MCQs review 25-36
Cancer Pain Management Quiz
Test your knowledge on effective pain management techniques in cancer care. This quiz covers critical aspects of using opioids, managing side effects, and understanding patient needs.
- 12 thought-provoking multiple choice questions
- Focus on morphine sulfate, antiemetics, and pain management strategies
- Ideal for healthcare professionals and students
What is the average starting daily dose of morphine sulfate in the treatment of a patient with moderately severe cancer pain?
10 to 15 mg
15 to 30 mg
30 to 60 mg
60 to 120 mg
120 to 240 mg
Which of the following statements regarding the use of morphine in the treatment of terminal cancer pain is (are) relevant to the patient in question?
A. Morphine produces rapid tolerance
Morphine produces euphoria
Morphine produces respiratory depression
None of the above
All of the above
Which of the following is (are) essential to cancer pain management?
A collaborative, interdisciplinary approach to care
An individualized pain control plan developed and agreed on by the patient
Ongoing assessment and reassessment of the patient’s pain
The use of both pharmacologic and nonpharmacologic therapies to prevent or to control pain
All of the above
Which of the following is (are) an aim(s) of pain management in palliative care?
To identify the cause of the pain
To prevent the pain from recurring
To maintain a clear sensorium
To maintain a normal affect
All of the above
Which of the following factors modify the pain threshold in patients with cancer pain?
Insomnia
Fear
Anxiety
Sadness
All of the above
A patient develops severe nausea and vomiting as the dose of morphine being used for terminal cancer pain (endometrial) is increased. The patient is undergoing triple antinauseant therapy, which includes dimenhydrinate, TK metoclopramide, and prochlorperazine. Which of the following statements regarding this situation is true?
You should add a fourth antinauseant to the regimen at this time, preferably a corticosteroid or ondansetron
You should put an IV line in place and make sure the input equals the output; do not change drugs
Decrease the dose of the morphine by 10% for 24 hours
Switch to another narcotic analgesic; no further investigations are necessary or desired
None of the above
A patient who is being treated for terminal cancer (esophageal adenocarcinoma) pain with oral morphine requires increased morphine doses daily. Six weeks ago, his morphine dose was 180 mg per day; it is 600 mg per day now. Which of the following statements regarding this increased dose of morphine is (are) true?
The dosage increase most likely represents tolerance to the morphine
The dosage increase most likely represents increased requirements as a result of tumor growth
Both a and b are true
Either a or b could be true, but not both
E. Neither a nor b
A patient is being treated for breast cancer with adjuvant chemotherapy after a lumpectomy. One of the drugs she is taking is cisplatin. She develops intractable nausea and vomiting while taking this drug. Which of the following antiemetic is the drug of first choice for this patient?
Prochlorperazine
Ondansetron
Dimenhydrinate
Metoclopramide
Dexamethasone
A patient develops intractable nausea and vomiting secondary to carcinoma of the colon with partial bowel obstruction. She has been taking both morphine and hydromorphone by mouth but is having great difficulty keeping anything down. What would you do at this time?
Switch to levorphanol for the pain
Switch to methadone for the pain
Switch from the oral medication route to a subcutaneous infusion
Switch from the oral route to the suppository route
Switch from the oral route to the intravenous route
Which of the following most accurately describes "breakthrough" pain?
Associated with pathological fractures
B. Refers to a new psychological or spiritual insight
Can occur as end-of-dose failure
An aspect of opioid pseudo-addiction
Madge is an 88 year-old with end stage colon cancer, who is transitioning. She has been minimally responsive for the past six hours, but opens her eyes in response to her name. She is restless at times with furrowing of her brow. She is still swallowing her secretions, and sucks on the oral sponge when mouth care is provided. Prior to her change in status, she was receiving Oxycontin 40 mg po tablets q12 hr ATC with liquid oxycodone 8-12 mg po q2hrs prn for breakthrough pain. In light of Madge's change in level of consciousness, what changes should be made to her pain management regimen?
Convert to IV infusion
Convert to subcutaneous infusion
Convert to liquid dosing orally
Convert to fentanyl patch
Which patient is at most risk for under-treatment of pain symptoms?
86-year old female with COPD, living in an assisted living facility
74-year old male with congestive heart failure, living with his wife
51-year old male, recently diagnosed with ALS; a former weight lifter
42-year old female with early-onset dementia, living with her sister.
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