MCQ Quiz: Assessment & Management of Chronic Pain

Chronic pain is a complex disease state that persists beyond normal healing time, profoundly impacting a patient’s function and quality of life. Its management, a key topic in the Patient Care 3 curriculum “, shifts the focus from simply reducing pain intensity to improving daily function and requires a multimodal approach. This quiz will test your knowledge on the assessment of chronic pain, the role of non-pharmacologic therapies, and the evidence-based use of non-opioid, adjuvant, and opioid analgesics.

1. Chronic pain is best defined as pain that persists or recurs for longer than:

  • a. 24 hours
  • b. 1 week
  • c. 1 month
  • d. 3-6 months

Answer: d. 3-6 months

2. The primary goal of chronic pain management is:

  • a. To completely eliminate all pain sensation (a pain score of 0/10).
  • b. To improve function and quality of life, even if some pain persists.
  • c. To find the highest tolerable dose of an opioid.
  • d. To ensure the patient receives a disability diagnosis.

Answer: b. To improve function and quality of life, even if some pain persists.

3. A patient describes their chronic pain as “burning, shooting, and electrical.” This is characteristic of what type of pain?

  • a. Nociceptive somatic pain
  • b. Nociceptive visceral pain
  • c. Neuropathic pain
  • d. Acute pain

Answer: c. Neuropathic pain

4. Which of the following is considered a first-line pharmacologic treatment for neuropathic pain?

  • a. A strong opioid like fentanyl.
  • b. An NSAID like naproxen.
  • c. An antidepressant like duloxetine or a gabapentinoid like pregabalin.
  • d. Acetaminophen.

Answer: c. An antidepressant like duloxetine or a gabapentinoid like pregabalin.

5. The “4 A’s” of monitoring a patient on chronic opioid therapy include Analgesia, Activity, Adverse effects, and:

  • a. Adherence
  • b. Aberrant drug-related behaviors
  • c. Addiction
  • d. Allergies

Answer: b. Aberrant drug-related behaviors

6. The “Pharmacotherapy of Pain” is a specific lecture in which course?

  • a. PHA5878C Patient Care 3
  • b. PHA5104 Sterile Compounding
  • c. PHA5703 Pharmacy Law and Ethics
  • d. PHA5787C Patient Care 5

Answer: a. PHA5878C Patient Care 3

7. Which non-opioid medication is considered a reasonable first-line option for mild-to-moderate chronic osteoarthritis pain?

  • a. Ibuprofen
  • b. Acetaminophen
  • c. Celecoxib
  • d. Tramadol

Answer: b. Acetaminophen

8. “Multimodal analgesia” in chronic pain refers to:

  • a. Using only opioid medications.
  • b. Using only non-pharmacologic therapies.
  • c. Combining different pharmacologic and non-pharmacologic strategies to target pain through multiple mechanisms.
  • d. Using only adjuvant analgesics.

Answer: c. Combining different pharmacologic and non-pharmacologic strategies to target pain through multiple mechanisms.

9. Which of the following is a key non-pharmacologic treatment for chronic pain?

  • a. Complete bed rest and inactivity.
  • b. Physical therapy and graded exercise.
  • c. A diet high in inflammatory foods.
  • d. Daily use of a heating pad only.

Answer: b. Physical therapy and graded exercise.

10. A patient on chronic opioid therapy develops tolerance. This means:

  • a. They are addicted to the medication.
  • b. They require a higher dose of the opioid to achieve the same level of pain relief.
  • c. They are experiencing withdrawal symptoms.
  • d. They are diverting their medication.

Answer: b. They require a higher dose of the opioid to achieve the same level of a pain relief.

11. The “Introduction to Pain and Treatment Options” is a module within the Patient Care 3 curriculum.

  • a. True
  • b. False

Answer: a. True

12. Amitriptyline is a tricyclic antidepressant used for neuropathic pain. Its use is often limited by:

  • a. Its high cost.
  • b. Its anticholinergic side effects.
  • c. Its lack of efficacy.
  • d. Its need for IV administration.

Answer: b. Its anticholinergic side effects.

13. A patient on chronic opioid therapy should always be co-prescribed what medication?

  • a. An antiemetic
  • b. A prophylactic bowel regimen (e.g., a stimulant laxative)
  • c. An anxiolytic
  • d. An antidepressant

Answer: b. A prophylactic bowel regimen (e.g., a stimulant laxative)

14. A state’s Prescription Drug Monitoring Program (PDMP) is a tool pharmacists should use when dispensing opioids to:

  • a. Check for overlapping prescriptions from multiple prescribers.
  • b. Assess for potential diversion or misuse.
  • c. Verify the patient’s controlled substance history.
  • d. All of the above.

Answer: d. All of the above.

15. Counseling patients on self-care for pain is a key objective for student pharmacists.

  • a. True
  • b. False

Answer: a. True

16. The primary goal of assessing chronic pain should be focused on:

  • a. The pain score only.
  • b. The patient’s mood only.
  • c. The impact of pain on the patient’s physical and social function.
  • d. The patient’s opioid tolerance.

