____ a. The person is  experiencing increased pain.

____ b. The person is experiencing increased anxiety or depression.

____ c. The person is requesting more staff attention.

____ a. The treating physician.

____ b. The person’s primary nurse.

____ c. The person experiencing pain.

____ d. The physical therapist.

____ a. Because of diverse and mixed cultures in the United States, there are no longer cultural influences on the pain experience.

____ b. Therapists should use knowledge that has defined clearly the influence of pain on culture (e.g., Asian patients are generally stoic, Italians are expressive and exaggerate their pain.

Using this definition, how likely is it that opioid addiction will occur as a result if treating pain with opioid analgesics? Circle the number closest to what you consider the correct answer.

1. that Stewart’s pain is due to his depression and his pain complaints do not require any further intervention.

2. Ignoring Stewart’s pain complaint is the most appropriate strategy.

3. Stewart is complaining about pain in order to get sympathy and avoid doing the exercises.

Frank is 60 years old and this is his first day following total hip arthroplasty. As you enter his room, he smiles at you and continues talking and joking with his visitors. When asked to rate his pain on a scale of 0-10 (0 = no pain, 10 = worst pain) he rates his pain as 8.

A. Circle the number that represents your assessment of Frank’s pain.

___ 1) He has much less pain than he reports and he is medication seeking.

___ 2) He is distracted by his visitors and misrepresents his pain.

___ 3) He is using distraction effectively to deal with his pain.

Lisa is a 22 year old college athlete who had a car accident 8 months ago in which she sustained fractures to right tib/fib, clavicle and multiple facial lacerations. Her physician reports her fractures are healed and she is cleared for full weightbearing on both upper and lower extremity. Lisa is currently completing her college degree, but reports that because of the pain she is constantly tired and unable to be involved in any social campus life. She appears anxious as she ambulates into your office with a single crutch and an extremely guarded gait. She reports her pain as 9 on a 0-10 visual analogue scale. To begin your intervention you:

___ 1) Complete the subjective part of the evaluation and request further consultation with the physician prior to completing the objective testing.

___ 2) Ignore her pain complaints, complete your assessment and set up a stress loading program for increasing weight bearing.

___ 3) Decide to focus on treating her pain before you can completely assess her or address her functional deficits.

Scott is a 49 year old former truck driver with a 15 year history of low back pain. He has had multiple laminectomies with subsequent rehabilitation in the past, and has completed vocational retraining. He last worked 4 months ago as a VCR repairman which was a job he held for less than a year. He is currently on workman’s compensation for a lifting injury sustained on that job. You observe Scott sitting comfortably in the waiting room reading but when you call him he grimaces, struggles to his feet and limps into the treatment area. Based on your observations, you surmise Scott:

___ 1) is in severe pain from sitting too long in the waiting room.

___ 2) is a symptom magnifier and is likely his pain will be out of proportion to his physical findings.

___ 3) is a malingerer and is faking his pain to get higher benefits.

__X__a. The person is experiencing increased pain.

____b. The person is experiencing increased anxiety or depression.

____ c. The person is requesting more staff attention.

____a. The treating physician.

____b. The person’s primary nurse.

__X__ c. The person experiencing pain.

____d. The physical therapist.

____ a. Because of diverse and mixed cultures in the United States, there are no longer cultural influences on the pain experience.

____ b. Therapists should use knowledge that has defined clearly the influence of pain on culture (e.g., Asian patients are generally stoic, Italians are expressive and exaggerate their pain.

Using this definition, how likely is it that opioid addiction will occur as a result if treating pain with opioid analgesics? Circle the number closest to what you consider the correct answer.

Stewart, a 12 year old boy with cerebral palsy, cries and complains about pain during his range of motion exercises in therapy. About 3 months ago, the clinic’s psychologist assessed Stewart as being depressed. You decide:

1. that Stewart’s pain is due to his depression and his pain complaints do not require any further intervention.

2. Ignoring Stewart’s pain complaint is the most appropriate strategy.

3. Stewart is complaining about pain in order to get sympathy and avoid doing the exercises.

Frank is 60 years old and this is his first day following total hip arthroplasty. As you enter his room, he smiles at you and continues talking and joking with his visitors. When asked to rate his pain on a scale of 0-10 (0 = no pain, 10 = worst pain) he rates his pain as 8.

A. Circle the number that represents your assessment of Frank’s pain.

___ 1) He has much less pain than he reports and he is medication seeking.

___ 2) He is distracted by his visitors and misrepresents his pain.

_X__ 3) He is using distraction effectively to deal with his pain.

___ 4) He is in denial about his illness.

Lisa is a 22 year old college athlete who had a car accident 8 months ago in which she sustained fractures to right tib/fib, clavicle and multiple facial lacerations. Her physician reports her fractures are healed and she is cleared for full weightbearing on both upper and lower extremity. Lisa is currently completing her college degree, but reports that because of the pain she is constantly tired and unable to be involved in any social campus life. She appears anxious as she ambulates into your office with a single crutch and an extremely guarded gait. She reports her pain as 9 on a 0-10 visual analogue scale. To begin your intervention you:

___ 1) Complete the subjective part of the evaluation and request further consultation with the physician prior to completing the objective testing.

___ 2) Ignore her pain complaints, complete your assessment and set up a stress loading program for increasing weight bearing.

___ 3) Decide to focus on treating her pain before you can completely assess her or address her functional deficits.

Scott is a 49 year old former truck driver with a 15 year history of low back pain. He has had multiple laminectomies with subsequent rehabilitation in the past, and has completed vocational retraining. He last worked 4 months ago as a VCR repairman which was a job he held for less than a year. He is currently on workman’s compensation for a lifting injury sustained on that job. You observe Scott sitting comfortably in the waiting room reading but when you call him he grimaces, struggles to his feet and limps into the treatment area. Based on your observations, you surmise Scott:

___ 1) is in severe pain from sitting too long in the waiting room.

___ 2) is a symptom magnifier and is likely his pain will be out of proportion to his physical findings.

___ 3) is a malingerer and is faking his pain to get higher benefits.