Deck 10: The Management of Pain and Discomfort

Question 1

There are ethnic differences in the ability to discriminate painful stimuli.

Answer 1

False

Question 2

Pain has important medical consequences because

A) patients' delay behaviour is related to the experience of debilitating pain.
B) practitioners are trained to devote a significant amount of time to diagnosing the source of pain, which often impairs the quality of medical interactions.
C) it is the symptom most likely to lead an individual to seek treatment.
D) after death, pain is the most feared aspect of illness or medical treatment.
E) chronic pain patients monopolize the health care system.

Answer 2

it is the symptom most likely to lead an individual to seek treatment.

Question 3

In Canada, _______ of dollars are spent every year on over-the-counter drugs.

A) millions
B) thousands
C) hundreds of thousands
D) billions
E) decreasing amounts.

Answer 3

billions

Question 4

Although depression is common among chronic pain patients, chronic pain is not a sufficient condition for the development of depression.

Question 5

Nociception is the _______________ of pain.

A) physiological process
B) chemical process
C) sensation
D) perception
E) description

Question 6

Cross-cultural differences have been found in the

A) discrimination of painful stimuli.
B) reporting and intensity of reactions to pain.
C) sensory aspect of pain.
D) categorization of pain
E) amount one seeks treatment for certain pain.

Question 7

The perception of pain may be influenced by

A) context.
B) culture.
C) attention.
D) coping styles.
E) context, culture, attention, and coping styles.

Question 8

Beecher's (1959) study of wartime injuries investigated the effect of _______________ on pain.

A) placebos
B) fear
C) arousal
D) interpretation
E) isolation

Question 9

Listening to favourite music is an easy-to-use and effective means of managing pain.

Question 10

Pain management programs include interventions aimed at the distorted negative perceptions patients hold about their pain.

Question 11

Self-report measures such as the McGill Pain Questionnaire typically measure

A) pain threshold.
B) the nature and intensity of pain.
C) pain tolerance.
D) pain and encouraged tolerance level.
E) personality and the experience of pain.

Question 12

Hypnosis is one of the oldest strategies for the management and treatment of acute and chronic pain.

Question 13

Acupuncture is effective in reducing the experience of pain.

Question 14

Athletes who continue to play, despite being injured, may be experiencing a short-term reduction of pain sensitivity due to

A) sympathetic arousal.
B) parasympathetic arousal.
C) effective training and coaching.
D) activities that focus their attention on the pain.
E) endogenous opioids.

Question 15

A-delta fibres are un-myelinated nerve fibres that transmit dull or aching pain.

Question 16

The McGill Pain Questionnaire assesses pain behaviours.

Question 17

Pain is significant because it

A) is directly related to the severity of physical symptoms.
B) has an important survival function.
C) causes physical symptoms critical for daily living.
D) is an important component of most medical school curricula.
E) allows clinicians to treat more important psychological issues.

Question 18

Beta-endorphins produce peptides that have widespread neuronal, endocrine, and central nervous system distributions.

Question 19

Pain behaviours

A) are observable, measurable behaviours that are manifestations of chronic pain.
B) have proven useful in identifying the dynamics of different pain syndromes.
C) are used in assessing the impact of pain on quality of life.
D) can be used to assess how pain has disrupted the life of particular patients or groups of patients.
E) All of these answers are correct.

Question 20

There is a strong positive correlation between perceived pain and severity of symptoms.

Question 21

The use of OxyContin for pain

A) has increased by two-thirds in Canada.
B) is very effective in eliminating side effects such as headaches associated with other drugs.
C) can lead to counterirritation.
D) has been discontinued in Canada because it is highly addictive.
E) is less effective when used in conjunction with caffeine.

Question 22

A migraine headache is an example of

A) acute pain.
B) chronic benign pain.
C) recurrent acute pain.
D) chronic progressive pain.
E) gradual chronic pain.

Question 23

Antidepressants combat pain by

A) reducing anxiety.
B) improving mood.
C) affecting the downward pathways from the brain that control pain.
D) reducing anxiety, improving mood, and affecting the downward pathways from the brain that control pain.
E) reducing anxiety and improving mood only.

Question 24

Chronic pain patients typically show elevated scores on the following three MMPI subscales:

A) hysteria, hypochondriasis, and depression.
B) hypochondriasis, hysteria, and mania.
C) negative affectivity, hypochondriasis, and anxiety.
D) hypochondriasis, anxiety, and depression.
E) chronic pain patients do not show elevated scores in any category of the MMPI.

