sedation and pain management

Question 1

The process of alleviating pain is:

Question 1 options:

A)

Analgesia.

B)

Sedation.

C)

Anesthetics.

D)

Anesthesia.

Answer 1

analgesia

Question 2

A medication that relieves anxiety that a patient might experience is known as a/an:

Question 2 options:

A)

Analgesic.

B)

Anxiolytic.

C)

Sympatholytic.

D)

Parasympathomimetic.

Answer 2

anxioltic

Question 3

Which of the following statements regarding the use of moderate sedation is TRUE?

Question 3 options:

A)

The patient is sedated to a point where they cannot be aroused.

B)

Cardiac function is impaired.

C)

Moderate sedation is designed for relief of anxiety.

D)

The patient is able to respond to verbal or tactile stimulation.

Answer 3

the patient is able to respond to verbal or tactile stimulation

Question 4

A narcotic analgesic that has both agonistic and antagonistic activities on opiate receptor sites is:

Question 4 options:

A)

Fentanyl.

B)

Morphine.

C)

Butorphanol tartrate (Stadol).

D)

Meperidine.

Answer 4

Butorphanol tartrate (stadol)

Question 5

A contraindication for the use of morphine sulfate is:

Question 5 options:

A)

Congestive heart failure.

B)

Moderate pain.

C)

Tachycardia.

D)

Hypotension.

Answer 5

hypotension

Question 6

Morphine has been determined to have potential for abuse and is an addictive medication. Therefore, the FDA has scheduled morphine as a Schedule ________ narcotic.

Question 6 options:

A)

I

B)

II

C)

III

D)

IV

Answer 6

II

Question 7

When utilizing morphine for pain management, the paramedic should:

Question 7 options:

A)

Never exceed 10 mg.

B)

Utilize Romazicon as an antagonist for respiratory depression should it occur.

C)

Be prepared to administer naloxone.

D)

Only administer intramuscularly in the field.

Answer 7

be prepared to administer naloxone

Question 8

You are treating a patient who has experienced a fracture of his right forearm while playing sports. The patient is alert, oriented, with normal vital signs. He reports pain is an “8” on a 10-point system. The patient has a history of depression and has taken phenelzine (Nardil) for many years with no problems. Which of the following is TRUE regarding the use of Demerol for this patient?

Question 8 options:

A)

A standard dose of meperidine will be suitable for this patient.

B)

The patient will most likely have developed a tolerance for narcotics and may require larger than normal doses.

C)

Demerol should not be used for this patient.

D)

Because Nardil is used for depression, you should only administer half the initial dosage and have naloxone available for respiratory depression.

Answer 8

Demerol should not be used for this patient

Question 9

An advantage to the use of fentanyl (Sublimaze) when compared to morphine or meperidine is that:

Question 9 options:

A)

It has less emetic effect than other narcotic analgesics.

B)

It does not produce the respiratory depression that accompanies morphine and meperidine.

C)

Romazicon is an effective antagonist.

D)

It is not a narcotic analgesic.

Answer 9

it has less emetic effect that other narcotic analgesics

Question 10

When administering fentanyl, an advantage is that:

Question 10 options:

A)

It may only be administered IV which makes administration more reliable.

B)

It lasts 4-5 times longer than other narcotic analgesics.

C)

The dosage is the same as morphine.

D)

It may be administered intranasally.

Answer 10

it may be administered intranasally

Question 11

When Nitronox has been removed from the patient who has been using it for pain relief, it will:

Question 11 options:

A)

Cause respiratory depression as the effects grow weaker.

B)

Be effective for at least 30-45 minutes before its half-life is diminished.

C)

Eliminate all pain that the patient is experiencing.

D)

Quickly dissipate from the patient’s system.

Answer 11

quickly dissipate from the patients system

Question 12

The use of Nitronox is contraindicated in a patient with a history of:

Question 12 options:

A)

Hyperventilation.

