Question 1

Chronic pain is a complex problem. Some specific strategies to deal with it include:

Accepted Answer

Option A is not an effective strategy as it puts the burden of treatment solely on the patient, who may not have the knowledge or resources to manage their pain effectively. Option B is not ideal as it may lead to undermedication or inconsistent pain management. Option C is the best choice as it ensures that the patient's pain is regularly monitored and addressed, potentially preventing a painful flare-up.

Question 2

Age is a factor in different responses to pain. Which of the following age-related statements about pain is NOT true?

Accepted Answer

Preterm and newborn infants do have functional pain pathways, and they can experience pain. However, their pain responses may differ from older children and adults due to their immature neurological system. It is important to manage pain in newborns and infants to prevent negative consequences on their development and long-term outcomes.

Question 3

Different areas of the brain are involved in specific aspects of pain. The reticular and limbic systems in the brain influence the:

Accepted Answer

The reticular and limbic systems in the brain are responsible for the motivational aspects of pain, such as the emotional response to pain and the motivation to seek relief or avoid further pain. The sensory and discriminative aspects of pain involve other areas of the brain, such as the somatosensory cortex and thalamus. The cognitive aspects of pain involve higher brain regions, such as the prefrontal cortex.

Question 4

A treatment plan for management of chronic pain should include:

Accepted Answer

A treatment plan for management of chronic pain should include negotiation with the patient to set personal goals for pain management, discussion of ways to improve sleep and stress, and an exercise program to improve function and fitness. All of these are important components in managing chronic pain and improving overall quality of life for patients.

Question 5

The chemicals that promote the spread of pain locally include:

Accepted Answer

Neurokinin A promotes the spread of pain locally by increasing the sensitivity of nearby nerves and enhancing inflammation. Serotonin and norepinephrine typically serve to inhibit pain signals. Enkephalin functions as an endogenous pain reliever by binding to opiate receptors in the nervous system.

Question 6

The Pain Management Contract is appropriate for:

Accepted Answer

The Pain Management Contract is appropriate for patients with chronic pain who will require long-term use of opiates, as it helps to ensure safe and effective use of opioids over an extended period of time. Patients with cancer who are taking morphine may also require opioid therapy but may not necessarily require a Pain Management Contract. Patients who have a complex drug regimen or see multiple providers for pain control may benefit from a pain management plan, but a contract may not be necessary.

Question 7

Chemical dependency assessment is integral to the initial assessment of chronic pain. Which of the following raises a "red flag" about potential chemical dependency?

Accepted Answer

Multiple requests to refill prescriptions due to lost medications can be a sign of potential chemical dependency, particularly if it becomes a frequent occurrence. Using multiple drugs to treat pain or having a preference for alternative medicines are not necessarily indicative of chemical dependency. Having a family member with a history of drug abuse may increase the risk for chemical dependency, but it is not a definitive marker.

Question 8

Which of the following statements is true about acute pain?

Accepted Answer

Referred pain occurs when pain is felt in an area distant from the source of the pain, but it is perceived there because the pain shares the same spinal segment as the actual site of the pain. This phenomenon is due to the way pain signals are processed in the central nervous system.

Question 9

One of the main drug classes used to treat acute pain is NSAIDs. They are used because:

Accepted Answer

NSAIDs are particularly effective in treating acute pain that is caused by inflammation, such as pain from swelling or injury. They work by blocking the production of certain chemicals in the body that cause pain and inflammation. NSAIDs are not necessarily safer than acetaminophen, and they can cause significant GI irritation and other side effects. Additionally, they can affect blood flow to the kidney, which is why they should be used with caution in individuals with kidney disease or other kidney problems.

Question 10

The goal of treatment of acute pain is:

Accepted Answer

The goal of treatment of acute pain is the reduction or elimination of pain with minimum adverse reactions. While options A, B, and D are also important considerations in treating acute pain, the primary goal is to relieve the pain itself, rather than simply reduce it to a tolerable level.

Question 11

Pain assessment to determine adequacy of pain management is important for all patients. This assessment is done to:

Accepted Answer

All of the above reasons are important for pain assessment to determine adequacy of pain management. The correct diagnosis of the source of pain is crucial for effective management, and assessing the current regimen is needed to determine if adjustments need to be made. It is also important to evaluate the patient's ability and willingness to participate in their own pain management.

Question 12

If interventions to resolve the cause of pain (e.g., rest, ice, compression, and elevation) are insufficient, pain medications are given based on the severity of pain. Drugs are given in which order of use?

Accepted Answer

The typical approach to managing pain involves starting with non-opiate medications (such as acetaminophen or NSAIDs), then increasing the dose of these non-opiates if necessary, and finally resorting to opiates if the pain remains uncontrolled. This strategy aims to minimize the use of opiates due to their potential for addiction and side effects.

Question 13

Which of the following statements is true about age and pain?

Accepted Answer

Acetaminophen is a recommended choice for both children and adults because it doesn't affect platelets and has fewer side effects than NSAIDs. Choice A is incorrect because it's a statement about adjusting drug dosages for young children based on renal function, not age and pain. Choice B is incorrect because although indomethacin may have lower adverse effects in some cases, it's not the preferred NSAID for treating pain. Choice C is incorrect because it's a false statement; dementia doesn't cause loss of pain receptors in the brain, and older adults with dementia can still experience pain.

Question 14

Patients need to be questioned about all pain sites because:

Accepted Answer

The answer of Patients need to be questioned about all...

Question 15

Narcotics are exogenous opiates. They act by:

Accepted Answer

Narcotics attach to receptors in the afferent neuron to inhibit the release of substance P, which is a neurotransmitter that transmits pain signals to the brain. By inhibiting this transmission, narcotics can reduce pain sensations.

Question 16

Pathological similarities and differences between acute pain and chronic pain include:

Accepted Answer

Chronic pain is associated with stimulation of C-neurons, while acute pain is typically associated with stimulation of A-delta neurons.

Answer: C 
 Acute pain is often caused by irritation of peripheral nerves, while chronic pain can have a variety of causes including nerve damage, inflammation, or psychological factors.

A and D are incorrect as decreased levels of endorphins are not present in all cases of acute or chronic pain, and acute pain is typically localized rather than diffuse.

Question 17

Opiates are used mainly to treat moderate to severe pain. Which of the following is NOT true about these drugs?

Accepted Answer

Opiates stimulate not only mu receptors, but also delta and kappa receptors for pain control.

Quiz 52: Pain Management: Acute and Chronic Pain