Self-Assessment Answers for Section 1: Opioid Analgesics in the Management of Acute and Chronic Pain
1 . Which type of pain is characterized by aberrant signal processing in the peripheral or central nervous system? 2 . What term describes the phenomenon of pain being caused by a normally innocuous stimulus such as light touch? 3 . What is the likely physiological basis for opioid-induced hyperalgesia? 4 . Which statement best summarizes the CDC finding about opioids for chronic pain? 5 . Opioid pain medications should not be combined with _______________? 6 . Which of the following topics should be routinely covered as part of patient education about opioid analgesics? 7 . Although the absolute risk for inducing opioid misuse or addiction due to prescriptions of opioids for acute pain is low, the large number of such prescriptions means that approximately how many people are at risk each year? 8 . Non-pharmacologic methods for treating acute pain are appropriate for which phase of healing? 9 . Long-acting (LA) and extended-release (ER) formulations of opioids should not be used for __________________? 10 . What is one suggestion for a way to augment opioid treatment in order to help improve a patient’s pain and function? 11 . Which of the following is an example of a functional goal? 12 . According to the Centers for Disease Control and Prevention, what amount of opioid analgesic is appropriate for most painful conditions? 13 . Which class of patients might require more frequent or intense monitoring when prescribed an opioid analgesic? 14 . Which of the following characteristics is typical of patients who are addicted to a pain medication? 15 . Most experts agree that opioid dosages should not be increased to _______ without careful justification based on diagnosis and on an individualized assessment of benefits and risks. 16 . The availability of naloxone was increased in 2019 by an FDA decision that ____________. 17 . Which of the following medications is a full mu-receptor agonist used to treat Opioid Use Disorder? 18 . Which of the following medications can be self-administered by patients with a medication obtained from a regular pharmacy? 19 . For which of the following must clinicians obtain a special waiver from the DEA prior to being able to prescribe the medication? 20 . Which of the following is a possible reason for prescribing naloxone to a patient who has been prescribed an opioid analgesic?
Self-Assessment Answers for Section 2: Managing Acute Pain
21 . Roughly how many people every year are at risk for opioid misuse or addiction due to their being prescribed opioid analgesics for acute pain conditions? 22 . Opioid-induced hyperalgesia is most likely the result of _______________? 23 . DIRE, ORT, and SOAPP are examples of tools for assessing what patient characteristic? 24 . A study found that surgeons prescribed a mean of 24 pills (standardized to 5 mg oxycodone) for post-surgical pain. How many pills did patients actually use? 25 . What amount of opioid analgesic has been recommended by the Centers for Disease Control and Prevention as appropriate for most painful conditions? 26 . During which phase of healing from acute conditions are non-pharmacologic methods most appropriate? 27 . Combination products for pain control join an opioid with a _________________. 28 . Which of the following is not an example of multimodal therapy for acute pain? 29 . For which type of pain should long-acting or extended-release opioid analgesics not be used __________________? 30 . Which of the following is not a topic that should be routinely covered as part of patient education about opioid analgesics?
Self-Assessment Answers for Section 3: Suicide Assessment & Prevention
31 . In 2017, what was the rank of suicide as a cause of death in the United States? 32 . About how much higher is the suicide rate among Veterans as compared to the non-Veteran population? 33 . The three levels of strategies for suicide prevention are _________, _________, and ____________. 34 . What is the name of the conceptual model that frames suicide risk as a balance between protective factors and risk factors at different levels? 35 . Which of the following is a tenet of the Patient-Centered Care model for suicide prevention? 36 . What is one of the advantages of adopting a Patient-Centered Care model of suicide prevention? 37 . Which of the following is a true statement about suicide risk? 38 . Which of the following is a true statement about suicide risk in Veteran and non-Veteran populations? 39 . Which of the following is a direct warning sign of acute suicide risk? 40 . Which of the following is true about asking patients about suicide or suicidal thinking? 41 . When attempting to elicit suicidal ideation from a patient, it is best if clinicians ________________? 42 . What would be an appropriate course of action for a patient determined to be at an intermediate level of acute suicide risk? 43 . Which non-pharmacological treatment modality has been shown to reduce the risk of suicide attempts by helping patients identify and change problematic thinking and behavioral patterns? 44 . Which non-pharmacological treatment modality focuses on helping patients cope with stressful life experiences by actively working on difficulties? 45 . Which pharmacological therapy has been shown to improve acute suicidal symptoms for up to a week after only a single dose? 46 . Which pharmacological therapy has been shown to reduce suicidal behaviors in patients with schizophrenia or schizoaffective disorder? 47 . What post-acute care modality has been shown to reduce the rate of suicide death following a psychiatric hospitalization for suicidal ideation/attempt? 48 . Which therapeutic modality may allow treatment for suicidal thoughts and behaviors regardless of geographic location or access to traditional care facilities? 49 . Which kind of suicide-prevention initiative has not been found to improve population-level suicide rates, either in the general U.S. population or among Veterans? 50 . In an effort to dispel stigma and foster a culture of support throughout the Department of Defense, which policy has been put into place?
Self-Assessment Answers for Section 4: Preventing Clinician Burnout
51 . What is the prevalence of burnout among physicians as in the United States when assessed using a rigorous definition of burnout? 52 . The estimated prevalence of suicidal ideation among physicians is approximately ____________? 53 . The prevalence of suicide is significantly higher among what subpopulation of physicians, compared to the general population? 54 . Which of the following statements most accurately describes an important aspect of burnout among physicians? 55 . Which component of physician workload has been shown to be particularly taxing and associated with higher levels of burnout? 56 . According to one study, for every hour physicians spend in face-to-face time with patients, how many hours do they spend using electronic health records or doing desk work? 57 . Roughly what percentage of patients could be classified as “difficult” and, hence, contribute to physician stress and emotional exhaustion? 58 . Although income levels are not associated with burnout, what aspect of physician compensation does appear to increase the risk of burnout? 59 . Which of the following is an example of systems-level intervention to help reduce physician burnout? 60 . What was the goal of the AMA’s Joy in Medicine Recognition Program? 61 . Which of the following is a component of the Patient-Centered Medical Home model that could help reduce burnout? 62 . Which type of technology has been the focus of literature about the relationship of physician burnout and technology? 63 . What occurred in 2009 that spurred the adoption of electronic health records across the country? 64 . How much time do primary care physicians typically spend using electronic health records? 65 . Which of the following is an example of an artificial-intelligence-based tool to facilitate better provider/patient encounters? 66 . What is one proposed solution to the problem posed by the increasing time demands of electronic health records? 67 . What individual-based practice has been shown to be an independent predictor of lower risk of burnout and higher quality of life among medical students? 68 . What is the name of an intervention consisting of group trainings for doctors about using patient-centered approaches with the aim of improving the doctor-patient relationship? 69 . _______________ is an example of a discussion-group intervention aimed at reducing symptoms of burnout among internal medicine physicians. 70 . A web-based Cognitive Behavioral Therapy program has been shown to _________________?