B)

Moderate burns.

C)

COPD.

D)

Musculoskeletal injury.

Answer 12

COPD

Question 13

It is important to remember when treating a narcotic-dependent patient that:

Question 13 options:

A)

Stadol has agonist effects that make it the preferred medication for narcotic dependent patients while not increasing dependence.

B)

All narcotic dosages should be reduced by at least one-half to avoid significant respiratory depression.

C)

They should not be given any other narcotics due to the potential of increasing their dependency.

D)

Stadol and Nubain may cause withdrawal to the narcotic-dependent patient.

Answer 13

all narcotic dosages should be reduced by at least one half to avoid significant respiratory depression

Question 14

A nonsteroidal anti-inflammatory medication capable of producing analgesia and is useful in the management of moderate to severe pain is ________.

Question 14 options:

A)

Meperidine

B)

Naloxone

C)

Ketorolac

D)

Diazepam

Answer 14

Ketorolac

Question 15

A nonsteroidal anti-inflammatory medication that is the MOST common cause of acute liver failure is ________.

Question 15 options:

A)

Ibuprofen

B)

Depo-Medrol

C)

Acetaminophen (Tylenol)

D)

Ketorolac

Answer 15

Acetaminophen Tylenol

Question 16

________ causes a disassociation between the limbic system and the cortical system that result in a seemingly awake patient who is disassociated with the environment.

Question 16 options:

A)

Diazepam

B)

Etomidate

C)

Ketamine

D)

Ativan

Answer 16

Ketamine

Question 17

A sedative that has the best safety profile of all the sedative/hypnotics that is very short-lived and indicated in rapid sequence intubation is:

Question 17 options:

A)

Morphine Sulfate

B)

Midazolam

C)

Etomidate

D)

Ketamine

Answer 17

Etomidate

Question 18

Propofol allows the health care provider to:

Question 18 options:

A)

Utilize either naloxone or flumazenil (Romazicon) for antagonism should the patient overdose with self-administration.

B)

Provide for maintenance of sedation during a procedure.

C)

Allow sedation and pain control post-procedure because of its short half-life.

D)

Allow the patient to self-administer for adequate sedation.

Answer 18

provide maintenance of sedation during a procedure

Question 19

Of the medications that produce neuromuscular blockade, ________ is the only one that is a depolarizing agent.

Question 19 options:

A)

Pancuronium

B)

Vecuronium

C)

Succinylcholine

D)

Propofol

Answer 19

succinycholine

Question 20

All of the following are correct regarding the use of succinylcholine EXCEPT which statement?

Question 20 options:

A)

It causes fractures if used in the pediatric patient.

B)

It should be administered by experienced personnel.

C)

It is a short-acting, long-lasting neuromuscular blocker.

D)

It is a depolarizing agent.

Answer 20

it is a short-acting long - lasting neuromuscular blocker

Question 21

Pancuronium bromide is a ________ neuromuscular blocker that causes the patient to experience flaccid paralysis following administration.

Question 21 options:

A)

Slow-acting, long-lasting

B)

Fast-acting, long-lasting

C)

Fast-acting, short-lasting

D)

Slow-acting, short-lasting

Answer 21

fast acting- long lasting

Question 22

The normal adult dosage of vecuronium is:

Question 22 options:

A)

1-2 mg/kg IV.

B)

0.08-0.1 mg/kg.

C)

0.08-0.1 mg IV.

D)

100-200 mg IV.

Answer 22

0.08- 0.1 mg/kg

Question 23

Neuromuscular blocking agents have no effect on consciousness, therefore, the paramedic should:

Question 23 options:

A)

Administer following a sedative/hypnotic.

B)

Only utilize neuromuscular blockers when a patient has lost consciousness.

C)

Only use neuromuscular blockade during seizures.

D)

Remember to utilize only small amounts of the neuromuscular blocker if necessary.

Answer 23

administer following a sedative hypnotic