Deck 12: Managing and Controlling Clinical Pain

Question 1

Match the following pain control techniques with the statements in
May help an individual understand the role of reacting to others as affecting his or her pain.

A)operant approach
B)acupuncture
C)distraction
D)redefinition
E)interpersonal therapy

Answer 1

interpersonal therapy

Question 2

Match the following pain control techniques with the statements in
Changes the consequences of the pain behaviour.

A)operant approach
B)acupuncture
C)distraction
D)redefinition
E)interpersonal therapy

Answer 2

operant approach

Question 3

Match the following pain control techniques with the statements in
Whenever she goes to the dentist, Clare counts the ceiling tiles while the dentist works.

A)operant approach
B)acupuncture
C)distraction
D)redefinition
E)interpersonal therapy

Answer 3

distraction

Question 4

Aspirin and acetaminophen are examples of centrally-acting analgesics.

Question 5

Distraction and guided imagery work best with mild to moderate pain.

Question 6

Interpersonal therapy is designed to help people deal with chronic pain by changing the way they interact with and perceive their social environments.

Question 7

Match the following with the descriptions in
Examples include aspirin and acetaminophen.

A)peripherally active analgesics
B)centrally acting analgesics
C)epidural block
D)biofeedback
E)transcutaneous electrical nerve stimulation (TENS)

Question 8

In a synovectomy, the surgeon disconnects portions of the peripheral nervous system to prevent pain signals from reaching the brain.

Question 9

With chronic pain, one's personality may become dominated by the neurotic triad of hypochondriasis, depression and hysteria.

Question 10

Match the following pain control techniques with the statements in
Based on the counter‑irritation principle.

A)operant approach
B)acupuncture
C)distraction
D)redefinition
E)interpersonal therapy

Question 11

Many patients experience greater‐than‐necessary pain following surgery.

Question 12

Match the following with the descriptions in
May involve recording of EMG.

A)peripherally active analgesics
B)centrally acting analgesics
C)epidural block
D)biofeedback
E)transcutaneous electrical nerve stimulation (TENS)

Question 13

The mechanisms that explain how hypnosis works in the reduction of pain are now clearly understood.

Question 14

Match the following pain control techniques with the statements in
Appears to be most effective with strong pain.

A)operant approach
B)acupuncture
C)distraction
D)redefinition
E)interpersonal therapy

Question 15

Match the following with the descriptions in
Examples include codeine, morphine and demerol.

A)peripherally active analgesics
B)centrally acting analgesics
C)epidural block
D)biofeedback
E)transcutaneous electrical nerve stimulation (TENS)

Question 16

Match the following with the descriptions in
Involves electrical stimulation.

A)peripherally active analgesics
B)centrally acting analgesics
C)epidural block
D)biofeedback
E)transcutaneous electrical nerve stimulation (TENS)

Question 17

A physical therapist is most likely to apply exercise, massage, traction, heat and cold as treatments for pain.

Question 18

Acupuncture effectiveness has been shown to be totally due to psychological factors.

Question 19

Match the following with the descriptions in
Injection of local anesthetic to area surrounding spinal cord.

A)peripherally active analgesics
B)centrally acting analgesics
C)epidural block
D)biofeedback
E)transcutaneous electrical nerve stimulation (TENS)

Question 20

According to operant approaches, placing medications on a fixed administration schedule should reduce requests for medications.

Question 21

Which of the following characteristics are likely to influence physicians' decisions regarding which drug and dosage to administer to a patient for pain relief?

A)Intensity, location, and cause of the pain
B)Characteristics of the patient
C)Sociocultural factors
D)all of the above

Question 22

Which of the following is not associated of chronic pain syndrome?

A)Excessive drug use to relieve pain.
B)Enhanced marital satisfaction since families are drawn together more closely during this time.
C)Disturbed sleep patterns.
D)Increased depression.

Question 23

The procedure known as synovectomy is most often used in the treatment of

A)low back pain.
B)acute pain.
C)phantom limb pain.
D)arthritis.

Question 24

The abbreviation "PRN" refers to

A)taking the drug on a fixed schedule.
B)a computerized pump that delivers a dose of drug into a vein.
C)the practitioner recommending no medication.
D)giving the drug as needed to control symptoms.

