Pain management Flashcards
(201 cards)
1
Q
What is the maximum single dose of morphine sulfate for adult non-ACS pain management? A. 5 mg B. 10 mg C. 20 mg D. 30 mg
A
C. 20 mg
2
Q
Which medication can be administered IN, IM, IV, or IO in 25-100 mcg increments for adults in pain? A. Ketamine B. Fentanyl C. Acetaminophen D. Ibuprofen
A
B. Fentanyl
3
Q
What is the maximum dose of fentanyl for adult pain management if systolic BP > 90? A. 100 mcg B. 200 mcg C. 250 mcg D. 300 mcg
A
D. 300 mcg
4
Q
What is the maximum number of ketamine doses allowed for refractory adult pain? A. 1 dose B. 2 doses C. 3 doses D. 4 doses
A
C. 3 doses
5
Q
Which medication should be administered with caution in patients with SpO2 < 90%? A. Acetaminophen B. Ibuprofen C. Fentanyl D. Ketamine
A
C. Fentanyl
6
Q
Which of the following is a non-opioid option for adult pain management? A. Ketamine B. Nitrous oxide C. Acetaminophen D. All of the above
A
D. All of the above
7
Q
What is the recommended adult dose of ibuprofen for pain? A. 200 mg PO B. 400-800 mg PO with water C. 500 mg IV D. 300 mg IM
A
B. 400-800 mg PO with water
8
Q
Which pain medication is appropriate for pediatric patients and may be administered IN, IM, IV, or IO? A. Ibuprofen B. Fentanyl C. Acetaminophen D. Ketamine
A
B. Fentanyl
9
Q
What is the pediatric single dose limit for morphine sulfate? A. 2 mg B. 3 mg C. 4 mg D. 5 mg
A
C. 4 mg
10
Q
Which pediatric medication is administered at 15 mg/kg PO or rectally? A. Ibuprofen B. Fentanyl C. Acetaminophen D. Morphine
A
C. Acetaminophen
11
Q
What is the initial dose of ketamine for pediatric refractory pain? A. 0.1 mg/kg B. 0.2 mg/kg C. 1 mg/kg D. 2 mg/kg
A
B. 0.2 mg/kg
12
Q
When is it appropriate to administer nitrous oxide for pain? A. Patient unable to self-administer B. Evidence of COPD C. Patient is alert and breathing normally D. Abdominal pain with distension
A
C. Patient is alert and breathing normally
13
Q
Which medication must be avoided in patients with severe liver disease? A. Morphine B. Ketamine C. Acetaminophen D. Fentanyl
A
C. Acetaminophen
14
Q
Which condition is a contraindication to nitrous oxide administration? A. Ankle fracture B. COPD C. Burns D. Back pain
A
B. COPD
15
Q
Which medication is indicated for ACS pain when BP > 100 mmHg? A. Ibuprofen B. Ketamine C. Fentanyl D. Nitrous oxide
A
C. Fentanyl
16
Q
Which medication requires Base Station contact for pediatric additional dosing? A. Ketamine B. Acetaminophen C. Fentanyl D. All of the above
A
D. All of the above
17
Q
Which drug is listed for both adult and pediatric use in the Pain Management protocol? A. Ibuprofen B. Ketamine C. Acetaminophen D. All of the above
A
D. All of the above
18
Q
What dose of morphine is recommended for adult STEMI pain if BP > 100 mmHg? A. 2-4 mg initial, 2-8 mg repeat IV B. 5 mg IM only C. 10 mg IM D. 20 mg total IV
A
A. 2-4 mg initial, 2-8 mg repeat IV
19
Q
Which drug should not be used if GCS is < 15? A. Fentanyl B. Ibuprofen C. Acetaminophen D. Any pain med
A
D. Any pain med
20
Q
For pain management, which patient must have Base Station contact prior to pediatric dosing? A. Any patient under 12 B. All patients < 18 years C. Any patient over 65 D. None
A
B. All patients < 18 years
21
Q
Which of the following is a cautionary sign for all pain medications? A. GCS 15 B. Systolic BP > 90 C. Hypoxia after oxygen D. No history of allergies
A
C. Hypoxia after oxygen
22
Q
Which condition warrants monitoring EtCO2 during pain medication use? A. Hypertension B. Hypoventilation C. Bradycardia D. Vomiting
A
B. Hypoventilation
23
Q
