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

A 5–10 minute lockout interval is standard for IV morphine PCA, allowing time to assess the effect of each demand dose before another can be delivered.

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

The Pasero Opioid-induced Sedation Scale (POSS) was specifically designed to assess sedation in patients receiving opioids and guides nursing interventions based on sedation level.

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

Safe PCA programming requires verification of the demand dose, lockout interval, and maximum dose limit together to prevent inadvertent opioid overdose.

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

Respiratory depression with decreased consciousness requires immediate administration of naloxone (opioid antagonist) and physician notification, as this is a life-threatening emergency.

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

PCA maintains more stable serum opioid concentrations by allowing small frequent doses, reducing the wide peaks and troughs seen with traditional as-needed intramuscular or IV bolus dosing.

CRNI Exam Practice Test

CRNI Exam Practice Test

CRNI Pain Management and Analgesic Infusion Therapy