Question 25

Research regarding the administration of pain‑killers to children shows that

A)drugs are given to them less frequently.
B)they are given doses below recommended levels.
C)their dosages are discontinued earlier than adults.
D)all of the above

Question 26

Which of the following statements best describes the relationship between psychosocial problems and pain?

A)Psychosocial problems are experienced most frequently by acute pain sufferers.
B)Psychosocial problems tend to precede rather than follow pain experiences.
C)Psychosocial problems are more characteristic of chronic pain than acute pain sufferers.
D)Psychosocial problems are not related to pain.

Question 27

Which of the following is true regarding acute pain?

A)It often has no survival value.
B)It responds poorly to treatment.
C)It rarely is influenced by psychosocial factors.
D)It does not hurt as much as chronic pain.

Question 28

Which group is more likely to self-administer more pain-killers than needed?

A)Patients who are relatively young.
B)Patients with high levels of anxiety.
C)Patients who have low levels of social support.
D)all of the above

Question 29

The class of pain reliever most likely to produce increased tolerance and addiction is

A)peripherally active analgesics.
B)centrally acting analgesics.
C)local anesthetics.
D)indirectly acting drugs.

Question 30

Under what conditions are surgical pain relief methods likely to be used?

A)If the patient lives in North America.
B)If the patient is severely disabled.
C)When nonsurgical pain treatments have failed.
D)all of the above

Question 31

To relieve her pain, Wren's physician has disconnected portions of her spinal cord.Wren is likely to experience

A)long lasting, permanent pain relief.
B)paralysis but no immediate pain relief.
C)an eventual return of her pain.
D)none of these

Question 32

According to the book, which of the following is a reason to treat clinical pain?

A)It may be a sign of progressive disease.
B)It increases contact with medical professionals.
C)It provides social contacts.
D)It changes important health beliefs.

Question 33

Chronic and acute pain

A)require different pain relief techniques.
B)do not respond well to drugs.
C)are treated with the same techniques.
D)do not present unique problems for treatment programs.

Question 34

Studies with patient‑controlled analgesia have shown

A)high probabilities of abuse.
B)low abuse risk.
C)they are not effective with cancer patients.
D)patients administer the medication as directed.

Question 35

Which of the following is a reason that children are undermedicated?

A)The belief that children can't develop addiction.
B)Fewer requests for medication from children.
C)Concerns that children experience more pain and thus require more medication than is safe.
D)Concerns that they are simply seeking attention when they ask for medication.

Question 36

The term clinical pain refers to

A)acute pain only.
B)pain experienced only in clinical settings.
C)pain that requires or receives professional treatment.
D)chronic pain only.

Question 37

Common pain relievers in the 19th century included

A)alcohol and medicinal elixirs laced with opiates.
B)antidepressants and Valium.
C)Tylenol and ibuprofen.
D)twigs and massage.

Question 38

Aspirin is to _____ as morphine is to _____.

A)peripheral; central
B)central; periperal
C)indirect; local
D)local; indirect

Question 39

Nadine is dying from cancer.Her physician likely to prescribe what medication for her?

A)Acetaminophen.
B)Novocaine.
C)Sedatives.
D)Narcotics.

Question 40

Which of the following patients is most likely to be undermedicated?

A)8 year-old Jamie
B)20 year-old Genevieve
C)20 year-old Kevin
D)60 year-old Miyu

Question 41

Some research regarding the use of narcotic pain‑killers with phantom limb pain indicates that

A)addiction usually results.
B)increased tolerance usually results.
C)pain was reduced without increased tolerance.
D)none of the above.

Question 42

For which type of chronic pain is the operant approach least likely to be successful?

A)recurrent
B)intractable
C)progressive
D)it is not successful with any type of chronic pain

Question 43

When getting an injection at the dentist's office, most children think of

A)school.
B)pleasant thoughts.
C)negative emotions and pain.
D)escaping the situation.

Question 44

Which of these is a major goal in the operant approach to treating chronic pain patients?

A)Keeping pain behaviours from becoming chronic.
B)Reducing reliance on medication.
C)Reducing accompanying disability.
D)all of the above

Question 45

One of the problems with Blanchard's longitudinal research on headache is

A)the lack of a control group.
B)the high rate of participant drop‑out.
C)the use of ineffective pain reduction techniques.
D)the inappropriate use of headache diaries.

Question 46

Which is an example of passive coping with chronic pain?