What dose of fentanyl is appropriate IN for an adult with chest pain? A. 25 mcg B. 50 mcg C. 100 mcg D. 200 mcg
A
B. 50 mcg
24
Q
What is the PO dose range of acetaminophen for adults in pain management? A. 200-500 mg B. 500-1000 mg C. 300-600 mg D. 1000-1500 mg
A
B. 500-1000 mg
25
Which pain medication may be used as an inhaled self-administered analgesic? A. Acetaminophen B. Ketamine C. Nitrous oxide D. Fentanyl
C. Nitrous oxide
26
Which patient condition is a contraindication to IV fentanyl use? A. Systolic BP < 90 mmHg B. Pain from trauma C. Chest pain with GCS 15 D. Headache
A. Systolic BP < 90 mmHg
27
What is the action of ketamine at analgesic doses? A. Sedation only B. Dissociative anesthesia C. NMDA receptor antagonist reducing pain perception D. Opioid agonist
C. NMDA receptor antagonist reducing pain perception
28
What is the onset time of IN fentanyl? A. 30 seconds B. 1–2 minutes C. 5–10 minutes D. 20 minutes
B. 1–2 minutes
29
Which side effect is most associated with IV morphine? A. Rash B. Nausea and vomiting C. Headache D. Bradycardia
B. Nausea and vomiting
30
Which pain medication can increase blood pressure and heart rate? A. Morphine B. Fentanyl C. Ketamine D. Acetaminophen
C. Ketamine
31
What is the preferred route for administering ketamine for pain in the field? A. Oral B. IV/IO C. IM D. Rectal
B. IV/IO
32
Which of the following is a common side effect of ketamine? A. Seizure B. Hallucinations C. Bradycardia D. Sweating
B. Hallucinations
33
When using ketamine, what is the maximum total adult dose for pain management? A. 0.5 mg/kg IV B. 1.0 mg/kg IV C. 1.5 mg/kg IV D. 2.0 mg/kg IV
A. 0.5 mg/kg IV
34
What is the most appropriate method to evaluate pain response? A. Pupil dilation B. Glasgow Coma Score C. Numerical pain score D. Capnography
C. Numerical pain score
35
What is the maximum acetaminophen dose for pediatric patients in a single administration? A. 250 mg B. 500 mg C. 15 mg/kg D. 20 mg/kg
C. 15 mg/kg
36
For pain management in burns, which medication is typically avoided? A. Fentanyl B. Nitrous oxide C. Morphine D. Ketamine
B. Nitrous oxide
37
Which pain medication is safest for renal function? A. NSAIDs B. Morphine C. Acetaminophen D. Ibuprofen
C. Acetaminophen
38
What is a key contraindication to NSAID use for pain? A. Diabetes B. Head trauma C. Gastrointestinal bleeding history D. Allergies
C. Gastrointestinal bleeding history
39
Which is a side effect of opioids that warrants EtCO2 monitoring? A. Hallucinations B. Respiratory depression C. Tachycardia D. Hyperventilation
B. Respiratory depression
40
What is a common adult IN dose range for fentanyl? A. 10–25 mcg B. 25–50 mcg C. 50–100 mcg D. 75–150 mcg
C. 50–100 mcg
41
In pediatric patients, what is the typical ketamine dose for pain? A. 0.2 mg/kg IV B. 0.5 mg/kg IV C. 1 mg/kg IM D. 2 mg/kg IV
A. 0.2 mg/kg IV
42
Which of the following should be documented after pain med administration? A. GCS score only B. Pain score, vitals, and drug effects C. Cap refill time D. Blood glucose
B. Pain score, vitals, and drug effects
43
Which medication is appropriate for pediatric extremity trauma with moderate pain? A. Atropine B. Acetaminophen C. Dopamine D. Epinephrine
B. Acetaminophen
44
Which route of administration is NOT appropriate for fentanyl? A. IM B. IV C. Rectal D. IN
C. Rectal
45
What is an absolute contraindication to all pain medications? A. Chest pain B. Head trauma C. Respiratory failure with altered mental status D. Fractures
C. Respiratory failure with altered mental status
46
What should be done if pain persists after maximum pain med dosing? A. Repeat same dose B. Contact base station for further instruction C. Stop care D. Start CPR
