VTNE Pain Management and Analgesia Exam Questions and Answers

which of the following is not one of the 3 primary factors included in a quality of life scale? a) social factors b) interpersonal factors c) physical factors d) behavioral factors - b) interpersonal factors The veterinary technician can play an important role in pain management by: a) monitoring urine and fecal output b) changing the medication when it is ineffective c) communicating directly with the clinician about particular concerns d) directing the veterinary assistant to provide medications - c) communicating directly with the clinician about particular concerns which of the following characteristics do cats exhibit when they are experiencing pain? a) sleeping continuously, overeating, and attention seeking behaviors b) resentment of being handled, aggression, and abnormal posture c) hyperactivity, pupillary enlargement, and tail swishing d) hypotension, hypocapnia, hypopnea, and bradycardia - b) resentment of bein handled, aggression, and abnormal posture during hospitalization, how often should a pain assessment be performed? a) every 4-6 hrs b) every 30min to an hour c) every 12-24 hrs d) every 8 hrs - a) every 4-6 hrs when a veterinary technician is trying to distinguish pain from dysphoria, which of the following would the technician do? a) place the patient on comfortable blankets b) speak in low tones and interacting with the animal makes the patient feel better, but behaviors resume when interaction stops c) move the animal to a different ward d) reverse the analgesic medication - b) speak in low tones and interacting with the animal makes the patient feel better, but behaviors resume when interaction stops which guidelines have elevated pain to the fourth vital sign? a) American College of Veterinary Anesthesiologist's Pain Management Guidelines b) The International Veterinary Academy of Pain Management's Guidelines c) AAHA/AAFP Pain Management Guidelines for Dogs and Cats d) The AVMA Pain Management Guidelines - c) AAHA/AAFP Pain Management Guidelines for Dogs and Cats Nociception is defined as: a) the activity in the peripheral pathway that transmits and processes info about the stimulus to the brain b) a normal response to tissue damage c) pain without apparent biological origin that has persisted beyond the normal tissue healing time d) any stimuli to the affected area that would normally be innocuous that become noxious - a) the activity in the peripheral pathway that transmits and processes info about the stimulus to the brain what is the correct sequence of steps to the pain pathway? a) transduction, transmission, modulation, perception b) modulation, transduction, perception, transmission c) transduction, modulation, transmission, perception d) transmission, transduction, modulation , perception - a) transduction, transmission, modulation, perception which of the following describes "wind up"? a) an increase in the excitability of spinal neurons, mediated in part by the activation of NMDA receptors in dorsal horn neurons b) it occurs when tissue inflammation lead to the release of a complex array of chemical mediators, resulting in reduced nociceptor thresholds c) when brief trauma or noxious stimulus result in physiological pain d) the perceived increase in pain intensity with time when given painful stimulus is delivered repeatedly in excess of a critical rate - d) the perceived increase in pain intensity with time when a given painful stimulus is delivered repeatedly in excess of a critical rate which of the following is an example of an opioid agonist? a) butorphanol b) naloxone c) morphine d) buprenorphine - c) morphine prostaglandins play an important role in: a) production of endorphins b) mammalian cardiovascular physiology c) production of leukotrienes d) mammalian renal physiology - d) mammalian renal physiology which of the following is an NMDA antagonist medication? a) ketamine b) lidocaine c) meperidine d) dexmedetomidine - a) ketamine which of the following classes of drugs would include gabapentin? a) corticosteroids b) sodium channel blockers c) antiepileptics d) nutraceuticals - c) antiepileptics an example of an agent that is only administered topically and provides analgesia is: a) buprenorphine b) EMLA cream c) bupivacaine d) fentanyl - b) EMLA cream which of the following statements can apply to an intratesticular block? a) intratesticular blocks can only be used in large animal patients b) intratesticular blocks can be used in canine and feline orchiectomies c) intratesticular blocks require the use of vaporizer d) intratesticular blocks should never been performed on