A)Canceling a date and going to bed.
B)Calling a friend and chatting.
C)Working on a crossword puzzle.
D)Building a birdhouse.

Question 47

Research using placebos with headache patients reveals that

A)placebos do not affect headache patients.
B)important psychological processes influence pain control.
C)the placebo effect does not occur in instances of chronic pain.
D)the placebo effect is only seen in instances of chronic pain.

Question 48

The age group that seems most likely to benefit from biofeedback and relaxation‑based pain control is

A)children and those who show certain physiological patterns
B)young adults.
C)middle‑aged.
D)elderly.

Question 49

Most studies on the effectiveness of relaxation and biofeedback have been conducted on

A)phantom limb pain.
B)headaches.
C)arthritis.
D)pain associated with cancer.

Question 50

One conclusion regarding patients' beliefs about pain is that

A)they have little influence on the pain experience.
B)they have little to no relationship to coping with pain.
C)physicians need to take these beliefs into consideration when treating pain.
D)most thoughts about how to deal with pain are positive.

Question 51

Dina suffers from phantom limb pain, ever since her leg was amputated following a car accident.She deals with the constant pain by focusing on her personal exercise and rehabilitation program, lifting weights and swimming several times a day.This is an example of

A)passive coping.
B)active coping.
C)progressive muscle relaxation.
D)EMG biofeedback.

Question 52

Focusing thoughts on the unpleasant aspects of a painful experience tends to

A)make the pain worse.
B)lessen the pain.
C)lead to hypnotic states.
D)have no effect on experienced pain.

Question 53

When referring psychological consultations for chronic pain patients, physicians should

A)explain the rationale for the referral to the patient.
B)turn the treatment completely over to the psychologist to reduce confusion.
C)pay as little attention to the patient's discomfort as possible so as not to reinforce it.
D)all of the above.

Question 54

Tension headaches can be treated with which type of biofeedback?

A)EMG.
B)Temperature.
C)EKG.
D)EEG.

Question 55

A 4‑year‑old burn patient is recovering more slowly than expected.A psychologist observes that medical staff is reinforcing some of the child's behaviours and allowing her to avoid uncomfortable activities.She suggests that medical staff ignore the pain behaviours and reinforce the coping behaviours. The psychologist is advocating principles of

A)classical conditioning.
B)specificity theory.
C)operant conditioning.
D)gate‑control theory.

Question 56

Who is most likely to use an active coping strategy in dealing with chronic pain?

A)Sarah, who believes her doctor doesn't know the source of her pain.
B)Jackson, who believes his pain will continue indefinitely.
C)Leyla, who believes she understands the nature of her condition.
D)Scott, who doesn't know what causes his pain.

Question 57

Which of the following is not a frequently cited reason for physicians' preference not to use drugs for long‑term pain control?

A)Undesirable side effects from these drugs.
B)The possibility of physical dependence.
C)Drugs' lack of sufficiency in controlling pain.
D)Long term expense of the medications.

Question 58

Among the current limitations to the use of operant procedures for chronic are which of the following?

A)Patients return to old pain behaviours when intervention is concluded.
B)Almost all chronic pain patients benefit from them so there really are no limitations.
C)Operant procedures work well regardless of levels of cooperation.
D)Disability compensation has no demonstrable effects on behavioural improvements in pain treatment.

Question 59

Which of the following reflects the clinical caution regarding the use of narcotics for chronic pain?

A)Clinical research needs to be done on a wider variety of chronic pain conditions.
B)The clinical effects of taking narcotics daily are widely known but seldom considered in treatment.
C)Researchers know why low addiction levels occur when such drugs are taken for pain relief but ignore this information.
D)Acupuncture is a far more effective treatment.

Question 60

Which of the following is not an advantage of group over individual therapy in pain‑coping?

A)More efficient use of therapist time.
B)Increased isolation from others.
C)The risk that the patient will stop listening to the therapist altogether.
D)A new patient social network.

Question 61

Most backaches are due to which of the following?

A)Normal wear and tear on joints in the spine.
B)Muscle or ligament strains.
C)Lack of exercise.
D)all of the above

Question 62

Which of the following pieces of evidence fails to support the idea that acupuncture works due to the power of suggestion?

A)Acupuncture appears to work better in highly suggestible people.
B)Patients who benefit from acupuncture are well indoctrinated.
C)Analgesia effects can be demonstrated with acupuncture in animals.
D)Gate-control theory cannot account for the effects of acupuncture.

