N 106-109

Non-narcotic drugs are appropriate for:
A) Moderate acute pain
B) Deep pain
C) Chronic pain
D) Mild superficial pain

The following NSAIDs are appropriate to treat inflammatory process EXCEPT:
A) Fenoprofen
B) Naproxen Sodium
C) Acetaminophen
D) Ibuprofen

Aspirin and NSAIDs relieve pain by inhibiting the synthesis of:
A) Prostaglandins
B) Enkephalin
C) Endorphins
D) Bradykinin

Aspirin is not recommended for the treatment in:
A) Viral infection
B) Bacterial infection
C) Inflammations
D) All of the above

NSAIDs should be taken:
a) with food
b) at mealtime
c) with a full glass or fluid
d) any of the above

Serious result of an overdose of Tylenol that extends beyond several days is:
A) hepatonecrosis
B) heart failure
C) retinal degeneration
D) all of the above

Narcotics act primarily on the ___ nervous system at the pain receptor sites:
A) central
B) peripheral
C) autonomic
D) none of the above

Non-narcotic analgesics act on the ___ nervous system at the pain receptor sites:
A) central
B) peripheral
C) autonomic
D) none of the above

Narcotics suppress:
A) Pain impulses
B) respirations
C) coughing
D) all of the above

The effects of narcotics - relieve pain, antitussive and:
A) antihypotensive
B) antidiarrheals
C) expectorant
D) antipyretic

Narcotics are contraindicated for use in patients with head injury and:
A) respiratory depression
B) elderly
C) pain associated with a non-specific injury
D) all of the above

What is the usual dose of Demerol post-op?
A) 50-100mg q 3-4 hours PRN
B) 25-100mg q 6 hours
C) 50-100mg daily PRN
D) 50mg q 3 hours

With Meperidine administration, frequent monitoring of ___ is required
A) blood pressure
B) pulse
C) urine output
D) temperature

Which of the following is an adverse effect of Meperidine:
A) constricted pupils
B) urinary retention
C) constipation
D) tachycardia

Client teaching for patient taking Demerol would include:
A) prevention of constipation
B) report side effects
C) do not use alcohol and CNS depressants while taking
D) all of the above

Based on your knowledge of analgesia, what if most relevant to the relief of chronic pain?
a) narcotic analgesics
b) use of drugs with long half-lives
c) use of injectable drugs
d) PRN medications

Narcotic antagonist used for overdose of morphine - like substance:
A) Probenecid/Benemid
B) Naloxone/Narcan
C) Ibuprofen/Motrin
D) Pentazocine/Talwin

Mixed narcotic agonist-antagonists were developed to decrease:
A) pain
B) respiratory depression
C) renal failure
D) narcotic abuse

Withdrawal symptoms usually start ___ hours after the last narcotic dose:
A) 72-96
B) 8-16
C) 48-72
D) 24-48

What is the recommended maintenance dose of methadone?
A) 2-10 mg/day
B) 10-35 mg/day
C) 100-150 mg/day
D) 40-120 mg/day

The reason elderly patients require a reduction in narcotic dosage to avoid side effects is:
A) decreased excretion of the drug
B) polypharmacy
C) decreased metabolism of drug
D) all of the above

Which drug tends to be more toxic in the elderly?
A) Acetaminophen
B) Codeine
C) Morphine
D) Demerol

Pain management for a child may be more successful if you do which of the following:
A) Use "ouch scale"
B) discuss child's response with parents
C) Use age appropriate communication skills
D) all of the above

Food-drug interactions that occur with Tylenol include:
A) increase effect of alcohol
B) decrease effect of antibiotics
C) increase effect with caffeine and diflunisal
D) increase effects with oral contraceptives

The half-life of cortecosteroids is greater than:
A) 72 hours
B) 36 hours
C) 48 hours
D) 24 hours

Vascular phase of inflammation is associated with:
A) Vasoconstriction with leukocyte infiltration to inflamed tissue
B) Vasodilation with increased capillary permeability
C) Vasoconstriction and fluid influx to interstitial space
D) Leukocyte and protein infiltration to inflamed tissue

All are among the 8 groups of NSAIDs EXCEPT:
A) Indoles
B) Fenamates
C) Oxicams
D) Macrolides

All are properties of anti-inflammatory agents EXCEPT:
A) Anticoagulant
B) Antipyretic
C) Antihypertensive
D) analgesic