Question 25

According to the gate control theory of pain, relaxation is a _________ factor that _________ the pain gate.

A) cognitive; opens
B) emotional; closes
C) physical; closes
D) physical; opens
E) emotional; opens

Question 26

Chronic low back pain and myofascial pain syndrome are examples of

A) acute pain.
B) chronic benign pain.
C) recurrent acute pain.
D) chronic progressive pain.
E) chronic terminal pain.

Question 27

In comparison with acute pain patients, chronic pain patients

A) share a similar psychological profile.
B) experience higher levels of pain.
C) are more responsive to pain management techniques.
D) suffer from a syndrome involving physiological, psychological, social and behavioural components.
E) experience greater satisfaction of their provider.

Question 28

Chronic pain

A) decreases with the passage of time.
B) begins with an acute pain episode.
C) readily responds to treatment.
D) unlike acute pain, has no subcategories.
E) is rare in people under 65.

Question 29

Pharmacological control of pain

A) is dangerous in that it usually leads to addiction to prescription drugs.
B) is of no concern to researchers and practitioners.
C) has a low probability of leading to addiction to prescription drugs.
D) is the treatment of last resort.
E) can contribute to psychological disorders in some patients.

Question 30

The sensory aspect of pain seems to be determined primarily by

A) A-delta fibres.
B) C-fibres.
C) the limbic system.
D) the cerebral cortex.
E) the adrenal medulla.

Question 31

The transition from acute to chronic pain is

A) always determined by the pain intensity.
B) unrelated to functional disability.
C) likely facilitated by a complex interplay of predisposing and contextual factors.
D) more common in women than in men.
E) inevitable.

Question 32

Compensation for pain resulting from an injury may _______________ the perceived severity of the pain.

A) increase
B) decrease
C) pacify
D) mask
E) exacerbate

Question 33

Pain control means

A) that the patient no longer feels anything in the area that once hurt.
B) that the patient is no longer concerned about the pain.
C) that the patient feels pain but is no longer concerned about it.
D) that the patient is still hurting but now able to stand it.
E) All of these answers are correct.

Question 34

Endogenous opioids appear to play a role in the

A) inhibition of pain.
B) stress response.
C) functioning of the immune system.
D) beneficial effects of exercise on health.
E) inhibition of pain, stress response, the functioning of the immune system, the beneficial effects of exercise on health.

Question 35

The affective and motivational aspect of pain seems to be determined primarily by

A) A-delta fibres.
B) C-fibres.
C) endorphins.
D) the cerebral cortex.
E) psychosocial factors.

Question 36

Pain that persists longer than six months and increases in severity is considered to be

A) acute pain.
B) chronic benign pain.
C) recurrent acute pain.
D) chronic progressive pain.
E) psychosomatic pain.

Question 37

Immersive virtual reality

A) creates a virtual limb to occupy the phenomenal space where the phantom limb is perceived to be.
B) uses virtual reality surgery to train potential surgeons in severing the amputee's nerve that was previously connected to the missing limb.
C) is accomplished by transposing amputees' intact limbs with mirrors.
D) is a meditation technique.
E) can be successful in just one visit.

Question 38

Chronic pain patients who are married often

A) experience good marital and sexual functioning.
B) do not communicate well with their spouse.
C) restrict their social contact to members of their immediate family.
D) take smaller amounts of pain killers than patients who are not married.
E) cope with pain more productively than patients who are not married.

Question 39

Compared to persons without acute pain, chronic pain patients

A) have a larger impact on families and society.
B) report more restrictions in their day to day activities.
C) experience less success with the pain control techniques commonly used to treat acute pain.
D) are more likely to view their lives as stressful.
E) All of these answers are correct.

Question 40

Acute pain

A) is not associated with anxiety and depression.
B) may precede the development of a chronic pain syndrome.
C) seldom responds to the administration of painkillers or other medication.
D) increases with the passage of time.
E) is more serious than chronic pain.

Question 41

Differentiate between acute and chronic pain.

Question 42

In general, distraction is most effective in reducing

A) acute pain.
B) chronic pain.
C) both acute and chronic pain.
D) intermittent pain.
E) gradual critical pain.

Question 43

Pain management programs incorporate

A) individualized treatment.
B) an interdisciplinary team of practitioners.
C) an evaluation of the patient's physical, emotional, and mental functioning.
D) making available to patients all that is known about pain control.
E) All of these are incorporated in pain management programs.

