Question 1

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

Accepted Answer

A)  Both have decreased levels of endorphins. 
B)  Chronic pain has a predominance of C-neuron stimulation. 
C)  Acute pain is most commonly associated with irritation of peripheral nerves. 
D)  Acute pain is diffuse and hard to localize. 
A)  Both have decreased levels of endorphins. 
B)  Chronic pain has a predominance of C-neuron stimulation. 
C)  Acute pain is most commonly associated with irritation of peripheral nerves. 
D)  Acute pain is diffuse and hard to localize. B

Question 2

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

A)  Use of more than one drug to treat the pain 
B)  Multiple times when prescriptions are lost with requests to refill 
C)  Preferences for treatments that include alternative medicines 
D)  Presence of a family member who has abused drugs 
A)  Use of more than one drug to treat the pain 
B)  Multiple times when prescriptions are lost with requests to refill 
C)  Preferences for treatments that include alternative medicines 
D)  Presence of a family member who has abused drugs B

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

A)  Sensory aspects of pain 
B)  Discriminative aspects of pain 
C)  Motivational aspects of pain 
D)  Cognitive aspects of pain 
A)  Sensory aspects of pain 
B)  Discriminative aspects of pain 
C)  Motivational aspects of pain 
D)  Cognitive aspects of pain C

Question 4

The Pain Management Contract is appropriate for:

Accepted Answer

A)  Patients with cancer who are taking morphine 
B)  Patients with chronic pain who will require long-term use of opiates 
C)  Patients who have a complex drug regimen 
D)  Patients who see multiple providers for pain control 
A)  Patients with cancer who are taking morphine 
B)  Patients with chronic pain who will require long-term use of opiates 
C)  Patients who have a complex drug regimen 
D)  Patients who see multiple providers for pain control

Question 5

Narcotics are exogenous opiates. They act by:

Accepted Answer

A)  Inhibiting pain transmission in the spinal cord 
B)  Attaching to receptors in the afferent neuron to inhibit the release of substance P 
C)  Blocking neurotransmitters in the midbrain 
D)  Increasing beta-lipoprotein excretion from the pituitary gland 
A)  Inhibiting pain transmission in the spinal cord 
B)  Attaching to receptors in the afferent neuron to inhibit the release of substance P 
C)  Blocking neurotransmitters in the midbrain 
D)  Increasing beta-lipoprotein excretion from the pituitary gland

Question 6

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

Accepted Answer

A)  Telling the patient to "let pain be your guide" to using treatment therapies 
B)  Prescribing pain medication on a "PRN" basis to keep down the amount used 
C)  Scheduling return visits on a regular basis rather than waiting for poor pain control to drive the need for an appointment 
D)  All of the above 
A)  Telling the patient to "let pain be your guide" to using treatment therapies 
B)  Prescribing pain medication on a "PRN" basis to keep down the amount used 
C)  Scheduling return visits on a regular basis rather than waiting for poor pain control to drive the need for an appointment 
D)  All of the above

Question 7

A treatment plan for management of chronic pain should include:

Accepted Answer

A)  Negotiation with the patient to set personal goals for pain management 
B)  Discussion of ways to improve sleep and stress 
C)  An exercise program to improve function and fitness 
D)  All of the above 
A)  Negotiation with the patient to set personal goals for pain management 
B)  Discussion of ways to improve sleep and stress 
C)  An exercise program to improve function and fitness 
D)  All of the above

Question 8

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

Accepted Answer

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

Question 9

The goal of treatment of acute pain is:

Accepted Answer

A)  Pain at a tolerable level where the patient may return to activities of daily living 
B)  Reduction of pain with a minimum of drug adverse effects 
C)  Reduction or elimination of pain with minimum adverse reactions 
D)  Adequate pain relief without constipation or nausea from the drugs 
A)  Pain at a tolerable level where the patient may return to activities of daily living 
B)  Reduction of pain with a minimum of drug adverse effects 
C)  Reduction or elimination of pain with minimum adverse reactions 
D)  Adequate pain relief without constipation or nausea from the drugs

Question 10

Which of the following statements is true about acute pain?

Accepted Answer

A)  Somatic pain comes from body surfaces and is only sharp and well-localized. 
B)  Visceral pain comes from the internal organs and is most responsive to acetaminophen and opiates. 
C)  Referred pain is present in a distant site for the pain source and is based on activation of the same spinal segment as the actual pain site. 
D)  Acute neuropathic pain is caused by lack of blood supply to the nerves in a given area. 
A)  Somatic pain comes from body surfaces and is only sharp and well-localized. 
B)  Visceral pain comes from the internal organs and is most responsive to acetaminophen and opiates. 
C)  Referred pain is present in a distant site for the pain source and is based on activation of the same spinal segment as the actual pain site. 
D)  Acute neuropathic pain is caused by lack of blood supply to the nerves in a given area.

Question 11

Patients need to be questioned about all pain sites because:

Accepted Answer

A)  Patients tend to report the most severe or important in their perception. 
B)  Pain tolerance generally decreases with repeated exposure. 
C)  The reported pain site is usually the most important to treat. 
D)  Pain may be referred from a different site to the one reported. 
A)  Patients tend to report the most severe or important in their perception. 
B)  Pain tolerance generally decreases with repeated exposure. 
C)  The reported pain site is usually the most important to treat. 
D)  Pain may be referred from a different site to the one reported.

