CPAN CPAN Pain Management 5

Question 1

A patient received preservative-free morphine intrathecally. For how long should the nurse monitor closely for delayed respiratory depression?

Accepted Answer

Up to 24 hours

Answer

Hydrophilic morphine spreads rostrally in the CSF and can cause delayed respiratory depression up to about 24 hours later.

Question 2

A patient with stage 4 chronic kidney disease needs IV opioid analgesia in the PACU. Which opioid should the nurse question?

Accepted Answer

Morphine

Answer

Morphine's active metabolites (M3G/M6G) build up in renal failure and can cause sedation, respiratory depression, and neurotoxicity.

Question 3

A patient with OSA on supplemental oxygen is receiving IV opioids. Which monitoring method detects hypoventilation earliest?

Accepted Answer

Continuous capnography (EtCO2)

Answer

Supplemental oxygen can keep SpO2 normal while CO2 rises, so capnography catches hypoventilation sooner.

Question 4

A patient on long-term buprenorphine for opioid use disorder is having elective surgery. Which approach follows current best practice?

Accepted Answer

Usually continue buprenorphine and add multimodal analgesia plus higher-affinity or higher-dose full agonists as needed

Answer

Current guidance generally favors continuing buprenorphine to prevent relapse and managing acute pain with multimodal strategies.

Question 5

A patient receiving a PRN IV opioid is also taking scheduled gabapentin. What should the nurse anticipate?

Accepted Answer

Higher risk of sedation and respiratory depression

Answer

The FDA warns that gabapentinoids combined with opioids increase the risk of serious respiratory depression.

(CPAN) Certified Post Anesthesia Nurse Practice Test