ABPANC ABPANC Pain Management 1 — Questions and Answers
Question 1: Which pain assessment scale is most appropriate for a non-verbal adult patient in the PACU?
- Wong-Baker FACES scale
- Behavioral Pain Scale (BPS) (Correct answer)
- Numeric Rating Scale (NRS)
- Visual Analog Scale (VAS)
Correct answer: Behavioral Pain Scale (BPS)
The Behavioral Pain Scale (BPS) is validated for non-verbal or intubated adult patients who cannot self-report pain.
Question 2: A patient in Phase I PACU reports pain rated 8/10 after a total knee replacement. Which analgesic approach aligns with multimodal pain management?
- Administer IV opioid only
- Withhold analgesics until the surgeon is notified
- Combine IV opioid with a non-opioid such as IV acetaminophen (Correct answer)
- Increase IV fluid rate to dilute the pain medication
Correct answer: Combine IV opioid with a non-opioid such as IV acetaminophen
Multimodal analgesia combines opioid and non-opioid agents to improve pain control while reducing opioid-related adverse effects.
Question 3: Which side effect of opioid analgesics requires the perianesthesia nurse to have naloxone immediately available?
- Nausea and vomiting
- Urinary retention
- Respiratory depression (Correct answer)
- Pruritis
Correct answer: Respiratory depression
Naloxone is the opioid antagonist used to reverse life-threatening respiratory depression, a critical opioid adverse effect.
Question 4: A patient recovering from abdominal surgery has a continuous epidural infusion of bupivacaine and fentanyl. The nurse notes bilateral lower extremity weakness. What is the priority action?
- Document the finding as expected
- Increase the epidural infusion rate
- Notify the anesthesia provider and assess sensory level (Correct answer)
- Administer IV naloxone immediately
Correct answer: Notify the anesthesia provider and assess sensory level
New-onset motor block with epidural infusion may indicate excessive spread or epidural hematoma, requiring immediate anesthesia provider notification and neurological assessment.
Question 5: Which numerical pain score on a 0–10 scale generally indicates the need for reassessment and intervention according to ASPAN standards?
- 1–2
- 3–4
- 5 or above (Correct answer)
- Any score above 0
Correct answer: 5 or above
A pain score of 5 or above on a 0–10 scale typically triggers reassessment and a pain management intervention per ASPAN guidelines.
Question 6: Ketorolac is administered to a post-surgical patient for pain management. Which contraindication is most important to verify before administration?
- History of seasonal allergies
- Renal impairment or recent renal surgery (Correct answer)
- Mild hypertension
- Previous use of acetaminophen
Correct answer: Renal impairment or recent renal surgery
Ketorolac is an NSAID that can worsen renal function; it is contraindicated in patients with renal impairment or procedures involving the kidneys.
ABPANC ABPANC Pain Management 1
Which pain assessment scale is most appropriate for a non-verbal adult patient in the PACU?