B. Contact base station for further instruction
47
Which medication requires patients to remain upright and supervised when self-administered? A. Acetaminophen B. Ketamine C. Nitrous oxide D. Fentanyl
C. Nitrous oxide
48
Which non-opioid analgesic is administered in 15 mg/kg oral doses in pediatrics? A. Ibuprofen B. Ketamine C. Acetaminophen D. Midazolam
C. Acetaminophen
49
How should pain severity be reassessed post-medication? A. Repeat GCS B. Pain score within 10 minutes C. Vital signs only D. No need to reassess
B. Pain score within 10 minutes
50
In which scenario should ketamine be avoided? A. Fracture B. Uncontrolled hypertension C. Dislocation D. Laceration
B. Uncontrolled hypertension
51
What is a key consideration before administering morphine for trauma? A. Age over 50 B. Systolic BP ≥ 100 mmHg C. Pain score < 5 D. Blood glucose under 100
B. Systolic BP ≥ 100 mmHg
52
Which pain medication has a dissociative effect at analgesic doses? A. Acetaminophen B. Morphine C. Ketamine D. Ibuprofen
C. Ketamine
53
What is the most appropriate dosing interval for repeat IV fentanyl? A. Every 1 minute B. Every 3 minutes C. Every 5 minutes D. Every 10 minutes
C. Every 5 minutes
54
Which route is not recommended for pediatric acetaminophen use in the field? A. PO B. IN C. Rectal D. All are acceptable
B. IN
55
What should always be monitored with fentanyl administration? A. Blood sugar B. EtCO2 and respiratory rate C. Pupil response D. Temperature
B. EtCO2 and respiratory rate
56
Which pain med has both analgesic and sedative properties? A. Ibuprofen B. Morphine C. Ketamine D. Acetaminophen
C. Ketamine
57
Which condition may increase the risk of respiratory depression from opioids? A. COPD B. Hypertension C. Fracture D. Fever
A. COPD
58
Which is the most appropriate indication for ibuprofen? A. Head injury B. Flank pain with kidney stones C. Chest pain D. Hypovolemia
B. Flank pain with kidney stones
59
What is the onset of action for IV morphine? A. 1 minute B. 2–3 minutes C. 5–10 minutes D. 15–20 minutes
B. 2–3 minutes
60
Which pain medication can cause emergence reactions like vivid dreams? A. Morphine B. Ketamine C. Fentanyl D. Ibuprofen
B. Ketamine
61
When should you avoid giving pain medication in trauma? A. GCS of 15 B. BP > 100 mmHg C. Suspected head injury with AMS D. Closed fracture
C. Suspected head injury with AMS
62
Which class of pain medications includes ibuprofen? A. NSAIDs B. Opioids C. NMDA antagonists D. Steroids
A. NSAIDs
63
How often should pain be reassessed after giving ketamine? A. Immediately B. Every 5 minutes C. Every 10 minutes D. Every 30 minutes
C. Every 10 minutes
64
Which drug may increase salivation as a side effect? A. Ketamine B. Acetaminophen C. Fentanyl D. Ibuprofen
A. Ketamine
65
What is a pediatric contraindication for ibuprofen? A. Pain < 3 B. Age < 6 months C. Weight > 20 kg D. Temperature > 100°F
B. Age < 6 months
66
Which drug may be safely administered rectally to pediatric patients? A. Ibuprofen B. Fentanyl C. Acetaminophen D. Morphine
C. Acetaminophen
67
In pediatric patients, what is the correct IN fentanyl dose range? A. 0.25–0.5 mcg/kg B. 0.5–1 mcg/kg C. 1–2 mcg/kg D. 2–3 mcg/kg
C. 1–2 mcg/kg
68
Which medication is appropriate for acute musculoskeletal pain in adults with no contraindications? A. Midazolam B. Fentanyl C. Acetaminophen D. All of the above
D. All of the above
69
Which sign indicates the need to stop further opioid dosing? A. Pain > 5 B. BP 110/70 C. Decreased respiratory rate D. Mild nausea
C. Decreased respiratory rate
70
