Pain Management Practice Exam ACTUAL
QUESTIONS AND CORRECT ANSWERS
B
Sedation is a concern because it may indicate that the patient is experiencing opioid-related side
effects. Advancing sedation may indicate that the patient may progress to respiratory depression. -
CORRECT ANSWER Which of the following signs or symptoms in an opioid-naive patient is
of greatest concern to the nurse when assessing the patient 1 hour after administering an opioid?
A. Oxygen saturation of 95%
B. Difficulty arousing the patient
C. Respiratory rate of 10 breaths/min
D. Pain intensity rating of 5 on a scale of 0 to 10
C
Constipation is a common opioid-related side effect, and patients do not become tolerant to it. -
CORRECT ANSWER A patient is being discharged home on an around-the-clock (ATC)
opioid for chronic back pain. Because of this order, the nurse anticipates an order for which class of
medication?
A. Opioid antagonists
B. Antiemetics
C. Stool softeners
D. Muscle relaxants
B
Long-acting or sustained-release opioids are dosed on a scheduled basis, not prn, to provide a base of
continuous opioid analgesia. - CORRECT ANSWER A new medical resident writes an order
for oxycodone CR (Oxy Contin) 10 mg PO q2h prn. Which part of the order does the nurse question?
,A. The drug
B. The time interval
C. The dose
D. The route
C
The Food and Drug Administration (FDA) recommends a maximum daily dose of 4 g of
acetaminophen, and many authorities believe that the maximum daily dose should be lower (3000 to
3200 mg/day) in the outpatient setting to reduce the risk of hepatotoxicity. - CORRECT ANSWER
The nurse reviews a patient's medical administration record (MAR) and finds that the patient
has received acetaminophen 2Gs, two tablets PO every 3 hours for the past 3 days. What concerns the
nurse the most?
A. The patient's level of pain
B. The potential for addiction
C. The amount of daily acetaminophen
D. The risk for gastrointestinal bleeding
D
The common symptoms of opioid withdrawal that are associated with physical dependence may
develop when an opioid is withdrawn rapidly. Symptoms include shaking chills, abdominal cramps,
and joint pain. - CORRECT ANSWER A patient with chronic low back pain who took an
opioid around-the-clock (ATC) for the past year decided to abruptly stop the medication for fear of
addiction. He is now experiencing shaking chills, abdominal cramps, and joint pain. The nurse
recognizes that this patient is experiencing symptoms of:
A. Opioid toxicity.
B. Opioid tolerance.
C. Opioid addiction.
D. Opioid withdrawal.
A
, Patient's self-report of pain. Sleep is not an indicator of pain intensity. Unless a patient is stimulated, it
is difficult to distinguish sleep from sedation, which may occur as a side effect of the opioid. Patients
in pain sometimes sleep from exhaustion. - CORRECT ANSWER A patient rates his pain as a
6 on a scale of 0 to 10, with 0 being no pain and 10 being the worst pain. The patient's wife says that
he can't be in that much pain since he has been sleeping for 30 minutes. Which is the most accurate
resource for assessing the pain?
A. Patient's self-report
B. Behaviors
C. Surrogate (wife) report
D. Vital sign changes
A
A pain assessment is still needed because sleep in a postoperative patient cannot be used as an
assessment of a patient's pain level. Sleep may result from sedating effects of medication, but
analgesia may not be present. It is important to wake and assess the patient to ensure that the pain is
controlled and the patient is not overly sedated from the medication (a sign of impending respiratory
depression). - CORRECT ANSWER A postoperative patient currently is asleep. Therefore the
nurse knows that:
A. The sedative administered may have helped him sleep, but it is still necessary to assess pain.
B. The intravenous (IV) pain medication given in recovery is relieving his pain effectively.
C. Pain assessment is not necessary.
D. The patient can be switched to the same amount of medication by the oral route.
A, C, E
The safety of PCA is based on the fact that it requires an awake patient to activate the button. The
safety is compromised when someone else pushes the button for the patient. A limit on the number of
doses per hour or 4-hour intervals may be set. Opioids (morphine PCA) are intended to provide
analgesia; drowsiness is an undesirable potential side effect of opioids, and the PCA should only be
used for analgesia. - CORRECT ANSWER Which of the following instructions is crucial for
the nurse to give to both family members and the patient who is about to be started on a patient-
controlled analgesia (PCA) of morphine? (Select all that apply.)