Question 63

Ryan thinks about lounging on a beautiful beach to take his mind of the pain of a series of shots at the doctor's office.He is using the cognitive strategy of

A)imagery.
B)redefinition.
C)reflection.
D)rejection.

Question 64

Interpersonal therapy is incorporated in pain treatment programs because

A)patients learn how to play "pain games" with their family members during the course of treatment.
B)patients have the opportunity to discover who is causing them the most trouble in their lives and confront them.
C)patients gain insight into the motivations for their behaviours and how their behaviours toward others affect their adjustment.
D)pain patients tend to experience psychotic symptoms.

Question 65

According to researchers, the most effective cognitive strategy for strong and chronic pain appears to be

A)imagery.
B)local anesthetic.
C)redefinition.
D)distraction.

Question 66

Which statement best summarizes the impact of hypnosis in pain control?

A)Patients use distraction and redefinition techniques only when told to do so under hypnosis.
B)Cognitive strategies produce more pain relief than does hypnosis.
C)The deep relaxation that people who are hypnotized experience is the sole reason for the effectiveness of hypnosis in pain relief.
D)Regardless of whether a patient receives hypnosis or relaxation therapy, persons who are high in hypnotic suggestibility benefit the most.

Question 67

Distraction efforts at pain control are most effective when the

A)pain is strong.
B)pain is diffuse.
C)pain is mild or moderate.
D)the technique commands little attention.

Question 68

During painful leg‑strengthening exercises following knee surgery, Marvin continued to tell himself that, "It hurts, but this must be done if I am to walk without a limp." He was using the cognitive strategy of

A)imagery.
B)redefinition.
C)distraction.
D)remission.

Question 69

Enhancing muscular strength and tissue flexibility to restore range of motion in pain patients is an important goal of

A)progressive muscle relaxation.
B)physical therapy.
C)insight therapy.
D)EMG biofeedback.

Question 70

Imagery differs from distraction in that it is based upon

A)the person's imagination.
B)intuitive sense.
C)real events.
D)real objects.

Question 71

Studies of the relative effects of physical therapy and behavioural/cognitive programs in the treatment of chronic low back pain have shown that

A)neither is very effective.
B)only physical therapy is effective.
C)only behavioural/cognitive programs are effective.
D)both approaches show good effects specific to their area of focus.

Question 72

Which of the following statements about hypnosis is most accurate?

A)Most people can be easily hypnotized.
B)Relaxation strategies are as effective as hypnosis in pain reduction among most people.
C)Hypnosis simply does not work at an anesthetic.
D)Hypnosis works solely by activating endorphins.

Question 73

Compared to patients who don't attend multidisciplinary pain clinics, patients who do

A)still have great difficulty with depression.
B)are less likely to be working a year after discharge.
C)are more likely to play "pain games."
D)experience far less pain at follow-up.

Question 74

Which of the following is an important determinant in the effectiveness of cognitive methods on pain reduction?

A)The severity of the pain.
B)The type of illness.
C)The cognitive method used.
D)all of the above

Question 75

One of the advantages of imagery over distraction is that

A)it is successful with severe pain whereas distraction is not.
B)it requires little involvement or attention.
C)it involves the use of a scene that can be easily carried in one's head.
D)most people are quite adept at imagery.

Question 76

Which of the following is not a class of pain‑coping cognitive strategies?

A)biofeedback.
B)distraction.
C)imagery.
D)redefinition.

Question 77

The basis for stimulation pain‑reduction therapies is the principle of

A)mental imagery.
B)counter‑irritation.
C)operant conditioning.
D)classical conditioning.

Question 78

Transcutaneous electrical nerve stimulation it based upon the view that counter‑irritation works on the principles of

A)operant conditioning.
B)classical conditioning.
C)specificity theory.
D)gate‑control theory.

Question 79

Kelly's pain therapy includes exercise, traction, and massage.Kelly is most probably seeing a person who specializes in

A)transcutaneous electrical nerve stimulation.
B)acupuncture.
C)group psychotherapy.
D)physical therapy.

Question 80

The concept of a "pain game" refers to

A)an operant conditioning treatment approach.
B)playing the role of "suffering person."
C)a distraction technique to takes one's mind off the pain.
D)a physical therapy approach that involves exercise and sporting events.