Deck 11: Drugs for Pain Management

Question 1

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."

Answer 1

"I think we need to ask the patient to rate his own pain."

Question 2

When assessing the blood pressure of a patient receiving pentazocine 30 mg orally for pain control two days after surgery, the reading is 166/100, which is much higher than the patient's presurgical blood pressure. What is your best action?

A)Assess the patient for other symptoms of addiction or dependency.
B)Give the next dose of the drug as prescribed.
C)Assess the patient for other cardiac changes.
D)Document the change as the only action.

Answer 2

Assess the patient for other cardiac changes.

Question 3

A patient being discharged to home is prescribed an oxycodone-acetaminophen combination for pain management. Which precaution is most important to teach this patient?

A)"If you still need this drug after 48 hours, notify your healthcare provider immediately."
B)"Be sure to drink plenty of water and eat foods high in fiber to prevent constipation."
C)"Always go to bed immediately after taking a dose of this drug."
D)"Avoid drinking alcohol while taking this drug."

Answer 3

"Avoid drinking alcohol while taking this drug."

Question 4

Indicate which analgesics are considered strong opioid agonists. (Select all that apply.)

A)Codeine
B)Fentanyl
C)Hydrocodone
D)Hydromorphone
E)Morphine
F)Oxycodone

Question 5

Which miscellaneous drugs are often prescribed to help with pain management? (Select all that apply.)

A)Antibiotics
B)Anticholinergics
C)Anticonvulsants
D)Antidepressants
E)Antihistamines
F)Anti-inflammatories

Question 6

A 10-month-old infant who weighs 22 lb is prescribed to receive acetaminophen 8 mg/kg by oral liquid. The drug on hand is acetaminophen liquid with a concentration of 70 mg/mL. How many mL is the correct dose for this patient? _____

Question 7

How does tramadol help control pain?

A)Binding to opioid receptors in the brain to reduce the perception of pain
B)Reducing the inflammatory substances at the site of injury to inhibit the actual cause of the pain
C)Binding to adrenergic receptors in the spinal cord preventing pain signals from reaching the brain
D)Inhibiting the generation of nerve impulses along the peripheral sensory nerves to alter the transmission of pain

Question 8

Why are natural and synthetic opioids considered "high-alert drugs?"

A)They have an increased risk for causing a patient harm if given in error.
B)They have a relatively high potential for addiction or abuse.
C)There is wide variation in the dosages between opioid types.
D)They can be given by a variety of routes.

Question 9

What types of drugs have the main purpose of relieving pain?

A)Anticholinergics
B)Antagonists
C)Analgesics
D)Agonists

Question 10

The postoperative orders for a large adult patient who has just arrived on your unit after major abdominal surgery reads morphine 15 mg IM every 4 to 6 h as needed for pain. What is the best schedule for pain relief during the first postoperative day for this patient?

A)Ask the patient every 4 to 6 h whether any drug for pain is needed.
B)Give the drug automatically every 4 h around the clock for the 24 h.
C)Give the drug automatically every 6 h around the clock for the first 24 h.
D)Wait until the patient rates the pain at an 8 or higher on a 0 to 10 pain rating scale before giving any dose of the prescribed drug.

Question 11

Which health problem is a severe adverse reaction to chronic acetaminophen therapy?

A)Asthma
B)Diabetes
C)Liver toxicity
D)Excessive bleeding

Question 12

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.

Question 13

You accidentally give a patient 30 mg orally of hydromorphone instead of the ordered hydrocodone. What is your first best action?

A)Notify the RN in charge immediately.
B)Induce the patient to vomit immediately.
C)Assess the patient's vital signs immediately.
D)Follow your agency's policy for documenting a drug error.

Question 14

Which drugs listed below help manage pain by acting at the tissue where pain starts and do not change the person's perception of pain? (Select all that apply.)

A)Acetaminophen
B)Antidepressants
C)Corticosteroids
D)NSAIDs
E)Opioid agonists
F)Skeletal muscle relaxants

Question 15

Which of the following assessments is most important to perform on a patient newly prescribed to take cyclobenzaprine for severe muscle pain?

A)Respiratory rate
B)Deep tendon reflexes
C)Blood pressure and heart rate
D)Muscle strength and coordination

Question 16

A patient is prescribed to receive 0.6 mg of hydromorphone intravenously. The drug on hand is hydromorphone 2 mg/mL. How many mL will you prepare to give this drug? _____

Question 17

Which patient should be assessed closely for complications of pain management with methocarbamol?

A)75-year-old man with benign prostatic hyperplasia
B)55-year-old woman with type 2 diabetes
C)34-year-old woman with a peanut allergy
D)17-year-old teenager who is near-sighted

Question 18

When you assess a patient's pain level an hour after giving 2 mg of hydromorphone intravenously, you find the patient sleeping with a respiratory rate of 10 breaths per minute. What is your best first action?

A)Give naloxone intravenously.
B)Document the finding as the only action.
C)Notify the healthcare provider immediately.
D)Assess the patient's oxygen saturation with pulse oximetry.

Question 19

A patient is prescribed Vicodin for pain, two tablets every 4 h. The tablets contain 2.5 mg of hydrocodone and 325 mg acetaminophen. In addition, this patient takes an over-the-counter cold preparation that contains 650 mg of acetaminophen. How much total acetaminophen does this represent in a 24-h period? _____