Practice Test Geeks(PSA) Prescribing Safety Assessment Practice Test
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Pain Management Flashcards

7 cards from real PSA practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.

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  1. A patient on methadone maintenance is prescribed erythromycin for a chest infection. What is the principal safety concern?

    Answer: Increased risk of QTc prolongation and torsades de pointes

    Methadone prolongs the QTc interval, and erythromycin also prolongs QT; combined use significantly increases the risk of torsades de pointes.

  2. A patient with Child-Pugh B hepatic cirrhosis requires regular analgesia. What is the maximum recommended daily paracetamol dose?

    Answer: 2 g

    In significant hepatic impairment, the maximum paracetamol dose is reduced to 2 g per day to avoid hepatotoxicity.

  3. Which observation in a patient on a morphine infusion requires the most urgent clinical review?

    Answer: Respiratory rate 8 breaths per minute

    A respiratory rate below 12 breaths per minute indicates opioid-induced respiratory depression requiring immediate assessment and possible naloxone.

  4. A patient on oral morphine 30 mg twice daily is switched to oral oxycodone. What is the approximate equianalgesic oxycodone dose?

    Answer: 20 mg twice daily

    Oral oxycodone is approximately 1.5 times more potent than oral morphine, so 60 mg/day morphine equates to approximately 40 mg/day (20 mg BD) oxycodone.

  5. A patient with chronic pain and an eGFR of 25 ml/min is prescribed gabapentin. What dosing adjustment is required?

    Answer: Dose reduction required as gabapentin is renally excreted

    Gabapentin is almost entirely excreted unchanged by the kidneys; dose reduction is mandatory in renal impairment to prevent toxicity.

  6. A patient on high-dose morphine for cancer pain develops jerking limb movements (myoclonus). What is the most appropriate management?

    Answer: Perform opioid rotation to an alternative opioid

    Myoclonus is a sign of opioid neurotoxicity (often due to metabolite accumulation); opioid rotation to a structurally different opioid resolves this.

  7. Which antiemetics are most appropriate for opioid-induced nausea and vomiting?

    Answer: Metoclopramide or haloperidol

    Metoclopramide (dopamine antagonist with prokinetic action) and haloperidol (acting on the chemoreceptor trigger zone) are first-line options for opioid-induced nausea.