ESTUDYR
NURS 5433 FAMILY II: PAIN MANAGEMENT MOST TESTED QUESTIONS
AND ANSWERS GRADED A+ WITH RATIONALES
axon membrane and produce effective blockade?
A. Protein binding, renal clearance, half-life
B. Molecular size, lipid solubility, degree of ionization at tissue pH
C. Route of administration, color, viscosity
D. Age of patient, heart rate, respiratory rate
Rationale: Small, lipid-soluble, and largely non-ionized molecules at tissue pH cross membranes
best and produce more rapid/robust nerve block.
injection?
A. Norepinephrine
B. Sodium bicarbonate
C. Epinephrine
D. Atropine
Rationale: Epinephrine vasoconstricts locally, reducing systemic absorption of lidocaine,
thereby prolonging anesthesia and lowering toxicity risk.
A. Apply liberally over large body areas for maximal effect
B. Apply, then cover the site snugly and exercise the area to increase absorption
C. Use the smallest amount needed, avoid broken/irritated skin, and avoid heat or tight
wraps
D. Apply only under occlusion to accelerate onset in all patients
Rationale: Small doses and avoiding heat/occlusion reduce systemic absorption and toxicity;
broken skin increases absorption and risk.
A. Loratadine
B. Tetracaine
C. Fentanyl transdermal
D. Ibuprofen
Rationale: Tetracaine (and topical cocaine in specific settings) are topical local anesthetics used
for mucosal/skin anesthesia.
, ESTUDYR
and the major adverse effects (respiratory
depression, euphoria, sedation, dependence)?
A. Delta
B. Mu
C. Kappa
D. Sigma
Rationale: Mu receptors are the principal site of action for opioid analgesia and many dose-
limiting adverse effects and dependence risk.
A. Muscle spasm and mydriasis only
B. Analgesia and sedation (may produce psychotomimetic effects with some agents)
C. Enhanced platelet aggregation only
D. Renal vasodilation exclusively
Rationale: Kappa receptor activation contributes to analgesia and sedation; some kappa activity
can cause dysphoria or psychotomimetic effects.
predominantly activate which receptors?
A. Delta only
B. Mu and kappa receptors
C. GABA receptors only
D. NMDA receptors only
Rationale: Strong (morphine) and moderate (codeine) opioid agonists act primarily at mu
receptors and also at kappa sites to produce analgesia.
–antagonist (can produce analgesia alone but
antagonize pure agonists)?
A. Morphine
B. Codeine
C. Nalbuphine
D. Fentanyl
Rationale: Nalbuphine, pentazocine, butorphanol and buprenorphine have mixed agonist–
antagonist properties; they can precipitate withdrawal in opioid-dependent patients.
A. Produce strong analgesia and euphoria
B. Increase opioid half-life
C. Reverse opioid-induced respiratory and CNS depression (do not produce analgesia)
D. Enhance opioid GI effects
NURS 5433 FAMILY II: PAIN MANAGEMENT MOST TESTED QUESTIONS
AND ANSWERS GRADED A+ WITH RATIONALES
axon membrane and produce effective blockade?
A. Protein binding, renal clearance, half-life
B. Molecular size, lipid solubility, degree of ionization at tissue pH
C. Route of administration, color, viscosity
D. Age of patient, heart rate, respiratory rate
Rationale: Small, lipid-soluble, and largely non-ionized molecules at tissue pH cross membranes
best and produce more rapid/robust nerve block.
injection?
A. Norepinephrine
B. Sodium bicarbonate
C. Epinephrine
D. Atropine
Rationale: Epinephrine vasoconstricts locally, reducing systemic absorption of lidocaine,
thereby prolonging anesthesia and lowering toxicity risk.
A. Apply liberally over large body areas for maximal effect
B. Apply, then cover the site snugly and exercise the area to increase absorption
C. Use the smallest amount needed, avoid broken/irritated skin, and avoid heat or tight
wraps
D. Apply only under occlusion to accelerate onset in all patients
Rationale: Small doses and avoiding heat/occlusion reduce systemic absorption and toxicity;
broken skin increases absorption and risk.
A. Loratadine
B. Tetracaine
C. Fentanyl transdermal
D. Ibuprofen
Rationale: Tetracaine (and topical cocaine in specific settings) are topical local anesthetics used
for mucosal/skin anesthesia.
, ESTUDYR
and the major adverse effects (respiratory
depression, euphoria, sedation, dependence)?
A. Delta
B. Mu
C. Kappa
D. Sigma
Rationale: Mu receptors are the principal site of action for opioid analgesia and many dose-
limiting adverse effects and dependence risk.
A. Muscle spasm and mydriasis only
B. Analgesia and sedation (may produce psychotomimetic effects with some agents)
C. Enhanced platelet aggregation only
D. Renal vasodilation exclusively
Rationale: Kappa receptor activation contributes to analgesia and sedation; some kappa activity
can cause dysphoria or psychotomimetic effects.
predominantly activate which receptors?
A. Delta only
B. Mu and kappa receptors
C. GABA receptors only
D. NMDA receptors only
Rationale: Strong (morphine) and moderate (codeine) opioid agonists act primarily at mu
receptors and also at kappa sites to produce analgesia.
–antagonist (can produce analgesia alone but
antagonize pure agonists)?
A. Morphine
B. Codeine
C. Nalbuphine
D. Fentanyl
Rationale: Nalbuphine, pentazocine, butorphanol and buprenorphine have mixed agonist–
antagonist properties; they can precipitate withdrawal in opioid-dependent patients.
A. Produce strong analgesia and euphoria
B. Increase opioid half-life
C. Reverse opioid-induced respiratory and CNS depression (do not produce analgesia)
D. Enhance opioid GI effects
