Test Bank for Local Anesthesia for Dental Professionals, 2nd Edition

Bassett / DiMarco: Local Anesthesia for Dental Professionals, 2e Chapter 2 Fundamentals of Pain Management Match the following A) Internal squeezing or gnawing sensation B) Sympathetic nerve responses C) Individual reaction to painful stimuli D) Caused by injury to nerve tissue E) Postoperative discussion with patient F) Rapid, reflexive, subconscious reaction G) Innate ability to detect painful stimuli H) Thermal, mechanical, chemical receptors I) Postoperative dental pain J) Detects tissue injury 1) Acute pain Objective: 1 2) Debriefing Objective: 1 3) Fight or flight Objective: 1 4) Neuropathic pain Objective: 1 5) Nociceptors Objective: 1 6) Pain threshold Objective: 1 7) Pain tolerance Objective: 1 8) Polymodal Objective: 1 9) Protective response Objective: 1 10) Visceral pain Objective: 1 © 2015 by Pearson Education, Inc. Bassett / DiMarco: Local Anesthesia for Dental Professionals, 2e Answers: 1) I 2) E 3) B 4) D 5) J 6) G 7) C 8) H 9) F 10) A Fill in the blank 1) Pain ________ is highly variable and may vary from one individual to another. Answer: tolerance Objective: 1 2) The three classifications of pain are ________; ________; and ________. Answer: nociceptive; neuropathic; pain disorders associated with psychogenic factors Objective: 4 3) Nociceptive pain is caused by _________ or disease in body tissues. Answer: injury Objective: 4 4) ________ pain is caused by nerve tissue injury or dysfunction of the sensory nerves in the central or peripheral nervous systems. Answer: Neuropathic Objective: 4 5) Pain disorders associated with psychogenic factors are related to mental or ________ problems that affect the experience of pain. Answer: emotional Objective: 4 6) ________ pain usually lasts for a few seconds to not more than six months. It is generally caused by tissue damage from an injury or disease. Answer: Acute Objective: 5 7) ________ pain is long-term pain that persists for more than six months with or without an identifiable cause. Answer: Chronic Objective: 5 8) Nociceptors are unique because they respond to ________, thermal, and chemical stimuli. Answer: mechanical Objective: 7 9) Physiological responses that occur as a result of the sympathetic nervous system’s reaction to pain include an ________ in heart rate, heart contractions, and blood pressure. Answer: increase Objective: 7 10) To help patients cope with anxiety and fear, the four PREP steps are ________; ________; ________; and _________. © 2015 by Pearson Education, Inc. Bassett / DiMarco: Local Anesthesia for Dental Professionals, 2e Answer: prepare; rehearse; empower; praise Objective: 9 11) Visualization is an example of a ________ distraction to help a patient reduce stress during dental treatment. Answer: cognitive Objective: 9 12) The ________ response is a restful state that modifies physical and emotional responses to stress. Answer: relaxation Objective: 9 Multiple choice 1) Which of the following statements related to an individual’s response to a pain experience is not correct? A) It is complex and includes both physiological and psychological factors. B) It is not influenced by an individual’s gender and physical health. C) It is proportionate to the intensity of physical injury and degree of harm. D) It is affected by attitudes and learned responses. Answer: B Objective: 2 2) Which statement best describes pain as a protective response? A) Pain is a physiological, conscious reaction. B) Pain is a rapid, reflexive, unconscious reaction. C) Pain is a psychological reaction based on blood flow to the injured site. D) Pain is a slow, deliberate reaction to avoid further tissue injury. Answer: B Objective: 2 3) Which statement correctly describes pain threshold? A) It is an individual’s reaction to a painful stimulus. B) It indicates the amount of pain an individual is able to endure. C) It is altered by environmental, personal, and social attitudes. D) It is identified when a stimulus begins to produce pain. Answer: D Objective: 3 4) Which statement correctly describes pain tolerance? A) It is an individual’s reaction to a painful stimulus. B) It is consistent among all individuals. C) It is innate and highly reproducible. D) It is identified when a stimulus begins to produce pain. Answer: A Objective 3 © 2015 by Pearson Education, Inc. Bassett / DiMarco: Local Anesthesia for Dental Professionals, 2e 5) Which of the following is classified as nociceptive pain? A) Trigeminal neuralgia B) Phantom limb pain C) Chronic muscle pain D) Traumatic tooth fracture Answer: D Objective: 4 6) Which statement correctly describes chronic pain? A) It follows a period of acute pain that persists for more than six months. B) It follows inception of nociceptive processes. C) It always has an identifiable cause and duration. D) It responds well to pain medication and limited interventions. Answer: A Objective: 5 7) Which is true regarding nociception? A) Pain perception and nociception are synonymous B) Trigger muscular neurons C) Activated without conscious awareness D) Deactivated by stimuli to minimize pain perception Answer: C Objective: 6 8) In response to pain from injection, the CNS activates the sympathetic nervous system to: A) Stimulate the adrenal medulla to release serotonin B) Increase heart rate, blood