Deck 10: The Management of Pain and Discomfort

Question 1

Athletes who continue to play,despite being injured,experience a reduction in pain sensitivity because of increased

A)sympathetic arousal.
B)parasympathetic arousal.
C)psychological distress.
D)stimulation of nociceptors.

Answer 1

sympathetic arousal.

Question 2

_____ are unmyelinated nerve fibers,involved in polymodal pain,that transmit dull,aching pain.

A)C-fibers
B)A-delta fibers
C)B-fibers
D)A-gamma fibers

Answer 2

C-fibers

Question 3

_____ refers to pain that triggers chemical reactions from tissue damage.

A)Phantom limb sensation
B)Thermal damage
C)Mechanical nociception
D)Polymodal nociception

Answer 3

Polymodal nociception

Question 4

A-delta fibers

A)are small,myelinated fibers.
B)typically transmit dull,aching pain.
C)do not respond to mechanical pain.
D)transmit pain signals at a slower rate than C-fibers.

Question 5

Which of the following statements is true about chronic pain?

A)Behaviors that arise from chronic pain cannot be measured.
B)Patients with chronic pain disorders show significant loss of gray matter in certain regions of the brain.
C)Unlike acute pain,chronic pain usually decreases with treatment and the passage of time.
D)Most pain control techniques work well to control chronic pain but are less successful with acute pain.

Question 6

C-fibers

A)are small,myelinated fibers that transmit sharp pain.
B)strongly influence the affective and motivational elements of pain.
C)respond to mechanical or thermal pain,but not to polymodal pain.
D)typically transmit pain signals more rapidly than A-delta fibers.

Question 7

When acute anxiety reduces sensitivity to pain,it is known as

A)stress-induced analgesia.
B)stimulation-produced analgesia.
C)primary hyperalgesia.
D)opioid-induced hyperalgesia.

Question 8

Which of the following is a similarity between physical pain and social pain?

A)Psychological distress is a key component of both physical pain and social pain.
B)Both social and physical pain enhance the neurobiological effects of the brain.
C)Social pain relies on the same pain-related neurocircuitry as physical pain.
D)Physical pain and social pain are mutually exclusive.

Question 9

Why are minor pains critical for survival?

A)They form a substantial cultural component and influence our perceptions.
B)They are insistent and overwhelm other basic needs.
C)They provide low-level feedback about the functioning of our body systems.
D)They pass sensory information from the physical world to the brain.

Question 10

Which of the following is the most common reason for euthanasia?

A)anxiety in a hospital setting
B)substantial cost of treatment
C)inadequate relief from pain
D)prospect of surgery

Question 11

The periductal gray is a structure in the _____ that provides pain relief when stimulated.

A)cerebellum
B)occipital lobe
C)meninges
D)midbrain

Question 12

Neurons in the periductal gray connect to the reticular formation in the medulla which makes connections with the neurons in the _____ of the dorsal horn of the spinal cord.

A)subarachnoid space
B)substantia nigra
C)septomarginal fasciculus
D)substantia gelatinosa

Question 13

The scientific understanding of pain was originally developed by Melzack in the _____ theory of pain.

A)peripheral pattern
B)three dimensions
C)intensive
D)gate-control

Question 14

_____ is a functional pain disorder in which there is no clear tissue damage present.

A)Polymyositis
B)Fibromyalgia
C)Hematoma
D)Tumefaction

Question 15

For a medical provider,pain

A)and the severity of an underlying problem are closely related.
B)is a by-product of a disorder,and it complicates diagnosis.
C)mitigates illnesses and assists recovery from medical procedures.
D)has no psychological or medical significance.

Question 16

Which of the following statements is true of A-delta fibers?

A)Sensory aspects of pain are heavily determined by activity in the A-delta fibers.
B)A-delta fibers are unmyelinated nerve fibers that are involved in polymodal pain.
C)Dull,aching pain is typically transmitted to the cerebral cortex by A-delta fibers.
D)A-delta fibers typically conduct pain signals at a slower rate than C-fibers.

Question 17

_____,such as distortions in posture or gait,facial and audible expressions of distress,and avoidance of activities,arise from chronic pain.

A)Reasoned actions
B)Cognitive behaviors
C)Pain controls
D)Pain behaviors

Question 18

_____ is a pain perception that results from a physical damage to the tissues of the body.

A)Silent nociception
B)Polymodal nociception
C)Thermal damage
D)Mechanical nociception

Question 19

Identify a true statement about pain.

A)The degree to which pain is felt and how incapacitating it is largely depends on how it is interpreted.
B)Men typically show a greater sensitivity to pain compared to women.
C)Cultural differences have no influence over the interpretation of pain.
D)Unlike acute pain,chronic pain is usually short in duration and decreases with treatment and the passage of time.

Question 20

Which of the following is a barrier to the treatment of pain?