Answer: c. The impact of pain on the patient’s physical and social function.

17. The “Self-Care for Pain and Fever” lecture is part of the Patient Care 3 curriculum.

  • a. True
  • b. False

Answer: a. True

18. Which of the following is a key difference in the management of acute versus chronic pain?

  • a. Opioids are first-line for all types of chronic pain.
  • b. The goals shift from simple pain relief to improved function and quality of life in chronic pain.
  • c. Non-pharmacologic therapy has no role in chronic pain.
  • d. Chronic pain is easier to treat than acute pain.

Answer: b. The goals shift from simple pain relief to improved function and quality of life in chronic pain.

19. A topical lidocaine patch is most effective for what type of pain?

  • a. Deep visceral pain
  • b. Diffuse, widespread neuropathic pain.
  • c. Localized neuropathic pain, such as postherpetic neuralgia.
  • d. Acute surgical pain.

Answer: c. Localized neuropathic pain, such as postherpetic neuralgia.

20. An active learning session on pain management is part of the Patient Care 3 course.

  • a. True
  • b. False

Answer: a. True

21. “Physical dependence” on an opioid means:

  • a. The patient is addicted.
  • b. The patient will experience withdrawal symptoms if the opioid is abruptly stopped.
  • c. The patient is using the drug for non-medical reasons.
  • d. The drug is no longer effective.

Answer: b. The patient will experience withdrawal symptoms if the opioid is abruptly stopped.

22. Which of the following is an example of an SNRI used for chronic pain?

  • a. Fluoxetine
  • b. Sertraline
  • c. Duloxetine
  • d. Citalopram

Answer: c. Duloxetine

23. The “Pharmacology of Analgesics” is a lecture within the Patient Care 3 curriculum.

  • a. True
  • b. False

Answer: a. True

24. An active learning session on pain is part of which course?

  • a. PHA5878C Patient Care 3
  • b. PHA5163L Professional Skills Lab 3
  • c. PHA5781 Patient Care I
  • d. PHA5782C Patient Care 2

Answer: a. PHA5878C Patient Care 3

25. A pharmacist’s role in chronic pain management includes:

  • a. Screening for risk factors for opioid misuse.
  • b. Counseling on the safe storage and disposal of opioids.
  • c. Recommending appropriate adjuvant analgesics.
  • d. All of the above.

Answer: d. All of the above.

26. The use of long-acting opioids is generally reserved for:

  • a. All patients with chronic pain.
  • b. Opioid-naïve patients.
  • c. Patients with persistent, moderate-to-severe pain who have demonstrated opioid tolerance.
  • d. The treatment of acute pain only.

Answer: c. Patients with persistent, moderate-to-severe pain who have demonstrated opioid tolerance.

27. What is a key principle when tapering a patient off of chronic opioid therapy?

  • a. The taper should be done as quickly as possible.
  • b. The taper should be slow and individualized to minimize withdrawal symptoms.
  • c. The patient should not be involved in the tapering plan.
  • d. All patients can be tapered off in one week.

Answer: b. The taper should be slow and individualized to minimize withdrawal symptoms.

28. An active learning session on pain is part of which course module?

  • a. Module 1: Introduction to Pain and Treatment Options
  • b. Module 3: Dyslipidemia
  • c. Module 5: Acute Coronary Syndrome
  • d. Module 8: Introduction to Pulmonary Disease

Answer: a. Module 1: Introduction to Pain and Treatment Options

29. The term “analgesic ceiling” means:

  • a. Higher doses of the drug will continue to provide additional pain relief indefinitely.
  • b. A point at which higher doses of a drug do not provide additional pain relief.
  • c. The maximum legal dose of a medication.
  • d. A side effect of an opioid.

Answer: b. A point at which higher doses of a drug do not provide additional pain relief.

30. The “Pharmacotherapy of Pain” is a lecture within the Patient Care 3 curriculum.

  • a. True
  • b. False

Answer: a. True

31. Which class of non-opioid analgesics has an “analgesic ceiling”?

  • a. Opioids
  • b. NSAIDs and acetaminophen
  • c. Gabapentinoids
  • d. None of the above

Answer: b. NSAIDs and acetaminophen

32. The primary goal of a “pain contract” or treatment agreement for chronic opioid therapy is to:

  • a. Create a legal document to protect the prescriber.
  • b. Establish clear expectations and responsibilities for both the patient and the prescriber.
  • c. Punish the patient for any violation.
  • d. Guarantee that the patient will not become addicted.

Answer: b. Establish clear expectations and responsibilities for both the patient and the prescriber.

33. Cognitive Behavioral Therapy (CBT) for chronic pain helps patients by:

  • a. Curing the underlying cause of the pain.
  • b. Changing negative thought patterns and behaviors related to their pain.
  • c. Providing a physical intervention.
  • d. Blocking pain signals in the spinal cord.

Answer: b. Changing negative thought patterns and behaviors related to their pain.

