Chapter 11: Drugs for Pain Management
Visovsky: Introduction to Clinical Pharmacology, 9 th Edition
MULTIPLE CHOICE
1. Whattypesofdrugshavethemainpurposeofrelievingpain?
a. Anticholinergics
b. Antagonists
c. Analgesics
d. Agonists
ANS: C
Analgesicshavethespecificpurposeofrelievingpaineitherbychangingthepatient’sperceptionofp
ainorbyreducingpainfulstimulationatitssource.Althoughsomeanalgesicsareopioidagonists,the
termagonistisnotspecificforapain-relievingdrug.
DIF: CognitiveLevel:Knowing REF: p.213
2. Thehealthcareproviderasksyoutorateapatient’spostoperativepain.Whatisyourbestresponse?
a. “Heisasleepnow,sohispainlevelisacceptable.”
b. “Ithinkweneedtoaskthepatienttoratehisownpain.”
c. “Hiswifesayshecanstillfeeltheincisionwhenheturnsorcoughs.”
d. “Sincehereceived15mgofmorphineanhourago,hispainisprobablyminimal.”
ANS: B
Painisalwaysasubjectiveexperience;thatis,painisasensationthepatientfeelsandthatcannotbefelt
ormeasuredbysomeoneelse.Accuratepainassessmentisbestmeasuredbythepatient,ifheorsheisn
otunconsciousorconfused.Beingasleepdoesnotmeanthatpainisrelieved.
DIF: CognitiveLevel:Applying REF: p.210
3.
Youarecaringforapatientwhoisparalyzedfromthewaistdownandhasalargeopenwoundonherrig
htheel.Whenaskedaboutherpaininthatfoot,shetellsyouitisa0ona0to10painratingscale.Whatdoe
sthisresponseindicate?
a. Theparalysispreventsherbrainfromperceivingthepain.
b. Thepatienthaschronicpainthatdoesnottriggerthestressresponse.
c. Sheisafraidofbecomingaddictedifshetakestheprescribeddrugtoooften.
d. Thispatient’sacutepainhasbeeneffectivelymanagedbytheprescribedpaindrug.
ANS: A
Painisfeltorperceivedinthebrainratherthaninthebodyareawhereitoccurs.Whenabodypartisinjur
ed,thisinjurystimulatespainnerveendingsinthethumbthatthensend(transmit)electricalnerveim
pulsesasasignalfromtheinjurysitealongnervestothespinalcord.Atthespinalcord,theoriginalsign
alistransferredtospecialpainnervetractsupthespinalcordtotheareaofthebrainwherepaininthatbo
dysiteisperceived.Paralysisfromthewaistdowninthespinalcordpreventsthetransmissionofapai
nsignalfromthefootsothatpainisnotperceivednomatterhowdeeporbadtheheelwoundis.
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, DIF: CognitiveLevel:Understanding REF: p.211
4. Whyarenaturalandsyntheticopioidsconsidered“high-alertdrugs?”
a. Theyhaveanincreasedriskforcausingapatientharmifgiveninerror.
b. Theyhavearelativelyhighpotentialforaddictionorabuse.
c. Thereiswidevariationinthedosagesbetweenopioidtypes.
d. Theycanbegivenbyavarietyofroutes.
ANS: A
Althoughopioidscancauseaddictionorabuse,havedifferentdosagesranges,andcanbegivenbythe
oral,intravenous,intramuscular,andtransdermalroutes,thesearenotthereasonstheyarecategorize
dashigh-alertdrugs.Allnaturalandsyntheticopioidsarehigh-
alertdrugsbecausetheyhaveanincreasedriskforcausingpatientharmifgiveninerror.
DIF: CognitiveLevel:Understanding REF: p.214
5.
Whenyouassessapatient’spainlevelanhouraftergiving2mgofhydromorphoneintravenously,you
findthepatientsleepingwitharespiratoryrateof10breathsperminute.Whatisyourbestfirstaction?
a. Givenaloxoneintravenously.
b. Documentthefindingastheonlyaction.
c. Notifythehealthcareproviderimmediately.
d. Assessthepatient’soxygensaturationwithpulseoximetry.
ANS: D
Manypatientshaveareducedrespiratoryrateafterreceivingadoseofastrongmorphineagonist.Alth
ough10breathsperminutemaybealittlelowerthannormal,itisnotlowenoughtoeithernotifythehea
lthcareproviderorgivenaloxonewithoutfurtherassessment.Thebestassessmentisoxygensaturati
onbypulseoximetrytodeterminetheeffectivenessofthecurrentrespiratoryrate.Ifoxygensaturatio
nislowerthan94%orthepatient’susualpercentage,awakenthepatientandassesswhetherthepatien
t’srespiratoryrateincreases.
DIF: CognitiveLevel:Applying REF: p.215
6. Apatientbeingdischargedtohomeisprescribedanoxycodone–
acetaminophencombinationforpainmanagement.Whichprecautionismostimportanttoteachthis
patient?
a. “Ifyoustillneedthisdrugafter48hours,notifyyourhealthcareproviderimmediately.”
b. “Besuretodrinkplentyofwaterandeatfoodshighinfibertopreventconstipation.”
c. “Alwaysgotobedimmediatelyaftertakingadoseofthisdrug.”
d. “Avoiddrinkingalcoholwhiletakingthisdrug.”
ANS: D
Drinkingalcoholwhileonamorphineagonistwillmakesideeffectsworseandincreasetheriskforres
piratorydepression.Althoughpreventingconstipationisimportant,preventingrespiratorydepress
ionismoreimportant.
