Question 1

Which of the following statements is true about acute pain?&#10;A)Somatic pain comes from body surfaces and is sharp and well-localized.&#10;B)Visceral pain comes from the internal organs and is most responsive to acetaminophen and opiates.&#10;C)Referred pain is present at a distant site from the pain source and is based on activation of the same spinal segment as the actual pain site.&#10;D)Acute neuropathic pain is caused by lack of blood supply to the nerves in a given area.&#10;

Accepted Answer

Referred pain is present at a distant site from the pain source and is based on activation of the same spinal segment as the actual pain site.

Question 2

Which of the following statements is true about age and pain?&#10;A)Use of drugs that depend heavily on the renal system for excretion may require dosage adjustments in very young children.&#10;B)Among the NSAIDs, indomethacin is the preferred drug because of a lower adverse effect profile than other NSAIDs.&#10;C)Older adults who have dementia probably do not experience much pain due to loss of pain receptors in the brain.&#10;D)Acetaminophen is especially useful in both children and adults because it has no effect on platelets and has fewer adverse effects than NSAIDs.&#10;

Accepted Answer

Acetaminophen is especially useful in both children and adults because it has no effect on platelets and has fewer adverse effects than NSAIDs.

Question 3

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?

A)NSAIDs, opiates, corticosteroids
B)Low-dose opiates, salicylates, increased dose of opiates
C)Opiates, nonopiates, increased dose of nonopiates
D)Nonopiates, increased dose of nonopiates, opiates

Accepted Answer

The correct order for administering pain medications based on the severity of pain typically starts with nonopiates (such as acetaminophen or NSAIDs), followed by an increased dose of nonopiates if necessary, and then progresses to opiates if the pain remains uncontrolled. This approach aims to manage pain effectively while minimizing the risk of side effects and dependence associated with stronger medications like opiates.

Question 4

A treatment plan for management of chronic pain should include:&#10;A)Negotiation with the patient to set personal goals for pain management&#10;B)Discussion of ways to improve sleep and stress levels&#10;C)An exercise program to improve function and fitness&#10;D)All of the above&#10;

Accepted Answer

All of the options listed are integral components of a comprehensive treatment plan for managing chronic pain. Negotiating personal goals with the patient ensures that the treatment plan is tailored to their specific needs and preferences. Discussing ways to improve sleep and stress levels addresses common factors that can exacerbate pain. An exercise program can help improve physical function and fitness, which can also contribute to pain reduction.

Question 5

Which statement is true regarding acute and chronic pain?&#10;A)Both have decreased levels of endorphins.&#10;B)Chronic pain has a predominance of C-neuron stimulation.&#10;C)Acute pain is most commonly associated with irritation of peripheral nerves.&#10;D)Acute pain is diffuse and hard to localize.&#10;

Accepted Answer

Chronic pain is often associated with a predominance of C-neuron stimulation, which contributes to its persistent and often diffuse nature. C-neurons are slow-conducting nerve fibers that carry chronic, dull, and aching pain signals, distinguishing chronic pain from the sharp, localized sensation typically associated with acute pain mediated by A-delta fibers.

Question 6

Different areas of the brain are involved in specific aspects of pain. The reticular and limbic systems in the brain influence the:&#10;A)Sensory aspects of pain&#10;B)Discriminative aspects of pain&#10;C)Motivational aspects of pain&#10;D)Cognitive aspects of pain&#10;

Accepted Answer

The reticular and limbic systems in the brain are primarily involved in the motivational and emotional aspects of pain, influencing how an individual emotionally responds to pain and how motivated they are to avoid or mitigate the pain.

Question 7

Age is a factor in different responses to pain. Which of the following age-related statements about pain is NOT true?&#10;A)Preterm and newborn infants do not yet have functional pain pathways.&#10;B)Painful experiences and prolonged exposure to analgesic drugs during pregnancy may permanently alter neuronal organization in the child.&#10;C)Increases in the pain threshold in older adults may be related to peripheral neuropathies and changes in skin thickness.&#10;D)Decreases in pain tolerance are evident in older adults.&#10;

Accepted Answer

Preterm and newborn infants do have functional pain pathways, and they are capable of experiencing pain. The statement that they do not is incorrect. Research has shown that even very young infants, including preterm infants, have the anatomical and functional capacity for pain perception.

