CRNI Pain Management and Analgesic Infusion Therapy 3

Question 1

A patient receiving epidural analgesia develops a respiratory rate of 7 breaths/min and cannot be aroused to voice. Which intervention is most urgent?

Accepted Answer

Administer IV naloxone and call the physician immediately

Answer

Epidural opioids can cause delayed respiratory depression; respiratory rate below 8 with unarousable sedation is a medical emergency requiring naloxone and immediate physician notification.

Question 2

Per infusion nursing standards, patients receiving continuous IV opioid infusions should have respiratory status assessed at minimum how often?

Accepted Answer

Every 1–2 hours

Answer

Infusion Nurses Society (INS) standards recommend respiratory assessment at minimum every 1–2 hours for patients on continuous opioid infusions to detect early respiratory depression.

Question 3

Intrathecal drug delivery differs fundamentally from epidural delivery in that:

Accepted Answer

Medication is delivered directly into the cerebrospinal fluid (CSF)

Answer

Intrathecal delivery places medication directly into the subarachnoid space within the CSF, allowing much smaller doses to achieve analgesia compared to epidural or IV routes.

Question 4

A nurse notes that a patient's PCA pump shows zero patient-activated demands in the past 8 hours, yet the patient reports severe uncontrolled pain. What is the priority assessment?

Accepted Answer

Assess the patient, IV site patency, and tubing connections

Answer

Zero demand dose deliveries with reported pain suggests a mechanical problem such as an occluded IV site, kinked tubing, or pump malfunction — assessment of the patient and system integrity comes first.

Question 5

When caring for a patient with an implanted intrathecal drug delivery pump, the nurse should recognize that the most serious risk is:

Accepted Answer

Catheter tip granuloma or pump programming error causing drug overdose

Answer

Programming errors and catheter tip inflammatory mass (granuloma) are the most serious complications of intrathecal pumps as they can cause catastrophic overdose or loss of analgesia.

CRNI Exam Practice Test

CRNI Exam Practice Test

CRNI Pain Management and Analgesic Infusion Therapy 3