Test Bank Chapter 12 Managing And Controlling Clinical Pain - Health Psychology 2e Canadian Test Bank by Edward P. Sarafino. DOCX document preview.
CHAPTER 12: MANAGING AND CONTROLLING CLINICAL PAIN
True or False Statements
1. Many patients experience greater‐than‐necessary pain following surgery.
Section Reference: Acute Clinical Pain
2. With chronic pain, one's personality may become dominated by the neurotic triad of hypochondriasis, depression and hysteria.
Section Reference: Chronic Clinical Pain
3. In a synovectomy, the surgeon disconnects portions of the peripheral nervous system to prevent pain signals from reaching the brain.
Section Reference: Surgical Methods for Treating Pain
4. Aspirin and acetaminophen are examples of centrally-acting analgesics.
Section Reference: Chemical Methods for Treating Pain
5. According to operant approaches, placing medications on a fixed administration schedule should reduce requests for medications.
Section Reference: Chemical Methods for Treating Pain
6. Distraction and guided imagery work best with mild to moderate pain.
Section Reference: Fear Reduction, Relaxation, and Biofeedback
7. The mechanisms that explain how hypnosis works in the reduction of pain are now clearly understood.
Section Reference: Hypnosis as a Treatment for Pain
8. Interpersonal therapy is designed to help people deal with chronic pain by changing the way they interact with and perceive their social environments.
Section Reference: Interpersonal Therapy for Pain
9. Acupuncture effectiveness has been shown to be totally due to psychological factors.
Section Reference: Stimulation Therapies
10. A physical therapist is most likely to apply exercise, massage, traction, heat and cold as treatments for pain.
Section Reference: Physical Therapy
Matching
Match the following with the descriptions in 11-15.
a. peripherally active analgesics
b. centrally acting analgesics
c. epidural block
d. biofeedback
e. transcutaneous electrical nerve stimulation (TENS)
11. May involve recording of EMG.
Section Reference: Fear Reduction, Relaxation, and biofeedback
12. Injection of local anesthetic to area surrounding spinal cord.
Section Reference: Chemical Methods for Treating Pain
13. Examples include aspirin and acetaminophen.
Section Reference: Types of Pain‐Relieving Chemicals
14. Involves electrical stimulation.
Section Reference: Stimulation Therapies
15. Examples include codeine, morphine and demerol.
Section Reference: Types of Pain‐Relieving Chemicals
Match the following pain control techniques with the statements in 16-20.
a. operant approach
b. acupuncture
c. distraction
d. redefinition
e. interpersonal therapy
16. Changes the consequences of the pain behaviour.
Section Reference: The Operant Approach
17. Whenever she goes to the dentist, Clare counts the ceiling tiles while the dentist works.
Section Reference: Fear Reduction, Relaxation, and Biofeedback
18. Appears to be most effective with strong pain.
Section Reference: Fear Reduction, Relaxation, and Biofeedback
19. May help an individual understand the role of reacting to others as affecting his or her pain.
Section Reference: Interpersonal Therapy for Pain
20. Based on the counter‑irritation principle.
Section Reference: Stimulation Therapies)
Multiple Choice
21. 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.
Section Reference: Clinical Pain
22. 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.
Section Reference: Acute Clinical Pain
23. 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.
Section Reference: Acute Clinical Pain
24. 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.
Section Reference: Acute Clinical Pain
25. 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.
Section Reference: Chronic Clinical Pain
26. 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.
Section Reference: Chronic Clinical Pain
27. 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.
Section Reference: Medical Treatments for Pain
28. 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
Section Reference: Surgical Methods for Treating Pain
29. 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.
Section Reference: Surgical Methods for Treating Pain
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
Section Reference: Surgical Methods for Treating Pain
31. 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
Section Reference: Chemical Methods for Treating Pain
32. 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
Section Reference: Surgical Methods for Treating Pain
33. 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
Section Reference: Chemical Methods for Treating Pain
34. 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.
Section Reference: Chemical Methods for Treating Pain
35. 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.
Section Reference: Chemical Methods for Treating Pain
36. Aspirin is to _____ as morphine is to _____.
a) peripheral; central
b) central; peripheral
c) indirect; local
d) local; indirect
Section Reference: Types of Pain‐Relieving Chemicals
37. 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.
Section Reference: Chemical Methods for Treating Pain
38. 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.
