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Chapter 34. Pain Management

Student Questions

Mrs. D is a 85-year-old resident of a long-term-care facility with a diagnosis of severe Alzheimer's disease and pancreatic cancer. Which of the following pain assessment tools may be helpful in monitoring the effectiveness of her pain medication?

A. Visual analog scale

B. PAINAD

C. Verbal analog scale

D. Pain diary

Answer: B

Option A: Incorrect. A patient with severe Alzheimer's disease will likely not be able to reliably utilize the visual analog scale to report pain due to cognitive decline.

Option B: Correct. The PAINAD is a caregiver-reported pain scale.

Option C: Incorrect. A patient with severe Alzheimer's disease will likely not be able to reliably utilize the verbal analog scale to report pain due to cognitive decline.

Option D: Incorrect. A patient with severe Alzheimer's disease will likely not be able to reliably utilize a pain diary to report pain due to cognitive decline.

Mrs. S. is a 65-year-old woman with breast cancer and bone metastases. Which of the following adjuvant therapies would provide pain relief for her bone pain?

A. Acetaminophen

B. Ibuprofen

C. Amitriptyline

D. Gabapentin

Answer: B

Option A: Incorrect. Pain from bony metastases involves inflammation. Acetaminophen does not provide anti-inflammatory effects.

Option B: Correct. Pain from bony metastases involves inflammation. Ibuprofen will provide anti-inflammatory effects.

Option C: Incorrect. Pain from bony metastases involves inflammation. Amitriptyline will provide relief from neuropathic pain, not inflammation.

Option D: Incorrect. Pain from bony metastases involves inflammation. Gabapentim will provide relief from neuropathic pain, not inflammation.

Ms. J. is an 81-year-old woman who is scheduled for surgery to repair a knee replacement. She has a documented allergy to morphine. Which of the following agents would be appropriate for her postoperative pain management?

A. Fentanyl

B. Hydromorphone

C. Oxymorphone

D. Oxycodone

Answer: A

Option A: Correct. Fentanyl is a phenylpiperidine, a meperidine-like opioid, with a chemical structure different than morphine.

Option B: Incorrect. Hydromorphone is a phenanthrene, a morphine-like opioid, with a chemical structure similar to morphine.

Option C: Incorrect. ...

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