No.

Item

Mean (SD)

Correct responses

n

%

True or false questions

1.            

Vital signs are always reliable indicators of the intensity of a patient’s pain.

0.46 (0.500)

88

46.1

2.            

Because their nervous system is under developed, children under two years of age have decreased pain sensitivity and limited memory of painful experiences.

0.50 (0.501)

95

49.7

3.            

Patients who can be distracted from pain usually do not have severe pain.

0.54 (0.499)

104

54.5

4.            

Patients may sleep in spite of severe pain.

0.45 (0.498)

85

44.5

5.            

Aspirin and other non-steroidal anti-inflammatory agents are NOT effective analgesics for painful bone metastases.

0.47 (0.500)

89

46.6

6.            

Respiratory depression rarely occurs in patients who have been receiving stable doses of opioids over a period of months.

0.38 (0.486)

72

37.7

7.            

Acetaminophen 650 mg PO is approximately equal in analgesic effect to codeine 32 mg PO.

0.60 (0.492)

114

59.7

8.            

Combining analgesics that work by different mechanisms (e.g., combining an opioid with an NSAID) may result in better pain control with fewer side effects than using a single analgesic agent.

0.55 (0.499)

105

55.0

9.            

The usual duration of analgesia of morphine IV is 4-5 hours.

0.49 (0.501)

93

48.7

10.         

Research shows that promethazine (Phenergan) is a reliable potentiates of opioid analgesics.

0.40 (0.491)

76

39.8

11.         

Patients with a history of substance abuse should not be given opioids for pain because they are at high risk for repeated addiction.

0.43 (0.496)

82

42.9

12.         

Beyond a certain dosage of morphine increases in dosage will NOT provide increased pain relief.

0.55 (0.499)

105

55.0

13.         

Elderly patients cannot tolerate opioids for pain relief.

0.50 (0.501)

96

50.3

14.         

Patients with pain should be encouraged to endure as much pain as possible before resorting to a pain relief measure.

0.36 (0.482)

69

36.1

15.         

Children less than 11-years-old cannot reliably report pain, so nurses should rely solely on the parent’s assessment of the child’s pain intensity.

0.48 (0.501)

91

47.6

16.         

Patients’ spiritual beliefs may lead them to think pain and suffering are necessary.

0.52 (0.501)

100

52.4

17.         

After an initial dose of opioid analgesic is given, subsequent doses should be adjusted in accordance with the individual patient’s response.

0.41 (0.493)

78

40.8

18.         

The child/adolescent should be advised to use non-drug techniques alone rather than concurrently with pain medications.

0.38 (0.487)

73

38.2

19.         

Giving patients sterile water by injection (placebo) is a useful test to determine if the pain is real.

0.53 (0.500)

102

53.4

20.         

Vicodin (hydrocodone 5 mg + acetaminophen 500 mg) PO is approximately equal to 5-10 mg of morphine PO.

0.64 (0.480)

123

64.4

21.         

If the source of the patient’s pain is unknown, opioids should not be used during the pain evaluation period, because this could mask the ability to correctly diagnose the cause of pain.

0.43 (0.496)

82

42.9

22.         

Anticonvulsant drugs such as gabapentin (Neurontin) produce optimal pain relief after a single dose.

0.60 (0.491)

115

60.2

23.         

Benzodiazepines are not effective pain relievers unless the pain is due to muscle spasm.

0.36 (0.482)

69

36.1

24.         

Narcotic/opioid addiction is defined as a chronic neurobiological disease, characterized by behaviors that include one or more of the following: Impaired control over drug use, compulsive use, continued use despite harm, and craving.

0.49 (0.501)

94

49.2

Multiple choice questions

25.

The recommended route of administration of opioid analgesics for patients with continuous persistent pain is:

0.42 (0.500)

80

41.9

26.

The recommended route administration of opioid analgesics for patients with brief, severe pain of sudden onset such as trauma or postoperative pain is

0.50 (0.501)

96

50.3

27.

Which of the following analgesic medications is considered the drug of choice for the treatment of prolonged moderate to severe pain for cancer patients?

0.38 (0.486)

72

37.7

28.

Which of the following IV doses of morphine administered over a 4-hour period would be equivalent to 30 mg of oral morphine given q 4 hours?

0.41 (0.493)

78

40.8

29.

Analgesics for post-operative pain should initially be given

0.45 (0.498)

85

44.5

30.

A patient with persistent cancer pain has been receiving daily opioid analgesics for 2 months. Yesterday the patient was receiving morphine 200 mg/hour intravenously. Today he has been receiving 250 mg/hour intravenously. The likelihood of the patient dev

0.57 (0.497)

108

56.5

31.

The most likely reason a patient with pain would request increased doses of pain medication is

0.35 (0.477)

66

34.6

32.

Which of the following is useful for treatment of cancer pain?

0.55 (0.499)

105

55.5

33.

The most accurate judge of the intensity of the patient’s pain is

0.55 (0.499)

105

55.0

34.

How likely is it that patients who develop pain already have drug abuse problem?

0.40 (0.492)

77

40.3

35.

The time to peak effect for morphine given IV is

0.35 (0.478)

67

35.1

36.

The time to peak effect for morphine given orally is

0.31 (0.465)

60

31.4

37.

Following abrupt discontinuation of an opioid, physical dependence is manifested by the following:

0.37 (0.485)

71

37.2

38.

Patients most able to endure pain:

0.43 (0.497)

83

43.5

Case studies

39. A

On the patient’s record you must mark his pain on the scale below. Circle the number that represents your assessment of Ahmed’s pain:

0.32 (0.469)

62

32.5

39. B

Your assessment, above, is made two hours after he received morphine 2 mg IV. Half hourly pain ratings following the injection ranged from 6 to 8 and he had no clinically significant respiratory depression, sedation, or other untoward side effects. He has

0.39 (0.490)

75

39.3

40. A

On the patient’s record you must mark his pain on the scale below. Circle the number that represents your assessment of Mohammed’s pain:

0.36 (0.482)

69

36.1

40. B

Your assessment, above, is made two hours after he received morphine 2 mg IV. Half hourly pain ratings following the injection ranged from 6 to 8 and he had no clinically significant respiratory depression, sedation, or other untoward side effects. He has

0.43 (0.496)

82

42.9