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Exam & Evaluation (Analgesic Drugs and Pain Management)
 
Questions: Please respond to following statements.

1 All of the following events can result from under treating pain except:
  catabolism and delayed wound healing
  stimulation of the bodyís immune response
  respiratory impairment
  anxiety, depression, and sleep deprivation
2 Which of the following patients are at high risk of having their pain under treated?
  Infants, children, and adults who are developmentally delayed
  Patients whose language and/or cultural backgrounds differ from their healthcare providers
  Patients who are cognitively impaired or emotionally disturbed
  All of the above
3 Which of the following terms is used to describe pain caused by abnormal processing of sensory input in the peripheral or central nervous systems?
  Nociceptive pain
  Chronic non-malignant pain
  Malignant pain
  Neuropathic pain
4 Which of the following terms is used to describe pain that is caused by the normal processing of stimuli that occurs in response to tissue damage, such as trauma or surgery?
  Nociceptive pain
  Chronic non-malignant pain
  Malignant pain
  Neuropathic pain
5 The most serious side effect of acetaminophen is:
  renal toxicity
  hepatotoxicity
  cardiotoxicity
  neurotoxicity
6 Which of the following patients is at greatest risk of acetaminophen toxicity, even at recommended therapeutic doses?
  A patient who abuses alcohol
  A patient who is fasting or malnourished
  A patient is who is taking other drugs that can cause liver damage
  All of the above
7 NSAIDs relieve pain by blocking the effects of:
  prostaglandins
  histamine
  serotonin
  substance P
8 Which of the following NSAIDs is available for parenteral administration?
  Ketoprofen
  Ketorolac
  Meloxicam
  Sulindac
9 The most serious side effect of NSAIDs affecting the gastrointestinal system is:
  dyspepsia
  nausea
  gastric ulceration
  diarrhea
10 The (adult) maximum daily dose of acetaminophen is:
  400 mg
  1000 mg
  2000 mg
  4000 mg
11 To avoid gastrointestinal side effects from NSAIDs, patients should be advised to:
  lower the dose or change to another NSAID
  take an enteric form of an NSAID
  take each NSAID dose with food or a large glass of water
  all of the above
12 Which of the following patients is at higher than normal risk of experiencing life-threatening complications from NSAIDs?
  A patient with a history of a gastric ulcer
  Patients over age 60
  A patient who is taking high doses of an NSAID.
  All of the above
13 An example of a selective NSAID is:
  ibuprofen
  indomethicin
  celecoxib
  naproxyn
14 To prevent NSAID related gastrointestinal complications, patients may be given:
  Meperidine
  Oxycontin
  Misoprostal
  Prednisone
15 Which of the following statements about morphine is accurate?
  Morphine has no analgesic ceiling
  Morphine relieves pain by binding to mu receptors in the nervous system
  Morphine is the opioid most often used to treat cancer pain
  All of the above
16 The most common side effect of opioid analgesics is:
  constipation
  respiratory despression
  sedation
  nausea
17 Which of the following opioid drugs can relieve pain for between 8 and 12 hours with a single dose?
  Tramadol
  Fentanyl
  Hydromorphone
  MS Contin
18 The major side effect limiting the effectiveness of meperidine is:
  renal toxicity
  respiratory depression
  neurotoxicity
  potential for addiction
19 Which of the following patients is at high risk for meperidine toxicity?
  A patient who receives meperidine for more than 48 hours
  A patient with pre-existing renal or central nervous system disease
  A patient who receives more than 600 mg in a 24 hour period
  All of the above
20 All of the following statements about opioids and respiratory depression are accurate except:
  Patients should be monitored closely when starting opioids or changing to a new drug or dosage.
  The patients at highest risk for respiratory depression are opioid naive patients.
  A sedation scale should be used to monitor sedation levels.
  Respiratory depression occurs before sedation.
21 Which of the following opioid side effects is more common in patients receiving opioids via an intraspinal route?
  constipation
  nausea
  itching
  sedation
22 A pattern of compulsive drug use characterized by continued craving for an opioid, and the need to use the drug for an effect other than pain relief, is known as:
  physical dependency
  addiction
  tolerance
  opioid naivete
23 The only opioid side effect for which tolerance does not develop is:
  respiratory depression
  sedation
  nausea
  constipation
24 The risk of clinically significant respiratory depression is increased when a patient receives an opioid via the _______________route.
  intravenous
  intramuscular
  epidural
  oral
25 Tolerance to opioid associated respiratory depression generally occurs within ____ days of regularly scheduled therapy.
  2
  3
  5
  9
26 A patient who has been experiencing adequate pain relief with oral morphine for 3 weeks is now complaining of a significant increase in pain. In this situation, the patient should be assessed for:
  progressive disease
  new pathology
  missed doses
  all of the above
27 A side effect common to both tricyclic antidepressants and selective serotonin reuptake inhibitors (SSRIs) is:
  sedation
  orthostatic hypotension
  mental clouding
  sexual dysfunction
28 Which of the following are proposed explanations for how hypnosis reduces pain levels in clients?
  Hypnosis activates the pain-inhibitory pathway from the brain to the spinal cord
  It may act on parts of the brain that shift a patientís attention away from the pain
  It reduces the automatic muscle tightening associated with a pain response through relaxation.
  All of the above (correct)
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