NSG 533 Exam 2 COMPLETE QUESTIONS AND
CORRECT DETAILED ANSWERS (VERIFIED
ANSWERS) |ALREADY GRADED A+||BRAND
NEW!!
Pain Classification - Correct Answer- Categories include acute, chronic, nociceptive,
neuropathic, and malignant pain, each with distinct characteristics and treatment
approaches.
Non-pharmacological Pain Approaches - Correct Answer- Methods such as stretches,
ice, and heat used as alternatives or complements to medication for pain management.
WHO Three-Step Ladder Approach - Correct Answer- 1. Non-opioid plus optional
adjuvant analgesic
2. Weak opioid plus non-opioid and adjuvant analgesics
3. Strong opioid plus non-opioid and adjuvant analgesics
NSAID Mechanism and Precautions - Correct Answer- Nonselective NSAIDs inhibit
COX-1 and COX-2, with COX-2 inhibition responsible for anti-inflammatory effects.
Precautions include increased GI and renal toxicity and peptic ulcers.
Acetaminophen (APAP) Use and Precautions - Correct Answer- Indicated for mild-
moderate pain, inhibits prostaglandin synthesis, with restrictions for maximum daily
doses and contraindications for certain health conditions and alcohol use. Overdose
and liver issues can happen.
Adjuvant Analgesics - Correct Answer- Medications with non-pain indications but useful
for pain management, especially for chronic and neuropathic pain, including examples
like gabapentin and antidepressants like duloxetine
,Opioids Mechanism of action - Correct Answer- Opioids stimulate CNS opioid receptors
for analgesia. Pure agonists (morphine) bind to u-receptors to produce analgesia that
increases with dose and does not have ceiling effects. Partial agonists such as tramadol
at the u-receptor cause less conformational change and receptor activation than full
antagonists.
Equianalgesic Doses and Opioid Rotation - Correct Answer- Converting total daily
opioid dose to morphine equivalents, considering incomplete cross tolerance and the
need for opioid rotation in some cases.
Migraine and Cluster Headache Classification - Correct Answer- Classification of
migraine headaches with and without aura, and cluster headaches according to the
International Headache Society (IHS).
Migraine Management Approach - Correct Answer- Stepwise approach involving
NSAIDs, triptans, and preventative strategies, considering factors like contraindications
and comorbidities.
Osteoarthritis (OA) Presentation and Goals - Correct Answer- Typical presentation
includes joint pain and morning stiffness, with therapy goals focused on pain relief,
mobility maintenance, and quality of life improvement.
OA Treatment Approach - Correct Answer- Stepwise treatment including non-
pharmacological interventions, NSAIDs as first-line therapy, and opioids for severe pain
or contraindications to other treatments.
NSAID Introduction and COXib Use - Correct Answer- NSAIDs are first-line therapy,
with COX-2 inhibitors preferred for patients at high risk for GI complications, while COX-
1 inhibitors provide pain and inflammation relief.
NSAIDs - Correct Answer- First-line therapy for pain and inflammation relief
, COX-1 - Correct Answer- Responsible for adverse effects on gastric mucosa, kidney,
and platelets
COX-2 - Correct Answer- Preferred for high-risk patients for GI complications; e.g.,
Celebrex in the US
Opioids / tramadol - Correct Answer- Reserved for unresponsive patients or when other
therapies are contraindicated
Risk Factors for Osteoporosis - Correct Answer- Includes low bone mineral density,
female sex, age over 65, hx of previous low trauma fracture after age 50, low BMI or
weight, RA, oral glucocorticoid therapy, premature menopause, cigarette smoking
Recommended Calcium and Vitamin D Intake - Correct Answer- NOF recommends
1000mg calcium for men 51-70, 1200 for women over 51, and 800-1000 IU vitamin D
for adults over 50
T Scores Interpretation - Correct Answer- Normal (-1), Osteopenia (-1 to -2.5),
Osteoporosis (< -2.5)
Prescription Drug Therapy for Osteoporosis - Correct Answer- Includes
Bisphosphonates, HRT, SERMs, Calcitonin, Denosumab, Teriparatide
Hyperuricemia and Gout - Correct Answer- SUA of 6.8 or above; 20% with
asymptomatic hyperuricemia develop gout within 5 years; consider foods, drugs, and
when to start urate lowering therapy
Therapy of Acute Gout Attack - Correct Answer- Consider patient-specific factors for
NSAIDs, colchicine, corticosteroids; first-line therapies for healthy and comorbid
patients
CORRECT DETAILED ANSWERS (VERIFIED
ANSWERS) |ALREADY GRADED A+||BRAND
NEW!!
