FNP 593 FINAL QUESTIONS AND ANSWERS
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 - CORRECT ANSWER-c. Pain is a subjective experience related to
actual or potential tissue damage.
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 - CORRECT ANSWER-b. Intra-abdominal metastases
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 - CORRECT ANSWER-d. Indomethacin/hydrocodone
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 - CORRECT ANSWER-d. None of the above
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. - CORRECT ANSWER-b. Prescribe a short-
acting opioid for breakthrough pain.
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." - CORRECT ANSWER-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."
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 - CORRECT ANSWER-c. 1:5
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?
the dose of short-acting oxycodone should be?
a. The short-acting dose should be 10% to 20% of the total 24-hour long-acting dose.
, b. The short-acting dose should be 40% to 50% of the total 24-hour long-acting dose.
c. The short-acting dose should be 10% to 20% of each long-acting dose.
d. The short-acting dose should be 40% to 50% of each long-acting dose. - CORRECT
ANSWER-a. The short-acting dose should be 10% to 20% of the total 24-hour long-
acting dose.
A patient is being switched from hydromorphone to methadone in an attempt to achieve
better pain
control. How much should the dose of methadone be reduced when calculating the
equianalgesic
dose of the two drugs?
a. 0%
b. 20%
c. 50%
d. 90% - CORRECT ANSWER-d. 90%
If a patient requires six rescue doses for breakthrough pain in a 24-hour period, what
would be an
appropriate intervention?
a. Increase the dose of the baseline long-acting medication.
b. Increase the dose of the rescue short-acting medication.
c. Switch to a different short-acting rescue medication.
d. Do nothing, because this is appropriate, and the patient's pain is well controlled. -
CORRECT ANSWER-a. Increase the dose of the baseline long-acting medication.
patient with bone metastases from prostate cancer inquires whether he is a candidate
for
radiopharmaceuticals. Which of the following conditions would exclude him as a
candidate?
a. Carnovsky performance status of 65
b. Pathologic fracture
c. Life expectancy of 5 months
d. Hypocalcemia - CORRECT ANSWER-b. Pathologic fracture
Which of the following is the best description of dyspnea?
a. An oxygen saturation of less than 90%
b. Respiratory rate greater than 24
c. A psychological state resulting in the feeling of air hunger
d. A subjective feeling of breathlessness - CORRECT ANSWER-d. A subjective feeling
of breathlessness
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 - CORRECT ANSWER-c. Pain is a subjective experience related to
actual or potential tissue damage.
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 - CORRECT ANSWER-b. Intra-abdominal metastases
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 - CORRECT ANSWER-d. Indomethacin/hydrocodone
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 - CORRECT ANSWER-d. None of the above
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. - CORRECT ANSWER-b. Prescribe a short-
acting opioid for breakthrough pain.
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." - CORRECT ANSWER-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."
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 - CORRECT ANSWER-c. 1:5
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?
the dose of short-acting oxycodone should be?
a. The short-acting dose should be 10% to 20% of the total 24-hour long-acting dose.
, b. The short-acting dose should be 40% to 50% of the total 24-hour long-acting dose.
c. The short-acting dose should be 10% to 20% of each long-acting dose.
d. The short-acting dose should be 40% to 50% of each long-acting dose. - CORRECT
ANSWER-a. The short-acting dose should be 10% to 20% of the total 24-hour long-
acting dose.
A patient is being switched from hydromorphone to methadone in an attempt to achieve
better pain
control. How much should the dose of methadone be reduced when calculating the
equianalgesic
dose of the two drugs?
a. 0%
b. 20%
c. 50%
d. 90% - CORRECT ANSWER-d. 90%
If a patient requires six rescue doses for breakthrough pain in a 24-hour period, what
would be an
appropriate intervention?
a. Increase the dose of the baseline long-acting medication.
b. Increase the dose of the rescue short-acting medication.
c. Switch to a different short-acting rescue medication.
d. Do nothing, because this is appropriate, and the patient's pain is well controlled. -
CORRECT ANSWER-a. Increase the dose of the baseline long-acting medication.
patient with bone metastases from prostate cancer inquires whether he is a candidate
for
radiopharmaceuticals. Which of the following conditions would exclude him as a
candidate?
a. Carnovsky performance status of 65
b. Pathologic fracture
c. Life expectancy of 5 months
d. Hypocalcemia - CORRECT ANSWER-b. Pathologic fracture
Which of the following is the best description of dyspnea?
a. An oxygen saturation of less than 90%
b. Respiratory rate greater than 24
c. A psychological state resulting in the feeling of air hunger
d. A subjective feeling of breathlessness - CORRECT ANSWER-d. A subjective feeling
of breathlessness
