Question 1

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:

Accepted Answer

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. 
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. B

Question 2

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:

Accepted Answer

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. 
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. B

Question 3

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:

Accepted Answer

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

Question 4

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:

Accepted Answer

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

Question 5

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:

Accepted Answer

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

Question 6

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.

Accepted Answer

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

Question 7

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:

Accepted Answer

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. 
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.

Exam 43: Analgesia and Pain Management

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 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 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 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 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 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 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:

Prescriptive Authority and Role Implementation: Tradition vs.Change

Historical Review of Prescriptive Authority: The Role of Nurses (NPs, CNMs, CRNAs, and CNSs)and Physician Assistants

General Pharmacokinetic and Pharmacodynamic Principles

Special Populations: Geriatrics

Special Populations: Pediatrics

Special Populations: Pregnant and Nursing Women

Over-the-Counter Medications

Complementary and Alternative Therapies

Establishing the Therapeutic Relationship

Practical Tips on Writing Prescriptions

Evidence-Based Decision Making and Treatment Guidelines

Design and Implementation of Patient Education

Dermatologic Agents

Eye, Ear, Throat, and Mouth Agents

Upper Respiratory Agents

Asthma and Chronic Obstructive Pulmonary Disease Medications

Hypertension and Miscellaneous Antihypertensive Medications

Coronary Artery Disease and Antianginal Medications

Heart Failure and Digoxin

Beta-Blockers

Calcium Channel Blockers

ACE Inhibitors and Angiotensin Receptor Blockers

Antiarrhythmic Agents

Antihyperlipidemic Agents

Agents that Act on Blood

Antacids and the Management of GERD

Histamine-2 Blockers and Proton Pump Inhibitors

Laxatives

Antidiarrheals

Antiemetics

Medications for Irritable Bowel Syndrome and Other Gastrointestinal Problems

Diuretics

Male Genitourinary Agents

Drugs for Urinary Incontinence and Urinary Analgesia

Acetaminophen

Aspirin and Nonsteroidal Antiinflammatory Drugs

Disease-Modifying Antirheumatic Drugs and Immune Modulators

Gout Medications

Osteoporosis Treatment

Muscle Relaxants

Medications for Attention Deficit/Hyperactivity Disorder

Medications for Dementia

Migraine Medications

Antiepileptics

Antiparkinson Agents

Antidepressants

Antianxiety and Insomnia Agents

Antipsychotics

Substance Abuse

Glucocorticoids

Thyroid Medications

Diabetes Mellitus Agents

Contraceptives

Hormone Replacement Therapy

Drugs for Breast Cancer

Principles for Prescribing Antiinfectives

Treatment of Specific Infections and Miscellaneous Antibiotics

Penicillins

Cephalosporins

Tetracyclines

Macrolides

Fluoroquinolones

Aminoglycosides

Sulfonamides

Antitubercular Agents

Antifungals

Antiretroviral Medications

Antiviral and Antiprotozoal Agents

The Immune System and Immunizations

Weight Management

Smoking Cessation

Vitamins and Minerals

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.