Question 44

The use of surgical techniques to control pain

A) involves the use of spinal blocks that block the upward transmission of impulses in the spinal column.
B) is becoming increasingly common as a treatment of last resort.
C) may result in only temporary improvement and have no lasting negative side effects.
D) may damage the nervous system and actually exacerbate chronic pain.
E) work if the individual has not already adapted to the pain.

Question 45

The incidence of relapse following initial successful treatment of persistent pain appears to range from about _______________ to _______________.

A) 10 percent; 90 percent
B) 30 percent; 60 percent
C) 50 percent; 75 percent
D) 60 percent; 90 percent
E) 10 percent; 20 percent

Question 46

Listening to music to reduce pain

A) is associated with higher quality of life scores among chronic pain sufferers.
B) has not been tested in hospital settings.
C) has no effect on pain tolerance.
D) is a form of audio-analgesia.
E) is a form of audio-analgesia and is associated with higher quality of life scores among chronic pain sufferers.

Question 47

Acupuncture may

A) function as a sensory method of controlling pain.
B) be effective because patients believe it will work.
C) trigger the release of endorphins.
D) be placebo-like in nature.
E) function as a sensory method of controlling pain, be effective because patients believe it will work, trigger the release of endorphins and be placebo like in nature.

Question 48

Hypnosis relies on

A) physiological relaxation.
B) distraction.
C) reinterpretation of sensations.
D) physiological relaxation, distraction, and reinterpretation of sensations.
E) physiological relaxation and distraction only, the senses do not play a role in hypnosis.

Question 49

Relaxation training strategies are

A) effective ways of coping with stress
B) generally less effective in reducing chronic pain than are meditation techniques.
C) effective in alleviating chronic but not acute pain.
D) most effective if combined with pharmaceutical interventions.
E) difficult for people to adhere to due to the level of education needed.

Question 50

Describe the gate control theory of pain. Outline the factors that open or close the pain gate.

Question 51

Aggressive imagery

A) may improve coping with the uncomfortable effects of a treatment or illness.
B) enhances perceptions of control over the pain.
C) can serve as a distraction to pain.
D) is more effective than some pharmacologic interventions.
E) All of these answers are correct.

Question 52

Counterirritation involves

A) influencing the central control mechanism.
B) inhibiting pain in one part of the body by stimulating another area.
C) creating lesions in pain fibres and receptors.
D) influencing the transmission of pain impulses from the peripheral receptors.
E) All of these answers are correct.

Question 53

Relapse following initial successful treatment of pain is directly related to

A) lack of social support.
B) coping styles.
C) non-adherence to treatment regimen.
D) personality traits.
E) gender.

Question 54

Cognitive-behavioural pain interventions

A) encourage patients to entrust the management of their pain to the treatment team.
B) attempt to modify maladaptive cognitions but not overt and covert behaviours.
C) encourage clients to attribute their success to the treatment intervention.
D) help patients reconceptualize the problem from overwhelming to manageable.
E) are less effective than meditation for controlling pain.

Question 55

Of the cognitive-behavioural treatment strategies for pain management, those designed to target _______________ may be especially helpful.

A) depression
B) hostility
C) hypochondriasis
D) self-efficacy
E) negative affect

Question 56

Explain why pain is important.

Question 57

Explain how social and psychological variables influence the perception of pain.

Question 58

Biofeedback training

A) shows a great deal of evidence that it is effective in reducing pain.
B) is not effective for reducing the frequency of migraine headache attacks.
C) is probably is no more effective for controlling pain than are relaxation techniques.
D) has not been used to treat chronic conditions.
E) requires a strong personal will and is not for everyone.

Question 59

One of the oldest methods of pain control is

A) biofeedback.
B) relaxation training.
C) hypnosis.
D) self-efficacy training.
E) meditation.

Question 60

Controlled breathing is a component of

A) hypnosis.
B) relaxation training.
C) distraction.
D) acupuncture.
E) All of these answers are correct.

Question 61

How effective are biofeedback, acupuncture, and hypnosis in pain management? Do they work better with some types of pain? Are they superior to simple distraction and relaxation?

Question 62

Pain control by use of physical or chemical techniques has long been used by health care providers. For which type of pain are they most useful and why?

Question 63

Describe the design and implementation of pain management programs.