Exam (elaborations)

NR 601 / NR601 Primary Care of the Maturing and Aged Family Practicum Week 8 (Ethical Issues and End-of-Life Care) |Grade A| Quiz Bank | LATEST, 2020/2021 | Chamberlain college

NR 601 / NR601 Primary Care of the Maturing and Aged Family Practicum Week 8 Quiz Bank | LATEST, 2020/2021 | Chamberlain college Palliative care and pain management ____ 1. A patient had a transdermal fentanyl patch placed 2 hours ago and is not getting any pain relief. What would be the most appropriate intervention? a. Remove the current patch and replace with a new fentanyl patch at a higher dose. b. Prescribe a short-acting opioid for breakthrough pain. c. Remove the patch and switch to a different intravenous opioid. d. Tell the patient not to worry, as it takes about 12 hours for the patch’s effects to be felt, and he will have relief at that time. ____ 2. A patient is preparing to be discharged to home with hospice. She is on a morphine patient-controlled analgesia (PCA) in the hospital. She is concerned as to whether she can stay on her morphine PCA at home even when she is not able to give herself boluses. What would be an appropriate response from the clinician? a. “We are unable to prescribe a PCA for use at home. If you are comfortable on the PCA, you should remain in the hospital.” b. “It would be possible for your nurse or another trained family member to activate the dosing button when you are unable to do so.” c. “A PCA is not an appropriate method of pain medication delivery once you are unable to use the dosing button. I will switch you to another form of pain control.” d. “You should not be concerned about your pain management at home. It will be taken care of for you.” ____ 3. A patient taking PO hydromorphone for pain control has developed dysphagia. The clinician decides to switch the patient to IV hydromorphone. What ratio of IV:PO hydromorphone does the clinician need to know to calculate the proper dose? a. 1:1 b. 1:2 c. 1:5 d. 1:7 4. Which of the following statements is true regarding pain? a. If a patient complains of pain but has no physical signs, he or she is most likely exhibiting drug-seeking behaviors. b. Acute pain is more intense and severe than chronic pain. c. Pain is a subjective experience related to actual or potential tissue damage. d. All of the above ____ 5. Which of the following would be a cause of visceral pain? a. Bone metastases b. Intra-abdominal metastases c. Musculoskeletal inflammation d. Postsurgical incisional pain ____ 6. According to the World Health Organization’s analgesic ladder, which drug combination would be most appropriate in an opiate-naïve patient who presents with moderate pain? a. Ibuprofen/imipramine b. Naproxen/morphine c. Aspirin/fentanyl d. Indomethacin/hydrocodone ____ 7. A 75-year-old man is being treated as an outpatient for metastatic prostate cancer. Which of the following statements is true regarding the management of pain with opioids in the elderly? a. Opioids with a long half-life, such as methadone, are a good choice, because they stay in the system longer, and patients do not have to remember to take multiple pills. b. Serum creatinine is the best measurement of renal function in the elderly and should be done prior to the initiation of treatment with opioids. c. Renal clearance of medications is faster in the elderly, so higher dosages of medications are needed to adequately control pain. d. None of the above ____ 8. A patient is receiving long-acting oxycodone for pain control. The clinician thinks that he also will benefit from a short-acting oxycodone for breakthrough pain. How will the clinician figure out what