Which route is most preferred for pediatric fentanyl administration in prehospital setting? A. IM B. PO C. IN D. Rectal
C. IN
71
Which of the following is a benefit of ketamine over opioids in trauma? A. Faster onset B. Less respiratory depression C. Less nausea D. All of the above
D. All of the above
72
What condition would preclude the use of nitrous oxide? A. Femur fracture B. Pneumothorax C. Isolated burn D. Laceration
B. Pneumothorax
73
Which vital sign must be recorded before administering any analgesic? A. Temperature B. Blood pressure C. Blood sugar D. Heart rhythm
B. Blood pressure
74
Which pain medication has the slowest onset? A. IV ketamine B. IN fentanyl C. Oral ibuprofen D. IV morphine
C. Oral ibuprofen
75
Which pain management strategy is least invasive and used when others are contraindicated? A. IV morphine B. Ketamine C. Acetaminophen PO D. Fentanyl IN
C. Acetaminophen PO
76
What is the maximum single dose of oral acetaminophen for an adult? A. 500 mg B. 750 mg C. 1000 mg D. 1500 mg
C. 1000 mg
77
Which of the following is a known side effect of opioids? A. Hypertension B. Diarrhea C. Constipation D. Tachycardia
C. Constipation
78
What should be done if a patient receiving opioids becomes hypoxic? A. Stop administration and assist ventilations B. Give more fluids C. Administer ibuprofen D. Apply hot packs
A. Stop administration and assist ventilations
79
Which medication requires base contact before repeat dosing in pediatric patients? A. Fentanyl B. Acetaminophen C. Ketamine D. All of the above
D. All of the above
80
Which of the following is an advantage of IN administration in pediatrics? A. Slower onset B. Avoids IV C. Not well tolerated D. Requires sedation
B. Avoids IV
81
Which analgesic is least likely to cause respiratory depression? A. Morphine B. Fentanyl C. Ketamine D. Acetaminophen
D. Acetaminophen
82
What is the expected onset of IV ketamine? A. 5 minutes B. 1 minute C. 10 minutes D. 15 minutes
B. 1 minute
83
Which patient should not receive ibuprofen? A. History of peptic ulcer B. GCS 15 C. Systolic BP 110 D. Musculoskeletal pain
A. History of peptic ulcer
84
Which medication is appropriate for pediatric moderate-to-severe pain and can be given IN? A. Ibuprofen B. Morphine C. Fentanyl D. Acetaminophen
C. Fentanyl
85
Which medication is contraindicated in head trauma with altered mental status? A. Morphine B. Ketamine C. Fentanyl D. All of the above
D. All of the above
86
Which pain medication may cause euphoria and confusion as side effects? A. Ibuprofen B. Acetaminophen C. Ketamine D. Nitrous oxide
C. Ketamine
87
What is the most important safety step before administering IV opioids? A. Insert nasogastric tube B. Confirm IV patency C. Apply cold compress D. Record pain score only
B. Confirm IV patency
88
Which of the following is a contraindication for nitrous oxide? A. Alert patient B. Air trapping condition C. Pain score 8/10 D. GCS 15
B. Air trapping condition
89
Which condition would best benefit from ketamine over opioids? A. Long bone fracture B. Chest pain C. Headache D. Abdominal cramps
A. Long bone fracture
90
Which side effect should be monitored when giving morphine? A. Tachypnea B. Hypotension C. Dilated pupils D. Hyperglycemia
B. Hypotension
91
What is the purpose of EtCO2 monitoring in patients receiving analgesics? A. Monitor heart rate B. Monitor renal function C. Monitor ventilatory status D. Detect dehydration
C. Monitor ventilatory status
92
Which medication can be used to prevent discomfort during cardioversion? A. Ketamine B. Acetaminophen C. Ibuprofen D. Lidocaine
A. Ketamine
93