A)development of pain questionnaires to assess pain
B)identical psychological profiles for both acute and chronic pain
C)difficulty faced by patients in objectively describing pain
D)personality traits that predispose a person to experience nonexistent pain

Question 21

Why are endogenous opioid peptides important to our body?

A)They form the central network of pathways in the limbic structures.
B)They are the natural pain suppression system of the body.
C)They contribute to the strong emotions often experienced during pain.
D)They convey pain-related information to the dorsal horn.

Question 22

Cancer and rheumatoid arthritis are degenerative disorders that are typically associated with

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

Question 23

According to the Minnesota Multiphasic Personality Inventory,which of the following is commonly referred to as the neurotic triad?

A)social introversion,anxiety,and schizophrenia
B)depression,delusion,and paranoia
C)anxiety,stress,and hysteria
D)hypochondriasis,hysteria,and depression

Question 24

Which of the following is a reason for chronic pain to get exacerbated?

A)inappropriate prior treatments
B)increased sympathetic arousal
C)appropriate prescription of medications
D)decreased stimulation of nociceptors

Question 25

_____ pain varies in severity,persists for six months or longer,and is relatively unresponsive to treatment.

A)Acute
B)Chronic benign
C)Recurrent acute
D)Chronic progressive

Question 26

_____ pain is due to an unidentifiable physical cause.

A)Nociceptive
B)Phantom
C)Neurogenic
D)Psychogenic

Question 27

Typically,chronic progressive pain

A)involves intermittent episodes of pain that are acute in character but chronic inasmuch as the condition repeats for more than six months.
B)involves constant pain that varies in severity,persists for six months or longer,and is relatively unresponsive to treatment.
C)is associated with degenerative disorders,involves constant pain that increases in severity over time,and lasts longer than six months.
D)goes on for six months or less and disappears when the tissue damage is repaired.

Question 28

How does compensation provide an incentive for being in pain?

A)by increasing the ability of patients to continue with life activities uninterrupted
B)by increasing the perceived severity of pain
C)by reducing the amount of disability experienced
D)by reducing the amount of distress that is reported

Question 29

Which of the following statements is a characteristic of acute pain?

A)Unlike chronic pain,acute pain usually goes on for six months or more.
B)Acute pain is usually short in duration compared to chronic pain.
C)Acute pain usually presents psychological profiles that are identical to chronic pain.
D)Unlike chronic pain,acute pain is usually unresponsive to treatment.

Question 30

Which of the following is an important feature of chronic pain?

A)It typically disappears with the passage of time.
B)It typically begins with an acute pain episode.
C)It typically presents psychological profiles that are identical to acute pain.
D)It typically lasts for six months or less.

Question 31

Typically,acute pain

A)does not decrease with treatment and the passage of time.
B)persists for six months or longer and increases in severity over time.
C)results from a specific injury that produces tissue damage.
D)always requires individualized pain control techniques for its management.

Question 32

Which of the following statements best describes recurrent acute pain?

A)The pain is constant and varies in severity,typically persists for six months or longer,and is relatively unresponsive to treatment.
B)The pain typically goes on for six months or less and disappears when the tissue damage is repaired.
C)It involves constant pain that increases in severity over time,due to a malignant condition,and typically lasts longer than six months.
D)It involves intermittent episodes of pain that are acute in character but chronic inasmuch as the condition repeats for more than six months.

Question 33

Which of the following best describes a pain-prone personality?

A)societal factors that force an individual to experience pain more intensely
B)a constellation of personality traits that predispose a person to experience chronic pain
C)an individual's congenital traits that make him or her more vulnerable to pain
D)individuals with personality traits that predispose them to deliberate self-injury

Question 34

Temporomandibular disorder and trigeminal neuralgia are examples of _____ pain.

A)acute
B)recurrent acute
C)chronic benign
D)chronic progressive

Question 35

Which of the following is a difference between acute pain and chronic pain?

A)Unlike acute pain,chronic pain has no psychological significance.
B)Unlike acute pain,chronic pain does not require individualized techniques for its management.
C)Acute pain involves a more complex interaction of physiological,psychological,social,and behavioral components than chronic pain.
D)Most pain control techniques work well to control acute pain,but are less successful with chronic pain.

Question 36

_____ is a personality attribute that is associated with chronic pain.

A)Denial
B)Anger suppression
C)Hypovigilance
D)Introversion

Question 37

Unlike acute pain,chronic pain does not

A)decrease with treatment and the passage of time.
B)carry an overlay of psychological distress.
C)require individualized techniques for its management.
D)increase in severity over time.

Question 38

_____ means that a patient no longer feels anything in an area of the body that once hurt.

A)Pain threshold
B)Pain sensitivity
C)Pain behavior
D)Pain control

Question 39

Which of the following characteristics is most likely to be displayed by patients suffering from chronic pain?