Section Reference: Chemical Methods for Treating Pain
39. 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
Section Reference: Chemical Methods for Treating Pain
40. Nadine is dying from cancer. Her physician likely to prescribe what medication for her?
a) Acetaminophen.
b) Novocaine.
c) Sedatives.
d) Narcotics.
Section Reference: Chemical Methods for Treating Pain
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.
Section Reference: Chemical Methods for Treating Pain
42. 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.
Section Reference: Chemical Methods for Treating Pain
43. 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.
Section Reference: Chemical Methods for Treating Pain
44. 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.
Section Reference: Chemical Methods for Treating Pain
45. 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.
Section Reference: Chemical Methods for Treating Pain
46. 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.
Section Reference: Chemical Methods for Treating Pain
47. 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.
Section Reference: The Operant Approach
48. 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
Section Reference: The Operant Approach
49. 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
Section Reference: The Operant Approach
50. 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.
Section Reference: The Operant Approach
51. Tension headaches can be treated with which type of biofeedback?
a) EMG.
b) Temperature.
c) EKG.
d) EEG.
Section Reference: Fear Reduction, Relaxation, and Biofeedback
52. 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.
Section Reference: Fear Reduction, Relaxation, and Biofeedback
53. 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.
Section Reference: Fear Reduction, Relaxation, and Biofeedback
54. 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.
Section Reference: Fear Reduction, Relaxation, and Biofeedback
55. 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.
Section Reference: Fear Reduction, Relaxation, and Biofeedback
56. 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.
Section Reference: Fear Reduction, Relaxation, and Biofeedback
57. 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.
Section Reference: Fear Reduction, Relaxation, and Biofeedback
58. 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.
Section Reference: Fear Reduction, Relaxation, and Biofeedback
59. 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.
Section Reference: Fear Reduction, Relaxation, and Biofeedback
60. 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.
Section Reference: Fear Reduction, Relaxation, and Biofeedback
61. Which of the following is not a class of pain‑coping cognitive strategies?
a) biofeedback.
b) distraction.
c) imagery.
d) redefinition.
Section Reference: Fear Reduction, Relaxation, and Biofeedback
62. 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) technique commands little attention.
Section Reference: Fear Reduction, Relaxation, and Biofeedback
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.
Section Reference: Fear Reduction, Relaxation, and Biofeedback
64. Imagery differs from distraction in that it is based upon
a) the person's imagination.
b) intuitive sense.
c) real events.
d) real objects.
Section Reference: Fear Reduction, Relaxation, and Biofeedback
65. 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.
Section Reference: Fear Reduction, Relaxation, and Biofeedback
66. 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.
Section Reference: Fear Reduction, Relaxation, and Biofeedback
67. 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.
Section Reference: Fear Reduction, Relaxation, and Biofeedback
68. 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
Section Reference: Fear Reduction, Relaxation, and Biofeedback
69. 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.
Section Reference: Hypnosis as a Treatment for Pain
70. 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.
Section Reference: Interpersonal Therapy for Pain
71. 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.
Section Reference: Hypnosis as a Treatment for Pain
72. 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.
Interpersonal therapy for pain
73. The basis for stimulation pain‑reduction therapies is the principle of
a) mental imagery.
b) counter‑irritation.
c) operant conditioning.
d) classical conditioning.
Section Reference: Stimulation Therapies
74. 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.
Section Reference: Stimulation Therapies
75. 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.
Section Reference: Stimulation Therapies
76. 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.
Section Reference: Physical Therapy
77. 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.
Section Reference: Physical Therapy
78. 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.
Section Reference: Physical Therapy
79. 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
Section Reference: Physical Activity and Back Pain
80. 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.
Section Reference: Evaluating the Success of Pain clinics
Short Answer Questions
81. Compare and contrast acute clinical pain with chronic clinical pain.
82. Compare and contrast behavioural versus cognitive methods for pain treatment.
83. Your confused cousin is upset that her son is going away to a pain clinic because she’s heard that all they do there is play “pain games.” Educate your dear cousin on the concept of pain games and how they relate to the pain experience and treatment.
Essay Questions
84. Discuss three issues pertaining to the use of chemicals for acute pain compared to the use of chemicals for chronic pain.
85. Your close friend is debating whether to go to a psychologist who uses biofeedback versus a psychologist who uses hypnosis to treat her chronic back pain. Provide a convincing set of evidence to inform her choice.
86. You have just begun work as a pain specialist in a multidisciplinary program pain clinic. Explain to your closest relative what it is that you do for a living.
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