What is the most reliable indicator of pain relief? A. Pupil constriction B. Patient report of decreased pain score C. Heart rate drop D. BP reduction
B. Patient report of decreased pain score
94
Which medication is an appropriate first-line choice for minor soft tissue injury pain? A. Fentanyl B. Morphine C. Acetaminophen D. Ketamine
C. Acetaminophen
95
Which of the following conditions is an absolute contraindication for nitrous oxide use? A. Headache B. Pneumothorax C. Fracture D. Burn
B. Pneumothorax
96
What is a common precaution after administering fentanyl? A. Avoid fluids B. Avoid movement C. Avoid further medications D. Monitor vitals closely
D. Monitor vitals closely
97
Which drug should be avoided if patient has respiratory depression? A. Ketamine B. Fentanyl C. Ibuprofen D. Acetaminophen
B. Fentanyl
98
What is the recommended observation time after pain med administration before re-assessing pain? A. 5 minutes B. 10 minutes C. 15 minutes D. 30 minutes
B. 10 minutes
99
What is the effect of opioids on pupils? A. Dilation B. No effect C. Constriction D. Asymmetry
C. Constriction
100
What must be documented following every pain med administration? A. Pupillary reaction B. Level of consciousness only C. Pain scale and vitals D. Lung sounds
C. Pain scale and vitals
101
Which medication is considered safest in pediatric fever with pain? A. Ketamine B. Acetaminophen C. Fentanyl D. Morphine
B. Acetaminophen
102
What is the appropriate adult oral dose of ibuprofen for musculoskeletal pain? A. 200 mg B. 400–800 mg C. 1000 mg D. 1200 mg
B. 400–800 mg
103
Which analgesic should be used with caution in liver disease? A. Ibuprofen B. Fentanyl C. Acetaminophen D. Ketamine
C. Acetaminophen
104
Which of the following pain medications is NOT an opioid? A. Morphine B. Fentanyl C. Ketamine D. Hydromorphone
C. Ketamine
105
Which of the following has the fastest onset of action? A. Oral acetaminophen B. IN fentanyl C. Oral ibuprofen D. IM morphine
B. IN fentanyl
106
Which symptom is a common side effect of opioids? A. Diarrhea B. Increased respiratory rate C. Sedation D. Hypertension
C. Sedation
107
What is the advantage of using IN route for fentanyl in EMS? A. Less effective B. Requires IV access C. Rapid onset and non-invasive D. High cost
C. Rapid onset and non-invasive
108
Which condition is a contraindication for NSAIDs? A. Chest pain B. Renal insufficiency C. Back pain D. Dental pain
B. Renal insufficiency
109
What should EMS providers document before and after pain med administration? A. Only BP B. Pain score and vital signs C. Blood glucose D. SpO2 only
B. Pain score and vital signs
110
Which drug does NOT require IV access for administration in the field? A. Morphine B. Ketamine C. IN Fentanyl D. Midazolam
C. IN Fentanyl
111
Which medication is appropriate for a pediatric patient with isolated extremity trauma and pain score of 6? A. Epinephrine B. Acetaminophen C. Glucose D. Naloxone
B. Acetaminophen
112
Which of the following is NOT a route for fentanyl administration? A. IM B. IV C. IN D. Rectal
D. Rectal
113
What is the goal of pain management in EMS? A. Total sedation B. Normalize blood pressure C. Safely reduce pain and improve comfort D. Slow heart rate
C. Safely reduce pain and improve comfort
114
Which pain medication is associated with emergence reactions in some patients? A. Morphine B. Ibuprofen C. Ketamine D. Acetaminophen
C. Ketamine
115
Which of the following is true about nitrous oxide use? A. Safe for all patients B. Self-administered analgesic gas C. Must be given IV D. Used only in trauma
B. Self-administered analgesic gas
116