veterinary patients - b) intratesticular blocks can be used in canine and feline orchiectomies many veterinary technicians are asked to calculate and administer constant rate infusions, as patients can benefit immensely. Which of the following statements is not a benefit of a CRI? a) CRIs provide a more stable plane of analgesia with less incidence of breakthrough pain b) CRIs provide greater control over drug administration c) CRIs allow a lower dose of drug to be delivered at any given time, resulting in a lower incidence of dose-related effects d) CRIs allow the veterinary technician to leave the practice for the evening while administering medication continuously - d) CRIs allow the veterinary technician to leave the practice for the evening while administering medication continuously massage is an example of which type of rehabilitation technique? a) manual therapy b) effleurage techniques c) physical modalities d) therapeutic exercise - a) manual therapy what is the benefit of cryotherapy? a) decreased metabolism so patient is less hungry b) decreased production of pain mediators, leading to analgesia c) prevention of hyperthermia d) useful 2-3 weeks postinjury - b) decreased production of pain mediators, leading to analgesia which of the following describes a myofascial trigger point? a) a point in the muscle at which a reflex can be elicited b) a transcutaneous electrical nerve stimulation c) a painful area of sustained muscle contraction that cannot easily self-release d) a technique where needles are used to pierce the skin at certain points to bring about a physiologic change to treat or prevent disease - c) a painful area of sustained muscle contraction that cannot easily self-release Visceral pain is quite common among companion animals. Which of the following is not an example of visceral pain? a) pancreatitis b) gastroenteritis c) bowel ischemia d) osteosarcoma - d) osteosarcoma which of the following are three examples that are all considered chronic diseases? a) lymphoma, diabetes, GDV b) osteoarthritis, IVDD, cancer c) respiratory infection, cardiac disease, blocked cat d) broken leg, bronchitis, hypertension - b) osteoarthritis, IVDD, cancer veterinary technicians that advocate for pain management are most closely compared to what group of nurses? a) orthopedic nurses b) psychiatric nurses c) human neonatal and pediatric nurses d) emergency and critical care nurses - c) human neonatal and pediatric nurses which of the following is essential for good communication between veterinarians and veterinary technicians who are working in pain management? a) knowing each other's routine and what is regularly done for patients b) knowledge of the physiology of pain and the pharmacology of analgesics c) veterinarians and vet techs should have attained the Certified Veterinary Pain Practitioner status from IVAPM d) communication is not an essential skill, and vet techs should just do as the attending vet tells them - b) knowledge of the physiology of pain and the pharmacology of analgesics Why are the differences in expression among dogs and cats of all ages, and variations among certain breeds, important for pain assessment? a) certain breeds vocalize and appear more sensitive to pain whereas others seem to remain stoic in the face of pain b) only cats exhibit facial expressions, dogs do not c) no comprehensive pain scale has been developed for companion animals d) expressions are insignificant, physiological parameters are what should be used to determine pain - a) certain breeds vocalize and appear more sensitive to pain whereas others seem to remain stoic in the face of pain The role of the vet tech in pain management includes: a) patient assessment b) differentiating pain from other stress c) monitoring and treating drug effects d) all of the above - d) all of the above Which of the following might a dysphoric or delirious animal experience because of opioid overdose? a) thrashing and yowling continuously b) claustrophobia c) only rare responses to soothing interactions d) chewing on cage doors - c) only rare responses to soothing interactions Which of the following behaviors are commonly associated with clinical signs of pain in dogs? a) vocalization and increased appetite b) playful actions and excessive licking of the owners c) panting, anorexia, and depression d) increased attention to the environment - c) playful actions and excessive licking of the owners It is sometimes difficult to distinguish normal from pain associated behaviors in cats and dogs. Which of the following behaviors is most likely to be a normal, nonpainful behavior? a) decreased appetite b) unusual