Question 8

Opiates are used mainly to treat moderate to severe pain. Which of the following is NOT true about these drugs?&#10;A)All opiates are scheduled drugs, which require a Drug Enforcement Administration (DEA) license to prescribe.&#10;B)Opiates stimulate only $\mu$receptors for the control of pain.&#10;C)Most of the adverse effects of opiates are related to $\mu$ receptor stimulation.&#10;D)Naloxone is an antagonist to opiates.

Accepted Answer

Opiates do not stimulate only one specific type of receptor for pain control; they can act on multiple types of opioid receptors, not just the one mentioned.

Question 9

The chemicals that promote the spread of pain locally include:&#10;A)Serotonin&#10;B)Norepinephrine&#10;C)Enkephalin&#10;D)Neurokinin A&#10;

Accepted Answer

Neurokinin A is a neuropeptide that is involved in the transmission of pain signals. It is released from the terminals of primary afferent neurons and binds to receptors on the surface of second-order neurons in the spinal cord. This binding leads to the activation of these neurons and the transmission of pain signals to the brain.

Question 10

The goal of treatment of acute pain is:&#10;A)Pain at a tolerable level where the patient may return to activities of daily living&#10;B)Elimination of all pain&#10;C)Reduction of pain with minimum adverse reactions&#10;D)Adequate pain relief without constipation or nausea from the drugs&#10;

Accepted Answer

The answer of The goal of treatment of acute pain...

Question 11

Chronic pain is a complex problem. Some specific strategies to deal with it include:&#10;A)Telling the patient to &#34;let pain be your guide&#34; to using treatment therapies&#10;B)Prescribing pain medication on a &#34;pro re nata&#34; (PRN) basis to keep the amount used as low as possible&#10;C)Scheduling return visits on a regular basis rather than waiting for poor pain control to drive the need for an appointment&#10;D)All of the above&#10;

Accepted Answer

The answer of Chronic pain is a complex problem. Some...

Question 12

Pain assessment to determine adequacy of pain management is important for all patients. This assessment is done to:&#10;A)Determine if the diagnosis of the source of pain is correct&#10;B)Determine if the current regimen is adequate or if different combinations of drugs and nondrug therapy are required&#10;C)Determine if the patient is willing and able to be an active participant in his or her pain management&#10;D)All of the above&#10;

Accepted Answer

The answer of Pain assessment to determine adequacy of pain...

Question 13

Patients need to be questioned about all pain sites because:&#10;A)Patients tend to report the most severe or important in their perception.&#10;B)Pain tolerance generally decreases with repeated exposure.&#10;C)The reported pain site is usually the most important to treat.&#10;D)Pain may be referred from a different site to the one reported.&#10;

Accepted Answer

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

Question 14

Narcotics are exogenous opiates. They act by:&#10;A)Inhibiting pain transmission in the spinal cord&#10;B)Attaching to receptors in the afferent neuron to inhibit the release of substance P&#10;C)Blocking neurotransmitters in the midbrain&#10;D)Increasing beta-lipoprotein excretion from the pituitary gland&#10;

Accepted Answer

The answer of Narcotics are exogenous opiates. They act by:&#10;A)Inhibiting...

Question 15

Chemical dependency assessment is integral to the initial assessment of chronic pain. Which of the following raises a &#8220;red flag&#8221; about potential chemical dependency?&#10;A)&#9;Use of more than one drug to treat the pain&#10;B)&#9;Multiple times when prescriptions are lost with requests to refill&#10;C)&#9;Preferences for treatments that include alternative medicines&#10;D)&#9;Presence of a family member who has abused drugs&#10;

Accepted Answer

The answer of Chemical dependency assessment is integral to the...

Question 16

One of the main drug classes used to treat acute pain is nonsteroidal anti-inflammatory drug (NSAIDs). They are used because:&#10;A)They have less risk for liver damage than acetaminophen.&#10;B)Inflammation is a common cause of acute pain.&#10;C)They have minimal gastrointestinal (GI) irritation.&#10;D)Regulation of blood flow to the kidneys is not affected by these drugs.&#10;

Accepted Answer

The answer of One of the main drug classes used...

Deck 44: Pain Management: Acute and Chronic Pain