UNDERSTANDING AND COMPASSION: PAIN, ADDICTION AND END-OF-LIFE CARE Choose the best possible answer for each question and mark your answers on the self-assessment answer sheet at the end of this book. There is a required score of 70% or better to receive a certificate of completion.
1. Roughly how many American adults have created an advance directive? A. One in two. B. One in three.
7. The opioids butorphanol, nalbuphine, and pentazocine, are not recommended in cancer pain management because ____________. A. They are likely to cause psychotomimetic effects. B. They are associated with an increased risk of pruritus. C. They commonly cause severe constipation. D. Their metabolites may be neurotoxic in the context of chemotherapy. 8. Unwarranted fear of what potential side effect of opioid analgesics can lead to underprescribing by clinicians and/or under use by patients? A. Respiratory depression.
C. One in four. D. One in five.
2. How accurate are physicians, generally, in predicting patient preferences for end-of-life care?
A. About 55% accurate. B. About 65% accurate. C. About 75% accurate. D. About 85% accurate.
B. Sedation. C. Nausea. D. Constipation.
3. In the United States, what term is generally used for care of people who are not expected to live more than 6 months? A. Palliative care. B. Nursing home care.
9. Which class of adjuvant analgesic has received increasing attention in recent years as a possible way to control neuropathic pain? A. Tricyclic antidepressants. B. Cannabinoids. C. Psychostimulants. D. Ketamine.
C. Hospice care. D. Terminal care.
4. The Karnofsky Scale may be useful for what clinical task? A. Assessing patient’s cognitive ability. B. Determining level of adverse effects associated with chemotherapy. C. Determining patient pain level. D. Determining patient life expectancy. 5. Which statement is true about the typical role of a referring physician relative to patients in hospice care? A. Hospice staff are expected to be in charge of patient care, with a referring physician consulted only for prescription refills. B. The referring physician is expected to remain in charge of care and be available by phone or other means. C. The referring physician transfers responsibility for patient care to the hospice medical director. D. The hospice team assumes responsibility for all patient care, including the ordering and administration of prescription medications as needed. 6. Which of the following forms of patient expressed end of life wishes are legally enforceable? A. Advance Directive. B. Living Will. C. POLST. D. Living Trust.
10. Which class of medications are first-line for treating dyspnea in end-of-life settings?
A. Corticosteroids. B. Benzodiazepines. C. Bronchodilators. D. Opioids.
11. Which of the following is an advantage of using function- based goals in pain management? A. The patient’s perceived pain levels are not the primary focus of treatment. B. Prescribing decisions are based on the patient’s subjective pain experience. C. Function-based goals require lower doses of opioids. D. Progress can be measured quickly when using function- based goals, over the course of several hours. 12. Which of the following is recommended by the American College of Physicians as a first-line non-pharmacological treatment for chronic low back pain? A. Meditation. B. Acupuncture. C. Deep breathing. D. Massage.
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