Palliative Care

Question 1

Pharmacologic tolerance develops to all of the
following side effects of opioid analgesics except:

Answer 1

Constipation

Question 2

The mixed opioid agonist-antagonists, such as
pentazocine, butorphanol, nalbuphine, and
dezocine, should not be used in the patient
already taking a pure agonist opioid as there is a
high risk they will precipitate withdrawal.

Answer 2

True

Question 3

If pain remains uncontrolled after 24 hours:

Answer 3

increase the routine dose by an amount
at least equal to the total dose of rescue
medication used during the previous 24
hours, or by 25% to 50% for mild to
moderate pain, and 50% to 100% for severe
to uncontrolled pain

Question 4

For each breakthrough dose:

Answer 4

offer 5% to 15% of the total 24-hour dose
of opioid at a frequency equal to Cmax for
the chosen route of administration.

Question 5

The nonopioid analgesics that characterize
step 1 of the WHO ladder (acetaminophen,
NSAIDs) all h moderate to maximal doses to
achieve optimal efficacy quickly.

Answer 5

True for only for nociceptic pain

Question 6

The route of administration for strong opioids
is preferable for chronic pain management is:

Answer 6

OP

Question 7

Neuropathic pain is

Answer 7

A result of disorderd nerve function.

Question 8

All of the following are key elements of
palliative care EXCEPT:

Answer 8

Getting the patient to be DNR

Question 9

The single MOST IMPORTANT feature that
defines opioid drug addiction (psychological
dependence) is

Answer 9

Development of withdrawal when the drug is
stopped.

Question 10

Every 12 hours, Mr. Kelly has been taking 60
mg of long-acting morphine. The best initial
order for breakthrough short-acting morphine is:

Answer 10

15 mg q4

Question 11

The single MOST IMPORTANT supplemental
therapy to consider at the time of starting
patients on opioids for pain is:

Answer 11

Anti emetic to treat nausea.

Question 12

You are completing a family meeting for a
patient with moderately advanced Alzheimer’s

Answer 12

Summarize the plan for care.

Question 13

Mrs. DeGilio is an 84-year-old woman with
rheumatoid arthritis affecting her hands, feet,
and knees. Today she notes increased swelling
and pain in her knees

Answer 13

How does it affect your life?

Question 14

Mr. Martin has locally advanced transitional
cell cancer of the bladder with chronic pelvic and
abdominal pain. Which of in determining the
maximum dose of oral morphine during dose
titration

Answer 14

pain relief

Question 15

There is no reason to delay the use of
analgesics while diagnosing and treating the
underlying cause of the pain

Answer 15

True

Question 16

The pain assessment should include

Answer 16

All: physical, functional, psychosocial impact

Question 17

fentanyl is contraindicated in

Answer 17

Heavy sweating or skin rash

Question 18

During opioid rotation, cross-tolerance may develop. How to adjust doses?

Answer 18

start at 50-75% of equianalgesic dose, adjust for methadone