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

A)  NSAIDs, opiates, corticosteroids 
B)  Low-dose opiates, salicylates, increased dose of opiates 
C)  Opiates, non-opiates, increased dose of non-opiate 
D)  Non-opiate, increased dose of non-opiate, opiate 
A)  NSAIDs, opiates, corticosteroids 
B)  Low-dose opiates, salicylates, increased dose of opiates 
C)  Opiates, non-opiates, increased dose of non-opiate 
D)  Non-opiate, increased dose of non-opiate, opiate

Question 13

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

Accepted Answer

A)  Preterm and newborn infants do not yet have functional pain pathways. 
B)  Painful experiences and prolonged exposure to analgesic drugs during pregnancy may permanently alter neuronal organization in the child. 
C)  Increases in the pain threshold in older adults may be related to peripheral neuropathies and changes in skin thickness. 
D)  Decreases in pain tolerance are evident in older adults. 
A)  Preterm and newborn infants do not yet have functional pain pathways. 
B)  Painful experiences and prolonged exposure to analgesic drugs during pregnancy may permanently alter neuronal organization in the child. 
C)  Increases in the pain threshold in older adults may be related to peripheral neuropathies and changes in skin thickness. 
D)  Decreases in pain tolerance are evident in older adults.

Question 14

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

Accepted Answer

A)  Determine if the diagnosis of source of pain is correct 
B)  Determine if the current regimen is adequate or different combinations of drugs and non-drug therapy are required 
C)  Determine if the patient is willing and able to be an active participant in his or her pain management 
D)  All of the above 
A)  Determine if the diagnosis of source of pain is correct 
B)  Determine if the current regimen is adequate or different combinations of drugs and non-drug therapy are required 
C)  Determine if the patient is willing and able to be an active participant in his or her pain management 
D)  All of the above

Question 15

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

Accepted Answer

A)  They have less risk for liver damage than acetaminophen. 
B)  Inflammation is a common cause of acute pain. 
C)  They have minimal GI irritation. 
D)  Regulation of blood flow to the kidney is not affected by these drugs. 
A)  They have less risk for liver damage than acetaminophen. 
B)  Inflammation is a common cause of acute pain. 
C)  They have minimal GI irritation. 
D)  Regulation of blood flow to the kidney is not affected by these drugs.

Question 16

The chemicals that promote the spread of pain locally include:

Accepted Answer

A)  Serotonin 
B)  Norepinephrine 
C)  Enkephalin 
D)  Neurokinin A 
A)  Serotonin 
B)  Norepinephrine 
C)  Enkephalin 
D)  Neurokinin A

Question 17

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

Accepted Answer

A)  All opiates are scheduled drugs which require a DEA license to prescribe. 
B)  Opiates stimulate only mu receptors for the control of pain. 
C)  Most of the adverse effects of opiates are related to mu receptor stimulation. 
D)  Naloxone is an antagonist to opiates. 
A)  All opiates are scheduled drugs which require a DEA license to prescribe. 
B)  Opiates stimulate only mu receptors for the control of pain. 
C)  Most of the adverse effects of opiates are related to mu receptor stimulation. 
D)  Naloxone is an antagonist to opiates.

Exam 52: Pain Management: Acute and Chronic Pain

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

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

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

The Pain Management Contract is appropriate for:

Narcotics are exogenous opiates. They act by:

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

A treatment plan for management of chronic pain should include:

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

The goal of treatment of acute pain is:

Which of the following statements is true about acute pain?

Patients need to be questioned about all pain sites because:

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?

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

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

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

The chemicals that promote the spread of pain locally include:

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

The Role of the Nurse Practitioner

Review of Basic Principles of Pharmacology

Rational Drug Selection

Legal and Professional Issues in Prescribing

Adverse Drug Reactions

Factors That Foster Positive Outcomes

Cultural and Ethnic Influences in Pharmacotherapeutics

An Introduction to Pharmacogenomics

Nutrition and Nutraceuticals

Herbal Therapy and Nutritional Supplements

Information Technology and Pharmacotherapeutics

Pharmacoeconomics

Over-The-Counter Medications

Drugs Affecting the Autonomic Nervous System

Drugs Affecting the Central Nervous System

Drugs Affecting the Cardiovascular and Renal Systems

Drugs Affecting the Respiratory System

Drugs Affecting the Hematopoietic System

Drugs Affecting the Immune System

Drugs Affecting the Gastrointestinal System

Drugs Affecting the Endocrine System

Drugs Affecting the Reproductive System

Drugs Affecting the Integumentary System

Drugs Used in Treating Infectious Diseases

Drugs Used in Treating Inflammatory Processes

Drugs Used in Treating Eye and Ear Disorders

Anemia

Chronic Stable Angina and Low-Risk Unstable Angina

Anxiety and Depression

Asthma and Chronic Obstructive Pulmonary Disease

Contraception

Dermatologic Conditions

Diabetes Mellitus

Gastroesophageal Reflux and Peptic Ulcer Disease

Headaches

Heart Failure

Human Immunodeficiency Virus Disease and Acquired Immunodeficiency Syndrome

Hormone Replacement Therapy and Osteoporosis

Hyperlipidemia

Hypertension

Hyperthyroidism and Hypothyroidism

Pneumonia

Smoking Cessation

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Upper Respiratory Infections, Otitis Media, and Otitis Externa

Urinary Tract Infections

Women As Patients

Men As Patients

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