Pain Classification - Correct Answer- Categories include acute, chronic, nociceptive,
neuropathic, and malignant pain, each with distinct characteristics and treatment
approaches.
Non-pharmacological Pain Approaches - Correct Answer- Methods such as stretches,
ice, and heat used as alternatives or complements to medication for pain management.
WHO Three-Step Ladder Approach - Correct Answer- 1. Non-opioid plus optional
adjuvant analgesic
2. Weak opioid plus non-opioid and adjuvant analgesics
3. Strong opioid plus non-opioid and adjuvant analgesics
NSAID Mechanism and Precautions - Correct Answer- Nonselective NSAIDs inhibit
COX-1 and COX-2, with COX-2 inhibition responsible for anti-inflammatory effects.
Precautions include increased GI and renal toxicity and peptic ulcers.
Acetaminophen (APAP) Use and Precautions - Correct Answer- Indicated for mild-
moderate pain, inhibits prostaglandin synthesis, with restrictions for maximum daily
doses and contraindications for certain health conditions and alcohol use. Overdose
and liver issues can happen.
Adjuvant Analgesics - Correct Answer- Medications with non-pain indications but useful
for pain management, especially for chronic and neuropathic pain, including examples
like gabapentin and antidepressants like duloxetine
,Opioids Mechanism of action - Correct Answer- Opioids stimulate CNS opioid receptors
for analgesia. Pure agonists (morphine) bind to u-receptors to produce analgesia that
increases with dose and does not have ceiling effects. Partial agonists such as tramadol
at the u-receptor cause less conformational change and receptor activation than full
antagonists.
Equianalgesic Doses and Opioid Rotation - Correct Answer- Converting total daily
opioid dose to morphine equivalents, considering incomplete cross tolerance and the
need for opioid rotation in some cases.
Migraine and Cluster Headache Classification - Correct Answer- Classification of
migraine headaches with and without aura, and cluster headaches according to the
International Headache Society (IHS).
Migraine Management Approach - Correct Answer- Stepwise approach involving
NSAIDs, triptans, and preventative strategies, considering factors like contraindications
and comorbidities.
Osteoarthritis (OA) Presentation and Goals - Correct Answer- Typical presentation
includes joint pain and morning stiffness, with therapy goals focused on pain relief,
mobility maintenance, and quality of life improvement.
OA Treatment Approach - Correct Answer- Stepwise treatment including non-
pharmacological interventions, NSAIDs as first-line therapy, and opioids for severe pain
or contraindications to other treatments.
NSAID Introduction and COXib Use - Correct Answer- NSAIDs are first-line therapy,
with COX-2 inhibitors preferred for patients at high risk for GI complications, while COX-
1 inhibitors provide pain and inflammation relief.
NSAIDs - Correct Answer- First-line therapy for pain and inflammation relief
, COX-1 - Correct Answer- Responsible for adverse effects on gastric mucosa, kidney,
and platelets
COX-2 - Correct Answer- Preferred for high-risk patients for GI complications; e.g.,
Celebrex in the US
Opioids / tramadol - Correct Answer- Reserved for unresponsive patients or when other
therapies are contraindicated
Risk Factors for Osteoporosis - Correct Answer- Includes low bone mineral density,
female sex, age over 65, hx of previous low trauma fracture after age 50, low BMI or
weight, RA, oral glucocorticoid therapy, premature menopause, cigarette smoking
Recommended Calcium and Vitamin D Intake - Correct Answer- NOF recommends
1000mg calcium for men 51-70, 1200 for women over 51, and 800-1000 IU vitamin D
for adults over 50
T Scores Interpretation - Correct Answer- Normal (-1), Osteopenia (-1 to -2.5),
Osteoporosis (< -2.5)
Prescription Drug Therapy for Osteoporosis - Correct Answer- Includes
Bisphosphonates, HRT, SERMs, Calcitonin, Denosumab, Teriparatide
Hyperuricemia and Gout - Correct Answer- SUA of 6.8 or above; 20% with
asymptomatic hyperuricemia develop gout within 5 years; consider foods, drugs, and
when to start urate lowering therapy
Therapy of Acute Gout Attack - Correct Answer- Consider patient-specific factors for
NSAIDs, colchicine, corticosteroids; first-line therapies for healthy and comorbid
patients
