Deck 43: Analgesia and Pain Management

Question 1

A patient has been taking an opioid analgesic for chronic pain and tells the primary care nurse practitioner (NP)that the medication doesn't work as well anymore.The NP should suspect drug:

A) addiction.
B) tolerance.
C) modulation.
D) dependence.

Answer 1

tolerance.

Question 2

A patient who is a recovering alcoholic is preparing for surgery and expresses fears about using opioid analgesics postoperatively for pain.The primary care NP should tell the patient:

A) that opioids should not be used.
B) to take a very low dose of the opioid.
C) that nonsteroidal antiinflammatory drugs will be the only safe option.
D) that opioids are safe when taken as directed.

Answer 2

that opioids are safe when taken as directed.

Question 3

A patient has pain caused by a chronic condition.The patient is reluctant to take opioids because of a fear of addiction.The primary care NP should tell the patient that opioids:

A) carry a high risk of psychological dependence when used long-term.
B) will help to improve the patient's functional outcomes and quality of life.
C) will eventually become ineffective for treating pain when used over a long period.
D) may require switching from one type of opioid to another to prevent tolerance over time.

Answer 3

will help to improve the patient's functional outcomes and quality of life.

Question 4

A patient has been taking intramuscular (IM)meperidine 75 mg every 6 hours for 3 days after surgery.When the patient is discharged from the hospital,the primary care NP should expect the patient to receive a prescription for _____ mg orally every _____ hours.

A) hydrocodone 30; 6
B) hydrocodone 75; 6
C) meperidine 300;12
D) meperidine 75; 6

Question 5

A patient is diagnosed with a condition that causes chronic pain.The primary care NP prescribes an opioid analgesic and should instruct the patient to:

A) wait until the pain is at a moderate level before taking the medication.
B) take the medication at regular intervals and not just when pain is present.
C) start the medication at higher doses initially and taper down gradually.
D) take the minimum amount needed even when pain is severe to avoid dependency.

Question 6

A patient has been taking an opioid analgesic for 2 weeks after a minor outpatient procedure.At a follow-up clinic visit,the patient tells the primary care NP that he took extra doses for the past 2 days because of increased pain and wants an early refill of the medication.The NP should suspect:

A) dependence.
B) drug addiction.
C) possible misuse.
D) increasing pain.

Question 7

A patient who is taking an antibiotic to treat bronchitis reports moderate rib pain associated with frequent coughing.The primary care NP should consider prescribing:

A) morphine.
B) hydrocodone.
C) hydromorphone.
D) oxycodone CR.