34. Pain management is considered a key topic in which course?

  • a. PHA5878C Patient Care 3
  • b. PHA5784C Patient Care 4
  • c. PHA5787C Patient Care 5
  • d. PHA5781 Patient Care I

Answer: a. PHA5878C Patient Care 3

35. A patient on chronic opioid therapy should be co-prescribed what medication for overdose prevention?

  • a. A benzodiazepine
  • b. An additional opioid
  • c. Naloxone
  • d. An NSAID

Answer: c. Naloxone

36. A key part of the initial assessment for chronic pain is:

  • a. Immediately prescribing a long-acting opioid.
  • b. A thorough patient history, including previous treatments and their efficacy.
  • c. Ordering an MRI for every patient.
  • d. Focusing only on the physical aspect of the pain.

Answer: b. A thorough patient history, including previous treatments and their efficacy.

37. Chronic pain is best managed by:

  • a. A single provider.
  • b. The patient alone.
  • c. A multidisciplinary team including physicians, pharmacists, physical therapists, and psychologists.
  • d. A surgeon only.

Answer: c. A multidisciplinary team including physicians, pharmacists, physical therapists, and psychologists.

38. The Pain & Fever Self-Care module is part of the Patient Care I course.

  • a. True
  • b. False

Answer: a. True

39. Opioid-induced hyperalgesia is a phenomenon where:

  • a. A patient becomes more sensitive to pain as a paradoxical effect of long-term opioid use.
  • b. A patient develops tolerance to the analgesic effects.
  • c. A patient experiences severe constipation.
  • d. A patient has an allergic reaction to an opioid.

Answer: a. A patient becomes more sensitive to pain as a paradoxical effect of long-term opioid use.

40. An active learning session covering pain management is part of which course?

  • a. PHA5878C Patient Care 3
  • b. PHA5163L Professional Skills Lab 3
  • c. PHA5781 Patient Care I
  • d. PHA5782C Patient Care 2

Answer: a. PHA5878C Patient Care 3

41. Which of the following is NOT a first-line agent for fibromyalgia?

  • a. Duloxetine
  • b. Pregabalin
  • c. Amitriptyline
  • d. Oxycodone

Answer: d. Oxycodone

42. The most important component of managing chronic pain is:

  • a. The specific medication prescribed.
  • b. A strong, trusting therapeutic relationship between the patient and the healthcare team.
  • c. The use of the newest available technology.
  • d. Regular imaging studies.

Answer: b. A strong, trusting therapeutic relationship between the patient and the healthcare team.

43. A pharmacist’s role in chronic pain management includes all of the following EXCEPT:

  • a. Assessing for aberrant drug-related behaviors.
  • b. Counseling on the risks of long-term opioid use.
  • c. Performing interventional pain procedures like nerve blocks.
  • d. Recommending non-pharmacologic therapies.

Answer: c. Performing interventional pain procedures like nerve blocks.

44. Urine drug testing in a chronic pain clinic is used to:

  • a. Monitor for adherence to prescribed opioids.
  • b. Screen for the use of non-prescribed or illicit substances.
  • c. Both a and b.
  • d. Punish the patient.

Answer: c. Both a and b.

45. Which of the following is a central principle of chronic pain management?

  • a. The goal is a quick fix.
  • b. The focus is on active patient participation and self-management strategies.
  • c. The patient is a passive recipient of care.
  • d. Pharmacologic therapy is the only effective treatment.

Answer: b. The focus is on active patient participation and self-management strategies.

46. “Defending a therapeutic plan” for a pain patient is an objective in the skills lab curriculum.

  • a. True
  • b. False

Answer: a. True

47. The laws regarding the prescribing of controlled substances are a key part of which course?

  • a. PHA5703 Principles of Pharmacy Law and Ethics
  • b. PHA5244 Principles of Evidence-Based Practice
  • c. PHA5104 Sterile Compounding
  • d. PHA5176 Drug Delivery Systems

Answer: a. PHA5703 Principles of Pharmacy Law and Ethics

48. An active learning session on pain is part of which course module?

  • a. Module 1: Introduction to Pain and Treatment Options
  • b. Module 2: Hypertension
  • c. Module 4: Ischemic Heart Disease
  • d. Module 7: Arrhythmias

Answer: a. Module 1: Introduction to Pain and Treatment Options

49. The overall management of chronic non-cancer pain should prioritize:

  • a. Opioid therapy above all other treatments.
  • b. Non-opioid and non-pharmacologic therapies.
  • c. Surgical interventions.
  • d. A “wait and see” approach.

Answer: b. Non-opioid and non-pharmacologic therapies.

50. The ultimate goal of learning about chronic pain management is to:

  • a. Be able to safely and compassionately help patients manage their condition to improve their overall quality of life and function.
  • b. Become an expert at denying opioid prescriptions.
  • c. Pass the final exam.
  • d. Memorize all the different types of pain scales.

Answer: a. Be able to safely and compassionately help patients manage their condition to improve their overall quality of life and function.

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