aggression c) stretching all four legs when the abdomen is touched d) decreased social interaction - c) stretching all four legs when the abdomen is touched Which of the following statements regarding pain assessment in dogs is true? a) physiological parsmeters, such as heart rate and blood pressure, are sensitive tools for assessing pain in dogs b) a visual analog scale is a type of multidimensional pain scale and is useful for assessing pain in dogs c) multidimensional pain scale yields better interobserver agreement than unidimensional pain scales d) multidimensional pain scales correlate closely with vocalization and serum cortosil levels in chronically painful dogs - c) multidimensional pain scale yields better interobserver agreement than unidimensional pain scales Which of the following is the most common sign of osetoarthritic pain in cats? a) hiding from company b) eating fewer meals c) reduced frequency of jumping up to high places d) sleeping all day - c) reduced frequency of jumping up to high places The observers subjective interpretation of behavior and assessment of physiologic pain can be described using a pain-rating instrument such as: a) visual analog scale b) force plate gait analysis c) health-related quality of life instrument d) serum cortisol levels - a) visual analog scale Regarding the use of pain scales in hospitalized animals, which of the following statements is false? a) pain scales may encourage routine evaluation of hospitalized animals b) pain scales can be used to determine whether analgesic therapy should be discontinued c) effective analgesic therapy should result in an animal with a low pain score d) a low pain score indicates that analgesic therapy is sufficient, even if an animal is exhibiting some questionable behaviors - d) a low pain score indicates that analgesic therapy is sufficient, even if an animal is exhibiting some questionable behaviors In cats, some diseases cause behavioral changes that are often ascribed to "old age" rather than pain. Examples include all of the following, except: a) Facet pain of spondylosis b) Intervertebral disc disease c) Osteoarthritis d) Basal cell tumor - d) basal cell tumor frequency of pain management depends on the situation. Which of the following is the most appropriate guideline for frequency of chronic pain assessment? a) every 8 hours during the postoperative period b) a minimum of every 3 months for an animal with chronic pain c) every 12 hours for animals with traumatic injuries d) yearly for an animal with chronic pain - b) a minimum of every 3 months for an animal with chronic pain the "gold standard" to assess pain is: a) a physiological assessment b) a clinical pathological assessment c) a behavioral assessment d) there is none - d) there is none the purpose of any pain scale is to: a) help guide analgesic, medical, or surgical treatment b) provide concrete diagnostic evidence c) provide legal documentation d) provide happy faces for the patient chart - a) help guide analgesic, medical, or surgical treatment the preemptive scoring system is a: a) visual analog scale b) subjective scoring system c) simple descriptive scale d) numerical rating scale - b) subjective scoring system the University of Melbourne Pain Scale is based on: a) Hematologic values b) Australian regulations c) Behavioral and physiologic responses d) physiologic responses - c) behavioral and physiologic responses the Glasgow Composite Pain Scale is based on specific behavioral signs in which of the following species? a) feline b) ferret c) equine d) canine - d) canine the Colorado State University Veterinary Medical Center Acute Pain Scale uses which of the following options as an indication of pain? a) number scale b) recorded sounds c) artistic renderings of animals at various levels of pain d) happy to sad faces - c) artistic renderings of animals at various levels of pain a mental nerve block provides analgesia to the: a) maxilla b) lower lip and incisors on the ipsilateral side c) upper lip and nose d) premolars and molars - b) lower lip and incisors on the ipsilateral side for which of the following can the lidocaine patch be used to provide analgesia? a) skin abrasions b) lacerations c) hot spots d) all of the above - d) all of the above in the Pain Buster Soaker catheter, the local anesthetic is delivered by: a) Elastomeric reservoir pump b) CRO c) syringe pump d) IV infusion - a) Elastomeric reservoir pump for which kind of pain would an interpleural block be recommended? a) heart pain b) pancreatic pain c) colon pain d) kidney pain - b) pancreatic pain for which of the following would a brachial plexus block