The nurse is completing the medication reconciliation form for a patient admitted with chronic cancer pain. Which medication is of most concern to the nurse?
a. Amitriptyline (Elavil) 50 mg at bedtime
b. Ibuprofen (Advil) 800 mg 3 times daily
c. Oxycodone (OxyContin) 80 mg twice daily
d. Meperidine (Demerol) 25 mg every 4 hours
Question 2When visiting a hospice patient, the nurse assesses that the patient has a respiratory rate of 11 breaths/minute and complains of severe pain. Which action is best for the nurse to take?
a. Inform the patient that increasing the morphine will cause the respiratory drive to fail.
b. Tell the patient that additional morphine can be administered when the respirations are 12.
c. Titrate the prescribed morphine dose upward until the patient indicates adequate pain relief.
d. Administer a nonopioid analgesic, such as a nonsteroidal antiinflammatory drug (NSAID), to improve patient pain control.
Question 3The nurse reviews the medication administration record in order to choose the most appropriate pain medication for a patient with cancer who describes the pain as deep, aching and at a level 8 on a 0 to 10 scale.
Which medication should the nurse administer?
a. Fentanyl (Duragesic) patch
b. Ketorolac (Toradol) tablets
c. Hydromorphone (Dilaudid) IV
d. Acetaminophen (Tylenol) suppository
Question 4A patient with chronic neck pain is seen in the pain clinic for follow-up. In order to evaluate whether the pain management is effective, which question is best for the nurse to ask?
a. Can you describe the quality of your pain?
b. Has there been a change in the pain location?
c. How would you rate your pain on a 0 to 10 scale?
d. Does the pain keep you from doing things you enjoy?
Question 5A patient who is receiving sustained-release morphine sulfate (MS Contin) every 12 hours for chronic pain experiences level 9 (0 to 10 scale) breakthrough pain and anxiety. Which action by the nurse is best?
a. Provide amitriptyline (Elavil) 10 mg orally.
b. Administer lorazepam (Ativan) 1 mg orally.
c. Offer ibuprofen (Motrin) 400 to 800 mg orally.
d. Give immediate-release morphine 30 mg orally.
Question 6A patient with chronic back pain has learned to control the pain with the use of imagery and hypnosis. The patient's spouse asks the nurse how these techniques work. Which response by the nurse is best?
a. The strategies work by affecting the perception of pain.
b. These techniques block the pain pathways of the nerves.
c. Both strategies prevent transmission of painful stimuli to the brain.
d. The therapies slow the release of chemicals in the spinal cord that cause pain.
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