CHPN Pain Management Strategies 3

Question 1

A palliative nurse recognizes that a patient's pain report is inconsistent with their behavioral cues. What is the gold standard for pain assessment in cognitively intact patients?

Accepted Answer

Patient self-report

Answer

Patient self-report is always the gold standard for pain assessment in patients who can communicate, regardless of discrepant behavioral cues.

Question 2

When transitioning a patient from IV morphine to oral morphine, what is the correct conversion ratio (IV to oral)?

Accepted Answer

1:3

Answer

IV morphine is approximately 3 times more potent than oral morphine, so the IV-to-oral conversion ratio is 1:3.

Question 3

A dying patient is unable to swallow and has moderate pain. The family refuses an IV line. Which route is most appropriate for opioid delivery?

Accepted Answer

Sublingual or buccal administration

Answer

Sublingual or buccal opioid administration is a noninvasive, effective alternative when the patient cannot swallow and IV access is unavailable.

Question 4

Which tool is most appropriate for assessing pain in a hospice patient with advanced dementia who cannot verbalize?

Accepted Answer

PAINAD (Pain Assessment in Advanced Dementia)

Answer

The PAINAD scale uses behavioral observation (breathing, vocalization, facial expression, body language, consolability) to assess pain in nonverbal dementia patients.

Question 5

Corticosteroids such as dexamethasone are used as adjuvant analgesics in palliative care primarily for which type of pain?

Accepted Answer

Pain from cord compression and bone metastases with inflammatory component

Answer

Dexamethasone reduces peritumoral edema and inflammation, making it effective for pain from spinal cord compression and bone metastases.

CHPN - Certified Hospice and Palliative Nurse Practice Test

CHPN - Certified Hospice and Palliative Nurse Practice Test

CHPN Pain Management Strategies 3