Management of Cancer Pain
Self-Study Examination
Instructions: After studying the text answer the following true/false or multiple choice questions. Remember, there's only one answer to each question.
a) Cancer causes 1 of every 10 deaths worldwide b) Pain associated with cancer in adults is frequently undertreated c) Cancer is diagnosed in over 1 million Americans annually. d) all are true
a) Tumor progression b) Surgery or other invasive procedures c) Toxicities of chemotherapy d) all of the above
a) True b) False
a) Unrelieved pain causes suffering. b) Patients are less demanding if pain is well-managed. c) Uncontrolled pain impairs the patient's participation in activities of daily living. d) a & c
a) Decreased functional capability b) Depression c) Increased appetite d) Re-evaluation of religious beliefs
a) Pain is a complex phenomenon involving physical, psychological, and emotional processes. b) The amount of pain is proportional to the amount of tissue damage. c) Pain can be managed with a standardized approach to therapy. d) None of the above.
a) Healthcare professionals' fear of patient addiction. b) The low priority given to cancer pain management within the healthcare setting as a whole. c) a & b d) neither a nor b
a) Reimbursement issues do not influence how pain is managed. b) Low income people experience greater pain than do Americans of other socioeconomic classes. c) Clinicians should not consider the cost of drugs when selecting pain management strategies. d) all of the above
a) Detailed medical history b) Physical examination c) Psychosocial assessment d) all of the above
a) Brief b) Easy to use c) Comprehensive d) all of the above
a) At regular intervals after starting the treatment plan. b) When the patient reports a new type of pain. c) 15-30 minutes after giving parenteral analgesics. d) all of the above.
a) Patient addiction or drug tolerance b) Patient fear of what the pain means c) Patient's use of diversionary activities d) b & c
a) Bone metastasis b) Spinal cord compression c) Plexopathies d) all of the above
a) Surgical conditions, e.g. appendicitis b) Obstruction of the small or large intestine c) metastatic liver disease d) all of the above
a) Cytotoxic chemotherapy b) Radiation to the head and neck c) Poor oral hygiene d) Parenteral narcotics
a) By the intravenous b) By the clock c) For the individual d) By the ladder
a) ibuprofen b) aspirin c) acetaminophen d) amantadine
a) telling her that the stomach discomfort is part of her cancer, and give her the ibuprofen b) calling the MD for a laxative and enema order c) comparing today's CBC results with those from last week, and notifying the MD other complaint d) none of the above
a) follow the order as given b) question the pentazocine order because of the agonist-antagonist effect c) question the order to dc the oxycodone rather thaN increasing the dose d) b&c
a) call the doctor and get an order for Meperidine 100 mg IM or IV every 4 hours. b) tell her to "tough-it out" and not take so much addictive pain medication. c) recognize that analgesia dosages require adjustment as patients develop tolerance to the drug, and call the MD for new orders d) none of the above
a) psychological addiction to the drug. b) onset of criminal behavior to obtain drugs c) appearance of abstinence syndrome after stopping the drug d) need to increase dose requirements over time to achieve pain control
a) it is not suitable for rapid dose titration b) the administration method is complicated c) some patients report nausea from the drug d) all of the above are limitations
a) instructing the patient to use caution when ambulating if the medication makes them drowsy or confused b) instructing the patient to increase dietary fiber, fluids, and to use a mild laxative as needed to prevent constipation c) instructing the patient to use the PCA dose as little as possible to prevent addiction d) a & b
a) dexamethasone b) phenytoin c) amitriptyline d) b & c
a) a written pain management pain b) information regarding activity or dietary restrictions c) instructions for preventing constipation d) all of the above
a) Exercise assists in the treatment of chronic pain in many cases. b) Patients should be encouraged to remain active as much as possible. c) During acute pain, exercise should be limited to self-administered range of motion. d) all of the above
a) joint contracture b) cardiovascular deconditioning c) both a & b d) neither a nor b
a) during episodes of brief pain b) during unpleasant procedures c) when the patient's ability to concentrate is compromised by anxiety d) all of the above
a) distraction b) counting c) refraining d) sublimation
a) information about preventing pain through use of regularly scheduled analgesics b) information to dispel myths about opioids c) specific information about any medication the patient is given d) all of the above
a) symptomatic metastases due to tumor infiltration b) initial debulking of large tumor masses c) ablation of pain pathways d) none of the above
a) anticoagulant therapy b) hormone replacement therapy c) antipsychotic therapy d) none of the above
a) the first resection offers the best opportunity for cure b) outstanding radiotherapy can compensate for inadequate surgical resection c) local tumor recurrence is not always the harbinger of disseminated disease d) the timing of a surgical intervention for pain control is important.
a) medicating the patient for the pre-existing pain prior to the procedure b) explain what the procedure will entail and what to expect c) incorporate nonpharmacological options such as music and imagery as appropriate d) all of the above
a) nausea and vomiting b) hypertension c) respiratory depression d) pain
a) patient-size-appropriate resuscitative equipment b) pulse oximetry equipment c) adequate amounts of nalozone for the patient's weight d) all of the above
a) young infants have higher in-brain concentration of opioids for a given dose than do children b) intensive monitoring is needed for infants receiving opioids due to the increased risk of respiratory depression c) both a & b d) neither a nor b
a) monitor for gastric and renal toxicity from the NSAIDs b) be aware that elderly people tend to be more sensitive to the analgesic effects of opioids c) monitor for urinary retention d) all of the above.
a) patients should be informed that effective pain management is an important part of their treatment b) patient satisfaction should d be surveyed to evaluate effectiveness of pain management c) patients should be encouraged to use nonpharmacologic interventions rather than drugs d) oral analgesics and other noninvasive routes of administration are used whenever possible.