CHPN CHPN Pharmacology & Medication Management 2 — Questions and Answers
Question 1: What is the equianalgesic oral dose of oxycodone compared to 30 mg of oral morphine?
- 20 mg (Correct answer)
- 30 mg
- 45 mg
- 60 mg
Correct answer: 20 mg
20 mg of oral oxycodone is equianalgesic to 30 mg of oral morphine, giving oxycodone roughly a 1.5:1 potency advantage.
Question 2: A hospice patient with renal failure needs opioid pain management. Which opioid should be avoided?
- Morphine (Correct answer)
- Hydromorphone
- Fentanyl
- Methadone
Correct answer: Morphine
Morphine's active metabolite (morphine-6-glucuronide) accumulates in renal failure, causing sedation and respiratory depression.
Question 3: Which co-analgesic is most effective for neuropathic pain in hospice patients?
- Gabapentin (Correct answer)
- Ibuprofen
- Acetaminophen
- Metoclopramide
Correct answer: Gabapentin
Gabapentin (and pregabalin) are first-line adjuvant analgesics for neuropathic pain, working by blocking calcium channels in the nervous system.
Question 4: A hospice patient is experiencing terminal restlessness unresponsive to lorazepam. Which medication may be used for palliative sedation?
- Midazolam (Correct answer)
- Haloperidol
- Dexamethasone
- Ondansetron
Correct answer: Midazolam
Midazolam is a fast-acting benzodiazepine commonly used for palliative sedation in refractory terminal agitation.
Question 5: What is the role of corticosteroids such as dexamethasone in hospice symptom management?
- Reduce inflammation, appetite stimulation, and relieve nausea and pain from pressure (Correct answer)
- Treat infection
- Provide sedation
- Control bleeding
Correct answer: Reduce inflammation, appetite stimulation, and relieve nausea and pain from pressure
Dexamethasone serves multiple palliative purposes including reducing tumor-related inflammation, stimulating appetite, and managing nausea and neuropathic pain.
Question 6: Which antiemetic is most appropriate for nausea caused by opioid-induced gastroparesis in a hospice patient?
- Metoclopramide (Correct answer)
- Ondansetron
- Prochlorperazine
- Meclizine
Correct answer: Metoclopramide
Metoclopramide is a prokinetic agent that improves gastric emptying, directly addressing opioid-induced gastroparesis as a cause of nausea.
CHPN CHPN Pharmacology & Medication Management 2
What is the equianalgesic oral dose of oxycodone compared to 30 mg of oral morphine?