Chapter 11: Drugs for Pain Management Vislosky: Introduction to Clinical Pharmacology, 9th Edition

MULTIPLE CHOICE 1. What types of drugs have the main purpose of relieving pain? a. Anticholinergics b. Antagonists c. Analgesics d. Agonists ANS: C Analgesics have the specific purpose of relieving pain either by changing the patient’s perception of pain or by reducing painful stimulation at its source. Although some analgesics are opioid agonists, the term agonist is not specific for a pain-relieving drug. DIF: Cognitive Level: Knowing REF: p. 213 2. The healthcare provider asks you to rate a patient’s postoperative pain. What is your best response? a. “He is asleep now, so his pain level is acceptable.” b. “I think we need to ask the patient to rate his own pain.” c. “His wife says he can still feel the incision when he turns or coughs.” d. “Since he received 15 mg of morphine an hour ago, his pain is probably minimal.” ANS: B Pain is always a subjective experience; that is, pain is a sensation the patient feels and that cannot be felt or measured by someone else. Accurate pain assessment is best measured by the patient, if he or she is not unconscious or confused. Being asleep does not mean that pain is relieved. DIF: Cognitive Level: Applying REF: p. 210 3. You are caring for a patient who is paralyzed from the waist down and has a large open wound on her right heel. When asked about her pain in that foot, she tells you it is a 0 on a 0 to 10 pain rating scale. What does this response indicate? a. The paralysis prevents her brain from perceiving the pain. b. The patient has chronic pain that does not trigger the stress response. c. She is afraid of becoming addicted if she takes the prescribed drug too often. d. This patient’s acute pain has been effectively managed by the prescribed pain drug. ANS: A Pain is felt or perceived in the brain rather than in the body area where it occurs. When a body part is injured, this injury stimulates pain nerve endings in the thumb that then send (transmit) electrical nerve impulses as a signal from the injury site along nerves to the spinal cord. At the spinal cord, the original signal is transferred to special pain nerve tracts up the spinal cord to the area of the brain where pain in that body site is perceived. Paralysis from the waist down in the spinal cord prevents the transmission of a pain signal from the foot so that pain is not perceived no matter how deep or bad the heel wound is