Questions

Frequency (percent)

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

19 (15.2%)

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

44 (36.7%)

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

41 (33.3%)

4. Patients may sleep in spite of severe pain.

18 (14.4%)

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

30 (24.6%)

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

73 (59.3%)

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

103 (82.4%)

8. The usual duration of analgesia of 1-2 mg morphine IV is 4 - 5 hours.

31 (25.0%)

9. Research shows that promethazine (Phenergan) and hydroxyzine (Vistaril) are reliable potentiators of opioid analgesics.

48 (40.3%)

10. Opioids should not be used in patients with a history of substance abuse.

19 (15.7%)

11. Elderly patients cannot tolerate opioids for pain relief.

50 (41.3%)

12. Patients should be encouraged to endure as much pain as possible before using an opioid.

40 (32.8%)

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

42 (34.7%)

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

76 (61.8%)

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

104 (85.2%)

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

79 (64.8%)

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

56 (47.5%)

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

12 (9.8%)

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

57 (47.5%)

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

90 (75.0%)

21. Narcotic/opioid addiction is defined as a chronic neurobiologic 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.

112 (91.1%)

22. The recommended route of administration of opioid analgesics for patients with persistent cancer-related pain is:

21 (17.5%)

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

97 (80.8%)

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

85 (70.8%)

25. Which of the following intravenous doses of morphine administered over a 4 hour period would be equivalent to 30 mg of oral morphine given 4 hours?

13 (10.9%)

26. Analgesics for post-operative pain should initially be given

98 (83.1%)

27. 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 developing clinically significant respiratory depression in the absence of new comorbidity is

10 (8.4%)