provide analgesia? a) thorax b) forefeet c) distal to the elbow d) proximal to the elbow - c) distal to the elbow the sciatic nerve block provides analgesia to the: a) medial portion of the thigh, tibia, and tarsus and akinesia of the quadriceps femoris muscle b) caudal muscles of the thigh c) portions distal to the elbow d) lumbosacral space and the first or second intercoccygeal space - b) caudal muscles of the thigh if a tourniquet is used when injecting a local anesthetic IV, the block is referred to as the: a) baer's block b) bayer's block c) byer's block d) bier's block - d) bier's block an epidural injection in a dog is injected between: a) L7-S1 b) L4-L5 c) L5-L6 d) S1-S2 - a) L7-S1 which of the following statements is not true regarding acupuncture? a) the points and channels of acupuncture follow neurovascular pathways b) acupuncture treats pain by inducing neuromodulation along peripheral, central, and autonomic pathways c) acupuncture treatments can involve needling, electroacupuncture, low-level laser, and manual pressure d) acupuncture relies on nonspecific identification of the structures responsible for generating pain - d) acupuncture relies on nonspecific identification of the structures responsible for generating pain which if the following examples does acupuncture usually involve? a) veterinary manual therapy b) the use of herbs for analgesia c) the insertion of thin, sterile needles into specific anatomic sites richly supplied with nerve endings d) diluted substances in homeopathic remedies - c) the insertion of thin, sterile needles into specific anatomic sites richly supplied with nerve endings which of the following are contraindications for acupuncture? a) pregnancy b) sepsis c) severe bleeding abnormalities d) all of the above - d) all of the above myofascial pain syndrome entails the palpation of: a) taut bands and trigger points b) swollen segments of muscle c) nodules of infection d) nerve bundles - a) taut bands and trigger points herbs used for COX inhibition do not include: a) ginger b) devils claw c) capsaicin d) white willow bark - c) capsiacin examples of complementary therapy for pain management include: a) manual therapy b) magnet therapy c) homeopathy d) all of the above - d) all of the above during cryotherapy, the cold temperature raises the activation threshold of: a) reflex muscles b) blood vessels c) tissue nociception d) painful nerves - c) tissue nociception when should cryotherapy be applied for best response? a) during the acute inflammatory phase of tissue healing b) after exercise to lessen inflammatory response c) immediately following surgery d) all of the above - d) all of the above caution should be used with cryotherapy if a patient has: a) a large percentage of fat b) localized vascular compromise c) areas of previous frostbite d) b and c - d) b and c the primary benefit of cryokinetics is to: a) aid the patient's ability to perform pain free, low level exercise b) cool down a body that is overheating c) allow an athlete to compete at the highest levels with no pain d) take the place of local anesthetics injections in advance of athletic stress - a) aid in patient's ability to perform pain free, low level exercise cold or white skin after a 20 minute cryotherapy session may indicate: a) circulation is restored and normal b) possible cold-induced tissue damage c) the need for external heat creams or rubs d) the need for more melanin in the diet - b) possible cold-induced tissue damage cryotherapy can include: a) ice packs b) cold immersion baths c) ice massage d) all of the above - d) all of the above which of the following scenarios is thermotherapy not useful for? a) chronic pain b) muscle pain c) acute inflammation d) stretching to enhance collagen extensibility - c) acute inflammation treatment for joint mobility includes: a) ROM b) stretching exercises c) a and b d) none of the above - c) a and c which of the following is not true for passive range of motion? a) treatment should be in a quiet, comfortable area b) a muzzle should be applied for initial treatments c) a patient's limb (of interest) is fully supported d) the patient's position is unimportant - d) the patient's position is unimportant which of the following is the target tissue for lengthening a muscle that is contracted? a) joint capsule b) muscle belly c) tendon d) ligament - b) muscle belly which of the following is an example of an active range of motion exercise? a) aquatic therapy b) walking in snow or sand c) climbing stairs d) all of the above - d) all of the above therapeutic exercises do not include: a) pulling or carrying weighs b) cavaletti rails