NR565 WEEK 2 QUESTIONS WITH ACCURATE ANSWERS
12 essential considerations for safe pain management correct answer 1. Opioids
are not first-line therapy
2. Establish goals for pain & function
3. Discuss risk & benefits
4. Use IR opioids when starting
5. Use the lowest effective dose
6. Prescribe short durations for acute pain
7. Evaluate benefits & harms frequently
8. Use strategies to mitigate risk
9. Review PDMP data
10. Use urine drug testing
11. Avoid concurrent opioid & benzodiazepine prescribing
12. Offer tx for opioid disorder
A follow-up visit within two weeks is appropriate for which of the following
reasons? Select all that apply.
a. Providers should reevaluate benefits and harms with patients within 1 to 4
weeks of starting opioid therapy or a dose escalation
b. This patient's new dosage is above the 50 MME/day threshold and therefore
should be closely monitored
c. It is less likely that continued opioid therapy will be effective for this patient if
she is not receiving relief 1 month after starting an opioid
d. Reassessment of pain and function within 1 month of initiating opioids provides
an opportunity to minimize risks of long-term opioid use correct answer a c d
,A new patient is suffering from chronic lower back pain. For his pain, he takes ER
oxycodone 30 mg BID. What is the daily MME that your patient has been
prescribed? correct answer 90 MME per day total
Rationale:
The first step is to determine the total daily amount of each prescription.
30 mg X 2 = 60 mg oxycodone/day
Oxycodone has a conversion factor of 1.5.
60 mg X 1.5 = 90 MME per day total
Dosages >=50 MME per day increase risk for opioid-related harms.
Acetaminophen correct answer -Drug Indication:
• Mild to moderate pain
-Dosing Considerations: Dose appropriately
• Mild pain: 325 to 650 mg q4-6 hrs
• Children: 10/kg/mg every 4 to 8 hours
• Moderate pain: 500 to 1,000 mg q4-6 hrs drugging indication used for fever
• Max: 4 gms/ 24 hrs use for fever &/or pain
• Children: 15 mg/kg/dose
-Adverse Drug Reactions:
• Usually well-tolerated
• Hepatic injury with overdose
• Renal disease with chronic use
-Drug interactions:
, • alcohol
-Patient Education:
• Do not exceed maximum dose (4gm/24 hours)
-Monitoring:
• Monitor for effectiveness. May need to add an opioid agonist
-Drug Interaction:
• None
Acute pain has an occurrence of fewer than __________ correct answer three
months
-often precipitated by trauma & acute medical conditions or tx
Applying CDC's Guidelines for Prescribing Opioids correct answer -use a validated
assessment tool to establish a baseline for evaluating the effectiveness of tx
-establish criteria for initiating opioids & clarify how therapy will be discontinued
if an opioid is prescribed & the risks start to outweigh the benefits
-calculate the morphine milligram equivalent (MME) to help dose medications
appropriately and refer to pain specialists as indicated.
APPLYING CDC'S GUIDELINES FOR PRESCRIBING OPIOIDS: ASSESSING AND
ADDRESSING OPIOID USE DISORDER (OUD) correct answer -OUD is diagnosed by
DSM-5 criteria
-Medication assisted therapy (MAT) is available for OUD
• Buprenorphine, naltrexone, or methadone
• Consider offering naloxone if indicated (i.e. concurrent benzodiazepine use)
12 essential considerations for safe pain management correct answer 1. Opioids
are not first-line therapy
2. Establish goals for pain & function
3. Discuss risk & benefits
4. Use IR opioids when starting
5. Use the lowest effective dose
6. Prescribe short durations for acute pain
7. Evaluate benefits & harms frequently
8. Use strategies to mitigate risk
9. Review PDMP data
10. Use urine drug testing
11. Avoid concurrent opioid & benzodiazepine prescribing
12. Offer tx for opioid disorder
A follow-up visit within two weeks is appropriate for which of the following
reasons? Select all that apply.
a. Providers should reevaluate benefits and harms with patients within 1 to 4
weeks of starting opioid therapy or a dose escalation
b. This patient's new dosage is above the 50 MME/day threshold and therefore
should be closely monitored
c. It is less likely that continued opioid therapy will be effective for this patient if
she is not receiving relief 1 month after starting an opioid
d. Reassessment of pain and function within 1 month of initiating opioids provides
an opportunity to minimize risks of long-term opioid use correct answer a c d
,A new patient is suffering from chronic lower back pain. For his pain, he takes ER
oxycodone 30 mg BID. What is the daily MME that your patient has been
prescribed? correct answer 90 MME per day total
Rationale:
The first step is to determine the total daily amount of each prescription.
30 mg X 2 = 60 mg oxycodone/day
Oxycodone has a conversion factor of 1.5.
60 mg X 1.5 = 90 MME per day total
Dosages >=50 MME per day increase risk for opioid-related harms.
Acetaminophen correct answer -Drug Indication:
• Mild to moderate pain
-Dosing Considerations: Dose appropriately
• Mild pain: 325 to 650 mg q4-6 hrs
• Children: 10/kg/mg every 4 to 8 hours
• Moderate pain: 500 to 1,000 mg q4-6 hrs drugging indication used for fever
• Max: 4 gms/ 24 hrs use for fever &/or pain
• Children: 15 mg/kg/dose
-Adverse Drug Reactions:
• Usually well-tolerated
• Hepatic injury with overdose
• Renal disease with chronic use
-Drug interactions:
, • alcohol
-Patient Education:
• Do not exceed maximum dose (4gm/24 hours)
-Monitoring:
• Monitor for effectiveness. May need to add an opioid agonist
-Drug Interaction:
• None
Acute pain has an occurrence of fewer than __________ correct answer three
months
-often precipitated by trauma & acute medical conditions or tx
Applying CDC's Guidelines for Prescribing Opioids correct answer -use a validated
assessment tool to establish a baseline for evaluating the effectiveness of tx
-establish criteria for initiating opioids & clarify how therapy will be discontinued
if an opioid is prescribed & the risks start to outweigh the benefits
-calculate the morphine milligram equivalent (MME) to help dose medications
appropriately and refer to pain specialists as indicated.
APPLYING CDC'S GUIDELINES FOR PRESCRIBING OPIOIDS: ASSESSING AND
ADDRESSING OPIOID USE DISORDER (OUD) correct answer -OUD is diagnosed by
DSM-5 criteria
-Medication assisted therapy (MAT) is available for OUD
• Buprenorphine, naltrexone, or methadone
• Consider offering naloxone if indicated (i.e. concurrent benzodiazepine use)