QUESTIONS AND CORRECT ANSWERS
B
Sedation is a concern because it may indicate that the patient is experiencing opioid-related side
effects. Advancing sedation may indicate that the patient may progress to respiratory depression. -
CORRECT ANSWER Which of the following signs or symptoms in an opioid-naive patient is
of greatest concern to the nurse when assessing the patient 1 hour after administering an opioid?
A. Oxygen saturation of 95%
B. Difficulty arousing the patient
C. Respiratory rate of 10 breaths/min
D. Pain intensity rating of 5 on a scale of 0 to 10
C
Constipation is a common opioid-related side effect, and patients do not become tolerant to it. -
CORRECT ANSWER A patient is being discharged home on an around-the-clock (ATC)
opioid for chronic back pain. Because of this order, the nurse anticipates an order for which class of
medication?
A. Opioid antagonists
B. Antiemetics
C. Stool softeners
D. Muscle relaxants
B
Long-acting or sustained-release opioids are dosed on a scheduled basis, not prn, to provide a base of
continuous opioid analgesia. - CORRECT ANSWER A new medical resident writes an order
for oxycodone CR (Oxy Contin) 10 mg PO q2h prn. Which part of the order does the nurse question?
,A. The drug
B. The time interval
C. The dose
D. The route
C
The Food and Drug Administration (FDA) recommends a maximum daily dose of 4 g of
acetaminophen, and many authorities believe that the maximum daily dose should be lower (3000 to
3200 mg/day) in the outpatient setting to reduce the risk of hepatotoxicity. - CORRECT ANSWER
The nurse reviews a patient's medical administration record (MAR) and finds that the patient
has received acetaminophen 2Gs, two tablets PO every 3 hours for the past 3 days. What concerns the
nurse the most?
A. The patient's level of pain
B. The potential for addiction
C. The amount of daily acetaminophen
D. The risk for gastrointestinal bleeding
D
The common symptoms of opioid withdrawal that are associated with physical dependence may
develop when an opioid is withdrawn rapidly. Symptoms include shaking chills, abdominal cramps,
and joint pain. - CORRECT ANSWER A patient with chronic low back pain who took an
opioid around-the-clock (ATC) for the past year decided to abruptly stop the medication for fear of
addiction. He is now experiencing shaking chills, abdominal cramps, and joint pain. The nurse
recognizes that this patient is experiencing symptoms of:
A. Opioid toxicity.
B. Opioid tolerance.
C. Opioid addiction.
D. Opioid withdrawal.
A
, Patient's self-report of pain. Sleep is not an indicator of pain intensity. Unless a patient is stimulated, it
is difficult to distinguish sleep from sedation, which may occur as a side effect of the opioid. Patients
in pain sometimes sleep from exhaustion. - CORRECT ANSWER A patient rates his pain as a
6 on a scale of 0 to 10, with 0 being no pain and 10 being the worst pain. The patient's wife says that
he can't be in that much pain since he has been sleeping for 30 minutes. Which is the most accurate
resource for assessing the pain?
A. Patient's self-report
B. Behaviors
C. Surrogate (wife) report
D. Vital sign changes
A
A pain assessment is still needed because sleep in a postoperative patient cannot be used as an
assessment of a patient's pain level. Sleep may result from sedating effects of medication, but
analgesia may not be present. It is important to wake and assess the patient to ensure that the pain is
controlled and the patient is not overly sedated from the medication (a sign of impending respiratory
depression). - CORRECT ANSWER A postoperative patient currently is asleep. Therefore the
nurse knows that:
A. The sedative administered may have helped him sleep, but it is still necessary to assess pain.
B. The intravenous (IV) pain medication given in recovery is relieving his pain effectively.
C. Pain assessment is not necessary.
D. The patient can be switched to the same amount of medication by the oral route.
A, C, E
The safety of PCA is based on the fact that it requires an awake patient to activate the button. The
safety is compromised when someone else pushes the button for the patient. A limit on the number of
doses per hour or 4-hour intervals may be set. Opioids (morphine PCA) are intended to provide
analgesia; drowsiness is an undesirable potential side effect of opioids, and the PCA should only be
used for analgesia. - CORRECT ANSWER Which of the following instructions is crucial for
the nurse to give to both family members and the patient who is about to be started on a patient-
controlled analgesia (PCA) of morphine? (Select all that apply.)