A common side effect of NSAIDs is:
A) Tachycardia
B) GI distress
C) Polyuria
D) Heartburn

An analgesic drug that SHOULD NOT BE GIVEN to a child with a virus of flu:
A) Ibuprofen
B) Indocin
C) Acetaminophen
D) Aspirin

Ibuprofen is a rapid-acting NSAID that inhibits prostaglandin synthesis - it is classified as:
A) Paraaminophenol derivative
B) antranilic acid derivative
C) Indoles/indenes derivative
D) Propionic acid derivative

Ibuprofen is usually scheduled to be taken:
A) 3-4 times a day
B) q 2 hours
C) 2-3 times a day
D) daily

The usual adult dosage of Ibuprofen is:
A) 400-1200 mg
B) 300-800 mg
C) 800-1200 mg
D) 100-200 mg

Ibuprofen:
A) Has a long half-life of 20-30 hours
B) Should be taken between meals with water
C) Has severe side effects including hypertension, deafness and renal insufficiency
D) Causes less GI upset than other NSAIDs

The advantage of Feldene (Piroxicam) over other agents is:
A) It is fast acting
B) It's low incidence of toxic problems
C) It is well-tolerated
D) It's long half-life

All the following are true of Ketoralac EXCEPT:
A) It can be administered intramuscularly
B) It has an efficacy equal to morphine
C) It has a usual adult dose of 30-60 mg q 6 hours
D) It is effective for short term pain management

Celebrex(celecoxib) is associated with what characteristics:
A) avoid during third trimester pregnancy
B) relieves pain and inflammation without GI distress
C) not to be used for cardiac precautions like ASA
D) all of the above

Patient teaching for those on gold therapy include all EXCEPT:
A) measures to control constipation are needed
B) meticulous dental hygiene is required
C) adherence to scheduled lab tests is essential
D) desired clinical effect may take 3-4 months

Colchicines used for gout, act by:
A) inhibiting the final steps of uric acid biosynthesis
B) blocking re-absorption of uric acid excretion
C) re-absorbing uric acid from distal tubules of the kidney
D) inhibiting migration of leukocytes to the inflamed area

Patient teaching for anti-gout drugs includes all EXCEPT:
A) Avoiding alcohol and caffeine
B) Avoid food high in Purine
C) Increasing fluid intake
D) Taking large does of Vitamin C

Probenecid (Benemid) - used in treatment of gout promotes
A) re-absorption of urates from the kidney
B) uric acid excretion by the kidney
C) retention of urate crystals in the body
D) uric acid excretion via the sweat glands

Side effect of Benemid:
A) Sore gums and headache
B) Blurred vision and urinary retention
C) Constipation and edema
D) Flushed skin and Oliguria

A factor that would NOT affect a child's tolerance for pain is:
A) His pain threshold
B) His cultural values and beliefs
C) The pain duration
D) The method by which narcotics are administered

The most important factor affecting a child's perception and expression of pain is:
A) Previous pain experiences
B) Cultural influences
C) Her developmental stage
D) Her coping strategies

Which statements about pain in children is true?
A) Recovery from pain experience occurs at a faster rate in children than in adults.
B) Immaturity of the nervous system in young children provides them with increased thresholds for pain.
C) Infants have the capacity to respond to a painful stimulus
D) Narcotic use in children is dangerous because of the increased risk of addiction and respiratory depression

Research indicates that a physiological response to pain in children under 1 year includes:
A) Increased vagal tone
B) Increased heart rate
C) Decreased respiratory rate
D) Increased 02 saturation

A common fear shared by parents regarding the administration of morphine to a child is the fear of:
A) Injury due to drowsiness
B) Psychological depression
C) A medication error
D) Respiratory depression

The use of distraction to interrupt a child's perception of pain can be evaluated as effective if the child:
A) Report that the pain has decreased
B) Asks to go to the playroom with other children
C) Ceases to request analgesic medication
D) Is able to focus on something other than the pain

Which non-pharmacological interventions used to help pain involves teaching children to use their imagination to create pleasant images?
A) Relaxation
B) Guided imagery
C) Distraction
D) Hypnosis

When discontinuing steroid therapy, the dose should to tapered over how many days?
A) 5-10
B) 4-7
C) 1-3
D) 3-5