Practice Test GeeksCHPN - Certified Hospice and Palliative Nurse Practice Test
← All CHPN Flashcard Decks

Pain Management Strategies Flashcards

7 cards from real CHPN practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.

Read the first 7 Pain Management Strategies flashcards as text

  1. A hospice patient on long-acting morphine reports breakthrough pain occurring 5-6 times per day. What is the most appropriate intervention?

    Answer: Increase the long-acting opioid dose

    Frequent breakthrough pain (more than 3-4 episodes/day) indicates the baseline long-acting opioid dose is inadequate and should be increased.

  2. Which equianalgesic conversion is correct when rotating from oral morphine 60 mg/day to oral oxycodone?

    Answer: 40 mg oxycodone/day

    The standard equianalgesic ratio of oral morphine to oral oxycodone is approximately 1.5:1, so 60 mg morphine converts to roughly 40 mg oxycodone per day.

  3. A palliative care nurse is assessing a patient with neuropathic pain unresponsive to opioids alone. Which adjuvant is first-line for this pain type?

    Answer: Gabapentin

    Gabapentin (and pregabalin) are first-line adjuvant analgesics for neuropathic pain in palliative care.

  4. When calculating an appropriate breakthrough opioid dose, what percentage of the total daily opioid dose should typically be used?

    Answer: 10-15%

    Breakthrough doses are standardly calculated as 10-15% of the total daily opioid dose, administered every 1-4 hours as needed.

  5. A patient with bone metastases has pain well-controlled at rest but reports severe movement-related (incident) pain. What intervention most specifically targets incident pain?

    Answer: Administering a rapid-onset opioid 20-30 minutes before activity

    Rapid-onset opioids given prophylactically before anticipated painful activities are the standard approach to incident (movement-related) pain.

  6. Which non-pharmacological intervention has the strongest evidence for reducing pain perception in hospice patients?

    Answer: Guided imagery and relaxation techniques

    Guided imagery and relaxation techniques have the strongest evidence base among non-pharmacological approaches for pain modulation in palliative populations.

  7. A hospice patient develops myoclonus and increased sedation after a recent opioid dose increase. What is the most likely cause?

    Answer: Opioid-induced neurotoxicity from accumulation of metabolites

    Opioid-induced neurotoxicity — often due to accumulation of active metabolites such as morphine-6-glucuronide — can cause myoclonus, sedation, and cognitive changes.