

Question 67

Relapse prevention techniques that help patients continue their pain management skills can maintain posttreatment pain reduction.

Question 68

Describe the design and implementation of pain management programs.

Question 69

Discuss the differences between acute and chronic pain.