DIF: CognitiveLevel:Applying REF: p.216
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Visovsky: Introduction to Clinical Pharmacology, 9 th Edition
MULTIPLE CHOICE
1. Whattypesofdrugshavethemainpurposeofrelievingpain?
a. Anticholinergics
b. Antagonists
c. Analgesics
d. Agonists
ANS: C
Analgesicshavethespecificpurposeofrelievingpaineitherbychangingthepatient’sperceptionofp
ainorbyreducingpainfulstimulationatitssource.Althoughsomeanalgesicsareopioidagonists,the
termagonistisnotspecificforapain-relievingdrug.
DIF: CognitiveLevel:Knowing REF: p.213
2. Thehealthcareproviderasksyoutorateapatient’spostoperativepain.Whatisyourbestresponse?
a. “Heisasleepnow,sohispainlevelisacceptable.”
b. “Ithinkweneedtoaskthepatienttoratehisownpain.”
c. “Hiswifesayshecanstillfeeltheincisionwhenheturnsorcoughs.”
d. “Sincehereceived15mgofmorphineanhourago,hispainisprobablyminimal.”
ANS: B
Painisalwaysasubjectiveexperience;thatis,painisasensationthepatientfeelsandthatcannotbefelt
ormeasuredbysomeoneelse.Accuratepainassessmentisbestmeasuredbythepatient,ifheorsheisn
otunconsciousorconfused.Beingasleepdoesnotmeanthatpainisrelieved.
DIF: CognitiveLevel:Applying REF: p.210
3.
Youarecaringforapatientwhoisparalyzedfromthewaistdownandhasalargeopenwoundonherrig
htheel.Whenaskedaboutherpaininthatfoot,shetellsyouitisa0ona0to10painratingscale.Whatdoe
sthisresponseindicate?
a. Theparalysispreventsherbrainfromperceivingthepain.
b. Thepatienthaschronicpainthatdoesnottriggerthestressresponse.
c. Sheisafraidofbecomingaddictedifshetakestheprescribeddrugtoooften.
d. Thispatient’sacutepainhasbeeneffectivelymanagedbytheprescribedpaindrug.
ANS: A
Painisfeltorperceivedinthebrainratherthaninthebodyareawhereitoccurs.Whenabodypartisinjur
ed,thisinjurystimulatespainnerveendingsinthethumbthatthensend(transmit)electricalnerveim
pulsesasasignalfromtheinjurysitealongnervestothespinalcord.Atthespinalcord,theoriginalsign
alistransferredtospecialpainnervetractsupthespinalcordtotheareaofthebrainwherepaininthatbo
dysiteisperceived.Paralysisfromthewaistdowninthespinalcordpreventsthetransmissionofapai
nsignalfromthefootsothatpainisnotperceivednomatterhowdeeporbadtheheelwoundis.
This study source was downloaded by 100000817936687 from CourseHero.com on 04-13-2022 07:44:59 GMT -05:00
https://www.coursehero.com/file/72568831/Chapter11Pharmacologydocx/
, DIF: CognitiveLevel:Understanding REF: p.211
4. Whyarenaturalandsyntheticopioidsconsidered“high-alertdrugs?”
a. Theyhaveanincreasedriskforcausingapatientharmifgiveninerror.
b. Theyhavearelativelyhighpotentialforaddictionorabuse.
c. Thereiswidevariationinthedosagesbetweenopioidtypes.
d. Theycanbegivenbyavarietyofroutes.
ANS: A
Althoughopioidscancauseaddictionorabuse,havedifferentdosagesranges,andcanbegivenbythe
oral,intravenous,intramuscular,andtransdermalroutes,thesearenotthereasonstheyarecategorize
dashigh-alertdrugs.Allnaturalandsyntheticopioidsarehigh-
alertdrugsbecausetheyhaveanincreasedriskforcausingpatientharmifgiveninerror.
DIF: CognitiveLevel:Understanding REF: p.214
5.
Whenyouassessapatient’spainlevelanhouraftergiving2mgofhydromorphoneintravenously,you
findthepatientsleepingwitharespiratoryrateof10breathsperminute.Whatisyourbestfirstaction?
a. Givenaloxoneintravenously.
b. Documentthefindingastheonlyaction.
c. Notifythehealthcareproviderimmediately.
d. Assessthepatient’soxygensaturationwithpulseoximetry.
ANS: D
Manypatientshaveareducedrespiratoryrateafterreceivingadoseofastrongmorphineagonist.Alth
ough10breathsperminutemaybealittlelowerthannormal,itisnotlowenoughtoeithernotifythehea
lthcareproviderorgivenaloxonewithoutfurtherassessment.Thebestassessmentisoxygensaturati
onbypulseoximetrytodeterminetheeffectivenessofthecurrentrespiratoryrate.Ifoxygensaturatio
nislowerthan94%orthepatient’susualpercentage,awakenthepatientandassesswhetherthepatien
t’srespiratoryrateincreases.
DIF: CognitiveLevel:Applying REF: p.215
6. Apatientbeingdischargedtohomeisprescribedanoxycodone–
acetaminophencombinationforpainmanagement.Whichprecautionismostimportanttoteachthis
patient?
a. “Ifyoustillneedthisdrugafter48hours,notifyyourhealthcareproviderimmediately.”
b. “Besuretodrinkplentyofwaterandeatfoodshighinfibertopreventconstipation.”
c. “Alwaysgotobedimmediatelyaftertakingadoseofthisdrug.”
d. “Avoiddrinkingalcoholwhiletakingthisdrug.”
ANS: D
Drinkingalcoholwhileonamorphineagonistwillmakesideeffectsworseandincreasetheriskforres
piratorydepression.Althoughpreventingconstipationisimportant,preventingrespiratorydepress
ionismoreimportant.
DIF: CognitiveLevel:Applying REF: p.216
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https://www.coursehero.com/file/72568831/Chapter11Pharmacologydocx/