pressure, and skeletal muscle vasculature C) Increase mesenteric vessel blood flow to digestive organs D) Depress the psychological state of a patient Answer: B Objective: 7 9) Which statement is true regarding fear and local anesthesia? A) Fear can be a barrier to obtaining adequate anesthesia. B) Fear causes little concern over dental treatment. C) Fear of injections causes over 40% of patients to avoid treatment. D) Fear is an insurmountable problem for most patients who experience fear of injections. Answer: A Objective: 8 10) Which of the following strategies helps patients cope with anxiety and fear? A) Avoid discussions about anxiety and fear. B) Only the dentist should ask about anxiety and fear to avoid patient embarrassment. C) Assure the patient that difficulties during past dental visits could not have been avoided. D) Prepare, rehearse, empower, and praise patients to reduce anxiety and fear. © 2015 by Pearson Education, Inc. Bassett / DiMarco: Local Anesthesia for Dental Professionals, 2e Answer: D Objective: 9 11) Which one of the following is not helpful in the process of debriefing? A) Patients relate which aspects of treatment did and did not go well. B) Patients provide input for subsequent appointments. C) Clinicians select strategies for appointments according to their observations of patient behavior. D) Clinicians listen carefully and consider patient input in planning next appointments. Answer: C Objective: 9 12) Which statement best describes the hypnosis? A) Hypnosis is most effective in conjunction with oral sedation. B) Hypnosis causes the inability to concentrate. C) Hypnosis reduces anxiety, stress, salivation and gag reflex. D) Hypnosis induces calmness, relaxation and amnesia Answer: C Objective 9 Short answer/essay 1) Discuss the value of pain as a protective response. Answer: As a physiological response to environment, pain is a protective response. Physiological pain serves to protect against harmful experiences. This protective response is a rapid, reflexive, and subconscious reaction. A less emergent painful annoyance, however, may elicit a slower, conscious level reaction. Without the protective pain response, the ability to maintain a healthy body would be seriously compromised. Objective: 2 2) Discuss variables that contribute to an individual’s experience of pain. Answer: Pain is influenced by many variables that contribute to an individual’s experience of pain. The sex of an individual provides genetic and hormonal influence. Gender adds numerous complex components that include an array of socially constructed roles and relationships, personality traits, attitudes, behaviors, values, and relative power and influence. Other factors, such as age, physical health, mental health, emotional status, expectations, previous experiences, learned responses, and ethnic and cultural norms also impact the pain experience. Objective: 3 3) Differentiate between acute and chronic pain. Answer: Acute pain usually lasts for a few seconds to no more than six months depending on the causative factors. It is generally caused by tissue damage from an injury or disease. Chronic pain is long-term pain that persists for more than six months with or without an identifiable cause. The longer an acute pain continues, the more likely the pain will become a chronic pain experience. © 2015 by Pearson Education, Inc. Bassett / DiMarco: Local Anesthesia for Dental Professionals, 2e Objective: 5 4) Explain the difference between pain and nociception. Answer: Pain and nociception are not synonymous. Nociception is the body’s neurophysiologic detection of tissue trauma by nociceptors and the process of transmission of signals of the tissue injury within the nervous system. Nociception is not a conscious process. The process of nociception is influenced by an individual’s age, general health, and genetics. An individual must have conscious awareness to experience pain. Pain cannot exist apart from consciousness and cannot be objectively measured. Objective: 6 5) Provide examples of the PREP strategies that help patients manage anxiety and fear. Answer: To help patients cope with anxiety and fear: Prepare by utilizing relaxation techniques such as deep breathing, distraction such as music or visualization, and muscle relaxation. Rehearse procedures allowing patients to practice control and self-calming techniques. Empower patients with strategies that give them control during procedures such as raising a hand to ask the clinician to stop. Praise patients for using specific coping techniques that are helpful to them. Objective: 9 6) Discuss strategies and provide examples that enhance positive communication with patients. Answer: Display a genuinely warm and caring attitude. Review the treatment plan addressing fears, including of the unexpected and of loss of control. Obtain patient’s permission to begin treatment and address fear of loss of control if necessary. Establish patient control strategy (time-out signal such as raising hand to stop.) Direct the focus on positive outcomes (“You may feel a bit of pressure.”) Acknowledge and compliment success (“You did great with the anesthesia today!”) Create positive expectations (“That went well today and I expect your next appointment will too.”) Objective: 9 © 2015 by Pearson Education, Inc.