c) treadmill walking d) wheelbarrowing - a) pulling or carrying weighs transcutaneous electrical nerve stimulation is a form of: a) LLLT b) NEMS c) EEG d) EMG - b) NEMS a contraindication for transcutaneous electrical nerve stimulation includes: a) cruciate ligament reconstruction b) rehab after orthopedic injury c) animals with pacemakers d) chronic OA - c) animals with pacemakers when should low-level laser therapy not be used? a) over muscle trigger points b) over acupuncture points c) with osteoarthritis and muscle spasms d) over areas of malignancy or cancer - d) over areas of malignancy or cancer massage techniques may include: a) effleurage b) petrissage c) trigger point therapy d) all of the above - d) all of the above extracorporeal shock wave treatment could be indicated for: a) pregnancy b) osteoarthritis c) neoplasms d) heart disease - b) osteoarthritis which tool is used to measure passive range of motion in companion animals? a) calipers b) slide rule c) goniometer d) oliometer - c) goniometer when should therapeutic ultrasound not be used? a) when the patient's area of interest has plastic or metal implants b) when the ultimate result is to decrease pain c) when the goal is to accelerate wound healing d) when the patient's ROM should be increased - a) when the patient's area of interest has plastic or metal implants phototherapy can be used for: a) soft-tissue injuries b) wound healing c) chronic pain d) all of the above - d) all of the above in cats, aquatic therapy is contraindicated for: a) muscle weakness b) OA c) cardiac dysfunction d) geriatric care - c) cardiac dysfunction an example of a proprioception exercise used for cats is: a) jump rope b) swimming c) balance board d) massage - c) balance board what organization requires that pain be included ini every veterinary patient assessment regardless of a presenting complaint? a) North American Veterinary Technician Association b) American College of Veterinary Anesthesia and Analgesia c) American Animal Hospital Association d) American Veterinary Medical Association - c) American Animal Hospital Association How can pain negatively impact the patient? a) treatment costs money so the client will refuse it b) pain promotes inflammation, which delays wound healing c) pain can induce viral disease d) pain can cause cateracts to form - b) pain promotes inflammation, which delays wound healing which pain scale should be used? a) does not matter as long as you like it and it makes you happy b) the longest and most complex is always best c) the shortest and simples in always best d) it is important to choose one system to be used by the entire veterinary team - d) it is important to choose one system to be used by the entire veterinary team how painful is abscess drainage? a) mild b) moderate c) severe d) extremely severe - a) mild how painful is a ovariohysterectomy? a) mild b) moderate c) severe d) extremely severe - b) moderate how painful is a thoracotomy? a) mild b) moderate c) severe d) extremely severe - c) severe what kind of scale is a visual analog scale? a) subjective b) objective c) a and b d) none of the above - a) subjective the Colorado State Canine and Feline Pain Scales fall under which category? a) objective b) subjective c) both a and b d) none of the above - b) subjective which pain scale is considered state of the art? a) Colorado State Canine and Feline Pain Scales b) a scale that you make for yourself c) Glasgow Pain Scoring System d) client specific outcome measures scale - c) Glasgow Pain Scoring System How often should a pain score be given to the client? a) never b) every 6 months c) yearly d) every time the pain score is assessed - d) every time the pain score is assessed which of the following parameters do horses most commonly exhibit for various states of pain? a) behavior parameters b) emotional parameters c) physiologic parameters d) all of the above - a) all of the above Pain that is abnormal and not beneficial for the patient is called: a) adaptive pain b) maladaptive pain c) physiologic pain d) peripheral pain - b) maladaptive where can inflammatory pain occur? a) muscles, joints, skin, and periosteum b) thorax c) abdomen d) all of the above - d) all of the above the most common types of pain experienced by horses are: a) ocular and head pain b) spine and pelvic pain c) orthopedic pain and abdominal/colic pain d) foot and dental pain - c) orthopedic pain and abdominal/colic pain what pain scoring systems are available for horses? a) Obel Laminitis Pain Scale b) AAEP lameness grade definition c) Horse Grimace Scale d) all of the above - d) all of the above Which of the following