CRNI Pain Management and Analgesic Infusion Therapy

Question 1

What is the standard lockout interval for most morphine patient-controlled analgesia (PCA) programs?

Accepted Answer

5–10 minutes

Answer

15–20 minutes

Answer

25–30 minutes

Answer

30–60 minutes

Question 2

Which sedation assessment tool was specifically developed to monitor opioid-induced sedation in patients receiving IV analgesic infusions?

Accepted Answer

Pasero Opioid-induced Sedation Scale (POSS)

Answer

Glasgow Coma Scale (GCS)

Answer

Richmond Agitation-Sedation Scale (RASS)

Answer

Ramsay Sedation Scale

Question 3

When programming a PCA pump, which set of parameters must ALL be verified to ensure safe analgesic delivery?

Accepted Answer

Maximum dose limit, lockout interval, and demand dose

Answer

Demand dose only

Answer

Demand dose and lockout interval only

Answer

Basal rate and demand dose only

Question 4

A patient receiving IV morphine via PCA has a respiratory rate of 8 breaths/min and is difficult to arouse. What is the priority nursing intervention?

Accepted Answer

Administer naloxone and notify the physician

Answer

Increase the lockout interval on the pump

Answer

Decrease the demand dose and continue monitoring

Answer

Discontinue PCA and switch to oral analgesics

Question 5

What is the primary pharmacokinetic advantage of IV patient-controlled analgesia over nurse-administered as-needed opioids?

Accepted Answer

More consistent serum drug levels with less peak-and-trough sedation

Answer

Lower total opioid consumption over 24 hours

Answer

Elimination of the risk of respiratory depression

Answer

Ability to use non-opioid analgesics exclusively

Question 6

Which route of opioid administration provides the fastest onset of analgesia in acute pain management?

Accepted Answer

Intravenous

Answer

Intramuscular

Answer

Oral

Answer

Subcutaneous

Question 7

A patient's family member repeatedly presses the PCA button when the patient is asleep. This practice is called 'PCA by proxy' and is dangerous primarily because:

Accepted Answer

It bypasses the patient's own sedation response, which normally prevents self-overdose

Answer

It causes the pump to malfunction and deliver inaccurate doses

Answer

It rapidly depletes the medication reservoir

Answer

It causes the lockout interval to reset inappropriately