CHPN Domain 2: Patient Care – Pain Management Welcome to your CHPN Domain 2: Patient Care – Pain Management 1. CHPN: Patient Care - Pain Management Which medication should be used cautiously in a palliative care patient with a history of chronic obstructive pulmonary disease 'COPD' and renal insufficiency requiring opioid therapy for cancer pain? Hydromorphone Fentanyl Morphine Oxycodone None 2. CHPN: Patient Care - Pain Management A patient with advanced pancreatic cancer complains of severe abdominal pain. Which adjuvant medication is most appropriate to add to their opioid regimen? Gabapentin Amitriptyline Lorazepam Dexamethasone None 3. CHPN: Patient Care - Pain Management For a patient experiencing neuropathic pain related to cancer metastasis, which of the following is the most appropriate initial treatment? Acetaminophen Gabapentin Ibuprofen Aspirin None 4. CHPN: Patient Care - Pain Management Which opioid administration method provides the most steady control of pain for a patient with constant cancer-related pain? Intravenous bolus Oral immediate-release Transdermal patch Oral as needed (PRN) None 5. CHPN: Patient Care - Pain Management What is the primary concern when using nonsteroidal anti-inflammatory drugs (NSAIDs) in the management of pain for a patient with end-stage renal disease? Respiratory depression Gastrointestinal bleeding Cardiac arrest Hepatic encephalopathy None 6. CHPN: Patient Care - Pain Management In managing a hospice patient's bone pain due to metastatic breast cancer, which combination therapy is typically most effective? Opioids and NSAIDs NSAIDs and acetaminophen Opioids and gabapentin Acetaminophen and antidepressants None 7. CHPN: Patient Care - Pain Management What is an essential monitoring parameter for a patient receiving opioid therapy for severe pain in a hospice setting? Serum glucose levels Blood pressure Respiratory rate Urine output None 8. CHPN: Patient Care - Pain Management Which factor should be primarily considered when initiating methadone for pain management in palliative care? Patient's cognitive function History of substance abuse Electrolyte balance QT interval None 9. CHPN: Patient Care - Pain Management In a patient with liver failure, which pain management strategy is generally safest? High-dose acetaminophen Nonsteroidal anti-inflammatory drugs (NSAIDs) Opioids that are not metabolized by the liver High-dose opioids None 10. CHPN: Patient Care - Pain Management Which technique is recommended to assess the efficacy of pain management interventions in a non-verbal hospice patient? Patient self-reporting Regular blood tests Behavioral and physical cues Family member reports None 11. CHPN: Patient Care - Pain Management Which medication is particularly useful in treating neuropathic pain associated with herpes zoster in a palliative care patient? Acetaminophen Ibuprofen Prednisone Pregabalin None 12. CHPN: Patient Care - Pain Management A patient in palliative care is experiencing breakthrough pain despite a scheduled opioid regimen. What is the appropriate initial step in managing this pain? Increase the frequency of the scheduled opioid Add a non-opioid analgesic Prescribe an immediate-release opioid for breakthrough pain Switch to a different class of opioid None 13. CHPN: Patient Care - Pain Management What is the main concern when using transdermal fentanyl in a patient with cachexia? Reduced effectiveness due to fat loss Increased risk of infection at the patch site Higher likelihood of psychological dependence Faster metabolism of the drug None 14. CHPN: Patient Care - Pain Management For patients with advanced dementia experiencing pain, which assessment tool is most appropriate to gauge their pain level? Verbal rating scale Numeric rating scale Visual analog scale Behavioral pain scale None 15. CHPN: Patient Care - Pain Management What is an important consideration when using opioids in the elderly for pain management? Increased risk of constipation Decreased risk of respiratory depression Increased risk of cognitive enhancement Decreased risk of gastrointestinal bleeding None 16. CHPN: Patient Care - Pain Management A hospice patient with a history of myocardial infarction requires pain management. Which of the following opioids is preferred due to its minimal cardiovascular effects? Morphine Methadone Hydromorphone Meperidine None 17. CHPN: Patient Care - Pain Management In managing a patient's chronic pain from osteoarthritis in hospice care, which medication should be avoided due to its side effect profile in long-term use? Acetaminophen Ibuprofen Celecoxib Naproxen None 18. CHPN: Patient Care - Pain Management Which adjuvant analgesic is indicated for bone pain secondary to metastatic cancer? Anticonvulsants Bisphosphonates Antidepressants Beta-blockers None 19. CHPN: Patient Care - Pain Management What is the most effective pain management strategy for a patient suffering from both cancer pain and severe depression? NSAIDs only Opioids combined with antidepressants Antidepressants only Cognitive behavioral therapy None 20. CHPN: Patient Care - Pain Management In a palliative care setting, what is the key reason for rotating different opioids when managing a patient's chronic pain? To prevent allergic reactions To minimize tolerance development To enhance placebo effects To reduce costs None 21. CHPN: Patient Care - Pain Management Which intervention is most appropriate for a patient experiencing pain associated with terminal liver cancer? High-dose NSAIDs Acetaminophen at maximum recommended daily dose Opioid therapy tailored to liver function Alcohol-based pain management None 22. CHPN: Patient Care - Pain Management What is a crucial consideration when prescribing opioids for a patient with renal failure in a palliative care context? Enhanced drug clearance Decreased drug absorption Accumulation of drug metabolites Increased drug synthesis None 23. CHPN: Patient Care - Pain Management For managing severe acute pain in a palliative care patient who is opioid-tolerant, what is an effective strategy? Reduce opioid dose to prevent overdose Use non-pharmacological methods exclusively Administer a higher-than-usual dose of opioids Discontinue opioids and switch to NSAIDs None 24. CHPN: Patient Care - Pain Management Which factor is critical when considering a patient's suitability for spinal cord stimulator (SCS) implantation for pain management? Previous success with transcutaneous electrical nerve stimulation (TENS) Absence of psychological disorders Patient's preference for invasive procedures All of the above None 25. CHPN: Patient Care - Pain Management A patient with terminal cancer is experiencing visceral pain. Which combination of medications is most likely to provide effective relief? Opioids and antispasmodics Antidepressants and antispasmodics NSAIDs and corticosteroids Corticosteroids and opioids None 26. CHPN: Patient Care - Pain Management When managing a patient with neuropathic pain who has shown inadequate response to first-line therapies, which second-line agent could be considered? Topical capsaicin High-dose acetaminophen Systemic corticosteroids Intravenous antibiotics None 27. CHPN: Patient Care - Pain Management For a patient in palliative care experiencing muscle spasms and pain, which medication is most appropriate to prescribe? Baclofen Warfarin Insulin Albuterol None 28. CHPN: Patient Care - Pain Management Which intervention should be prioritized for a patient with chronic pain and a history of substance use disorder in a hospice setting? Strict opioid use under supervised administration Avoidance of all controlled substances Liberal use of non-opioid analgesics only Implementation of a comprehensive pain management and substance use monitoring program None 29. CHPN: Patient Care - Pain Management When considering the use of topical NSAIDs in elderly patients for pain management, what is a significant advantage? Faster systemic absorption Reduced risk of systemic side effects Increased potency compared to oral forms Enhanced cardiovascular safety None 30. CHPN: Patient Care - Pain Management A patient in palliative care with biliary colic is experiencing significant pain. Which treatment option is most suitable? Oral calcium channel blockers Intravenous opioids Subcutaneous insulin Oral anticholinergics None 1 out of 30 Time is Up! Time's up