A)increased communication with family members
B)preference for loud noises
C)reduced pain behavior
D)discomfort because of bright lights

Question 40

Migraine headache is an example of _____ pain.

A)acute
B)chronic benign
C)recurrent acute
D)chronic progressive

Question 41

Stress and psychological distress aggravate the experience of pain.

Question 42

Which of the following methods is one of the oldest known techniques of pain control?

A)counterirritation
B)cognitive restructuring
C)psychoeducation
D)biofeedback

Question 43

_____ is a psychological technique for the management of pain and can be thought of as an operant learning process.

A)Counterirritation
B)Distraction
C)Biofeedback
D)Spinal cord stimulation

Question 44

_____ involves a mindful distancing from the pain experience,where patients are trained to control their emotional responses to pain.

A)Acceptance and commitment therapy
B)Counterirritation technique
C)Relaxation technique
D)Biofeedback training

Question 45

_____ is defined as a disorder in which the small arteries in the extremities constrict,limiting blood flow and producing a cold,numb aching.

A)Alzheimer's disease
B)Raynaud's disease
C)Parkinson's disease
D)Hodgkin's disease

Question 46

Emotional factors have no effect on the experience of pain.

Question 47

In _____,an individual shifts his or her body into a state of low arousal by progressively loosening different parts of the body.

A)counterirritation
B)biofeedback
C)coping skills training
D)relaxation

Question 48

Surgical techniques to control pain involve

A)inhibiting pain in one part of the body by stimulating or mildly irritating another area.
B)using spinal blocking agents to decrease the transmission of pain impulses from the peripheral receptors to the spinal cord.
C)providing biophysiological feedback to a patient about some bodily process of which the patient is usually unaware.
D)creating lesions in pain fibers at various points in the body so that pain sensations can no longer be conducted.

Question 49

The brain controls the amount of pain an individual experiences by transmitting messages down the spinal cord to block the transmission of pain signals.

Question 50

Distraction is most effective in coping with

A)high-intensity pain.
B)low-level pain.
C)chronic progressive pain.
D)severe pain.

Question 51

_____ is a pain control technique that completely eliminates the feeling of pain.

A)Counterirritation
B)Spinal block
C)Distraction
D)Relaxation

Question 52

Nociceptors in the peripheral nerves first sense injury and,in response,release chemical messengers,which are conducted to the spinal cord.

Question 53

Which of the following is a goal of an individualized pain management program?

A)reducing physical activity
B)increasing reliance on medication
C)reducing perception of disability
D)increasing the use of health care services

Question 54

The childbirth experience and the perception of pain associated with it is uniform for all women across different cultures.

Question 55

Jay fractured his left leg while playing football and now suffers from chronic postsurgical pain.His doctor recommended a psychological technique for pain management.Now,whenever Jay experiences pain,he listens to his favorite music while trying out new recipes.This helps him deal more effectively with the pain and also helps in reducing the intensity of pain.Which of the following techniques is Jay using to control his pain?

A)counterirritation
B)biofeedback
C)hypnosis
D)distraction

Question 56

_____ is a sensory technique of inhibiting pain where a set of small electrodes is placed near the point at which the nerve fibers from the painful area enter the spinal cord.When the patient experiences pain,he or she activates a radio signal,which delivers a mild electrical stimulus to that area of the spine.

A)Spinal block
B)Spinal cord stimulation
C)Acupuncture
D)Biofeedback

Question 57

_____ is a psychological pain management technique in which a patient turns his or her attention away from pain by focusing attention on an irrelevant and attention-getting stimulus.

A)Distraction
B)Biofeedback
C)Acupuncture
D)Counterirritation

Question 58

Which of the following features is a component of pain management programs?

A)psychotropic medications
B)psychoanalytic approach
C)evidence-based practices
D)patient education

Question 59

Pain is easy to treat because patients are comfortable describing it objectively.

Question 60

Which of the following is a disadvantage of using morphine as a painkiller?

A)It can be addictive,and patients may build up a tolerance to it.
B)It is ineffective in relieving chronic progressive pain.
C)It is effective only when used in conjunction with other painkillers.
D)It projects onto specific receptor sites in the body and permanently damages them.

Question 61

Why is the distinction between acute and chronic pain important in clinical management?

Question 62

Processes in the thalamus are involved in cognitive judgments about pain,which contributes to the strong emotions often experienced during pain.

Question 63

In cognitive behavioral therapy,patients are taught how and when to employ overt and covert behaviors in order to make adaptive responses to a pain problem.

Question 64

What is pain control? Briefly explain the traditional methods of controlling pain.

Question 65

Explain biofeedback and relaxation techniques for pain management.

Question 66

Catastrophic thinking reduces the pain experience.

Question 67

Explain the importance of social and psychological components of pain.

Question 68

Describe the design and implementation of pain management programs.

Question 69

Relapse prevention techniques that help patients continue their pain management skills can maintain posttreatment pain reduction.