clinical signs might a cow in pain exhibit? a) dull and depressed b) inappetence and grinding teeth c) a stance with one foot behind the other d) all of the above - d) all of the above Goats are intolerant of painful procedures. How do sheep react to a painful procedure? a) they refuse to eat b) they show subtle signs of pain c) they always vocalize when in pain d) they develop a fever from pain - b) they show subtle signs of pain Squealing is a normal behavior in pigs. When could squealing be considered a result of pain? a) when a painful area is palpated b) when squealing becomes excessive c) when squealing involves a lack of social behavior d) all of the above - d) all of the above what is a benefit of using local anesthetics? a) local anesthetics produce true analgesia resulting in the complete absence of pain for the duration of the block b) long term (chronic) pain states may be diminished or eliminated c) these drugs are nonscheduled agents d) all of the above - d) all of the above side effects of local anesthetics can include: a) cardiovascular effects b) CNS effects c) allergic reactions d) all of the above - d) all of the above which of the following is a local block used for onychectomy procedure? a) leg block b) brachial plexus block c) circumferential ring block d) foot block - c) circumferential ring block of the following listed blocks, which is not a dental nerve block? a) mandibular nerve block b) mental nerve block c) infraorbital nerve block d) retrobulbar nerve block - d) retrobulbar nerve block what block can be performed before surgery of the abdominal cavity? a) sacrococcygeal block b) incisional block c) mental nerve block d) bier's block - b) incisional block which bones serve as a landmark for an intercostal block? a) sternum b) thoracic vertebrae c) humerus d) ribs - d) ribs what are the advantages of an interpleural block over the intercostal block? a) ability to redose easily b) ease of administration c) ability to provide analgesia following median sternotomy d) all of the above - d) all of the above which block an be used in a castration procedure for companion animals, large animals, and exotic animals? a) intratesticular block b) epidural block c) intra-articular block d) intrapleural block - a) intratesticular block Which of the following is considered an excellent block that can be used for cats with a urinary blockage? a) epidural b) sacrococcygeal block c) pelvic block d) penile block - b) sacrococcygeal block of the following procedures, which is not an indication for an epidural block? a) cesarean section b) tibial-femoral fractures c) TECA procedure d) cruciate ligament repair - c) TECA procedure what type of needle is recommended for an epidural catheter? a) tuohy-type b) butterfly catheter needle c) 16 gauge IV catheter needke d) auto-vac needle - a) tuohy-type which of the following is an indication for an epidural in a horse? a) difficult parturition b) caslick's closure c) urethrosotmy d) all of the above - d) all of the above what type of nerve block is used to dehorn cattle? a) cornual nerve block b) epidural nerve block c) facial nerve block d) disbudding nerve block - a) cornual nerve block what can happen to goats if they experience unrelieved pain? a) faint b) death c) goats will roll and vocalize d) goats can suddenly become lame - b) death in which ruminant species can an epidural nerve block be performed? a) cattle b) sheep and goats c) camelids d) all of the above - d) all of the above which of the following are goals of physical rehabilitation therapy? a) decreased pain and inflammation b) maintained or increased joint ROM and flexibility c) maintained or increased strength d) all of the above - d) all of the above benefits of massage include which of the following? a) decreased muscle spasms and increased local blood and lymphatic flow b) help for the patient to reach niravana c) no physiological benefits d) cannot be performed on canine species - a) decreased muscle spasms and increased local blood and lymphatic flow what modalities does thermotherapy encompass? a) heat therapy only b) cold therapy only c) laser therapy only d) heat and cold therapy - d) heat and cold therapy when starting a patient on aquatic swimming therapy, which of the following would be a main recommendation? a) start the patient on a long, difficult program to increase tolerance b) swim several times a day, building in 30 min increments c ) slowly introduce aquatic therapy depending on patient's level d) aquatic therapy swimming is recommended for all patients regardless of incisions - c) slowly introduce aquatic therapy depending on patient's level