Deck 10: Pain and Its Management

Question 1

According to the gate control theory of pain, relaxation is a(n) _ ________ the pain gate.

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

Answer 1

emotional; closes

Question 2

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

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

Answer 2

the nature and intensity of pain.

Question 3

The McGill Pain Questionnaire assesses pain behaviours.

Answer 3

False

Question 4

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

Question 5

Pain behaviours

A) are observable, measurable behaviours that are manifestations of chronic pain.
B) cannot be used to assess how pain has disrupted the life of particular patients or groups of patients.
C) have no physiological components.
D) have not proven useful in identifying the dynamics of different pain syndromes.
E) are not reliable in assessing the impact of pain on quality of life.

Question 6

Which of these following behaviours is a manifestation of chronic pain?

A) Distortions in posture or gait
B) Hyperactivity
C) Incoherent speech
D) Positive effect
E) Bodily expressions of stress

Question 7

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) amount one seeks treatment for certain pain.
E) categorization of pain

Question 8

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

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

Question 9

The perception of pain may be influenced by

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

Question 10

Pain is significant because it

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

Question 11

Pain has important medical consequences because

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

Question 12

nociception is pain that triggers chemical reactions from tissue damage.

A) Polymodal
B) Intermodal
C) Chronic
D) Polymorphic
E) Acute

Question 13

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

Question 14

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

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

Question 15

Nociception is the of pain.

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

Question 16

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

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

Question 17

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

Question 18

The sensory aspect of pain seems to be determined primarily by

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

Question 19

The neuromatrix theory of pain suggests

A) pain is caused by chemical factors alone.
B) pain is caused by sensory factors alone.
C) pain is caused by cognitive and sensory factors.
D) pain is a multidimensional experience caused by multiple factors.
E) pain is caused by cognitive and chemical factors.

Question 20

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

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

Question 21

Pharmacological control of pain

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

Question 22

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

Question 23

Chronic pain patients who are married often

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

Question 24

The use of OxyContin for pain

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

Question 25

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

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

Question 26

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

Question 27

In comparison with acute pain patients, chronic pain patients

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

Question 28

Compared to persons with chronic pain, acute pain patients

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

Question 29

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

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

Question 30

Pain control means

A) that the patient is concerned about the pain.
B) that the patient feels pain and is constantly concerned about it.
C) that the patient is still hurting but now able to stand it.
D) that the pain comes and goes.
E) that the patient has a tingling sensation in the area that once hurt.

Question 31

Immersive virtual reality

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

Question 32

Chronic low back pain and myofascial pain syndrome are examples of

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

Question 33

A migraine headache is an example of

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

Question 34

Acute pain

A) is long term and persists for more than six months.
B) responds to the administration of painkillers or other medication.
C) increases with the passage of time.
D) is not associated with anxiety and depression.
E) is more serious than chronic pain.

Question 35

Nina has chronic pain, and her physician is certain that it is associated with another condition she has, that of _.

A) influenza
B) an upset stomach
C) depression
D) eczema
E) persistent coughing

Question 36

Endogenous opioids appear to play a role in the

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

Question 37

Antidepressants combat pain by

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

Question 38

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

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

Question 39

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) inevitable.
E) more common in women than in men.

Question 40

Chronic pain

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

Question 41

Counterirritation involves

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

Question 42

In general, distraction is most effective in reducing pain when distraction techniques are used

A) intermittently.
B) only to treat acute pain.
C) only to treat chronic pain.
D) regularly.
E) in conjunction with other pain control strategies.

Question 43

Relaxation training strategies are

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

Question 44

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

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

Question 45

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

Question 46

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

Question 47

Anna received acupuncture as an analgesic before her surgery. During her surgery, she

A) is conscious but unable to talk with the surgeons.
B) has phases of being alert, and then sleeps a bit.
C) is partly alert.
D) is unconscious.
E) is conscious.

Question 48

Aggressive imagery

A) is not effective as it excites the body which increases pain.
B) may improve coping with the uncomfortable effects of a treatment or illness.
C) is still in its early experimental stages.
D) is another term for guided imagery.
E) has no effect on perceptions of control over the pain.

Question 49

Biofeedback training

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

Question 50

One of the oldest methods of pain control is

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

Question 51

The use of surgical techniques to control pain

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

Question 52

Hypnosis relies on

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

Question 53

Listening to music to reduce pain

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

Question 54

Pain management programs

A) provide patients with pain killers such as morphine.
B) are privately funded.
C) have less wait times than other programs.
D) involve an evaluation of the patient's physical, emotional, and mental functioning.
E) encourage patients to rest so pain is not aggravated.

Question 55

Cognitive-behavioural pain interventions

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

Question 56

Acupuncture

A) may trigger the release of endorphins.
B) may 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.
C) may function as a sensory method of controlling pain.
D) may be effective because patients believe it will work.
E) may increase endogenous opioids bringing about relevant physiological changes with its use.

Question 57

Exercise releases endogenous opioids, which are

A) enzymes that help clotting of blood.
B) pain killers.
C) pain enhancers.
D) mood enhancers.
E) responsible for making the body tired.

Question 58

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

Question 59

Controlled breathing is a component of

A) acupuncture.
B) relaxation.
C) hypnosis.
D) distraction.
E) aerobics.

Question 60

Acupuncture is effective in reducing the experience of pain.

Question 61

Explain why pain is important.

Question 62

Relapse following initial successful treatment of pain is directly related to

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

Question 63

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 64

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

Question 65

Differentiate between acute and chronic pain.

Question 66

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

Question 67

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

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

Question 68

Describe the design and implementation of pain management programs.

Question 69

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?