Which vital sign change is most concerning after opioid administration? A. BP drop of 10 mmHg B. HR drop of 5 bpm C. Decreased respiratory rate D. Slight pupil change
C. Decreased respiratory rate
117
Which pain medication is best avoided in a patient with altered mental status? A. Acetaminophen B. Ibuprofen C. Fentanyl D. None of the above
C. Fentanyl
118
How often can adult fentanyl doses be repeated? A. Every 1 minute B. Every 2 minutes C. Every 5 minutes D. Every 10 minutes
C. Every 5 minutes
119
What is the primary goal when administering ketamine for pain? A. Deep sedation B. Dissociation and full unconsciousness C. Analgesia while maintaining airway and breathing D. Induce vomiting
C. Analgesia while maintaining airway and breathing
120
Which of the following should be avoided immediately after giving nitrous oxide? A. Transport B. Ongoing assessment C. Base contact D. Supine positioning
D. Supine positioning
121
Which pediatric medication can be administered rectally if oral is not tolerated? A. Ketamine B. Fentanyl C. Acetaminophen D. Ibuprofen
C. Acetaminophen
122
Which of the following is a side effect of ketamine? A. Hypoglycemia B. Seizures C. Hypertension D. Diarrhea
C. Hypertension
123
Which class does acetaminophen belong to? A. NSAID B. Antipyretic and analgesic C. Narcotic D. Anticholinergic
B. Antipyretic and analgesic
124
Which medication has little to no effect on respiratory drive at analgesic doses? A. Fentanyl B. Morphine C. Ketamine D. All of the above
C. Ketamine
125
Which is a benefit of administering acetaminophen over NSAIDs in older adults? A. Longer duration B. Less GI irritation C. Sedation D. More potent
B. Less GI irritation
126
What is a potential risk of high-dose ibuprofen use in adults? A. Respiratory arrest B. GI bleeding C. Hyperkalemia D. Bradycardia
B. GI bleeding
127
Which of the following medications is NOT typically used in the field for pain control? A. Fentanyl B. Acetaminophen C. Ketamine D. Naloxone
D. Naloxone
128
What is the safest analgesic choice for a pregnant patient in EMS? A. Fentanyl B. Acetaminophen C. Ketamine D. Ibuprofen
B. Acetaminophen
129
Which pain medication has minimal cardiovascular effects? A. Morphine B. Ketamine C. Ibuprofen D. Acetaminophen
D. Acetaminophen
130
What is the mechanism of action of NSAIDs like ibuprofen? A. NMDA receptor blockade B. COX enzyme inhibition C. Opioid receptor agonism D. Sodium channel blockade
B. COX enzyme inhibition
131
Which of the following must be monitored closely after opioid administration? A. Bowel sounds B. Respiratory rate C. Skin color D. Pupil size
B. Respiratory rate
132
Which pain medication can be administered without IV access? A. Morphine B. IV acetaminophen C. Ketamine D. IN fentanyl
D. IN fentanyl
133
Which symptom is NOT typically caused by opioid overdose? A. Respiratory depression B. Bradycardia C. Hyperactivity D. Pinpoint pupils
C. Hyperactivity
134
Which medication is used off-label in EMS to reduce pain while minimizing sedation? A. Midazolam B. Ketamine C. Naloxone D. Lidocaine
B. Ketamine
135
How is pediatric IV ketamine administered for pain control? A. Rapid IV push B. IM injection only C. Slowly over 1 minute D. Orally
C. Slowly over 1 minute
136
Which medication is safest in patients with allergy to NSAIDs? A. Fentanyl B. Ibuprofen C. Aspirin D. Ketorolac
A. Fentanyl
137
What is a major contraindication to using acetaminophen? A. Renal disease B. Hypertension C. Liver dysfunction D. Asthma
C. Liver dysfunction
138
What should be done before administering ketamine to a patient? A. Ensure airway equipment is ready B. Sedate the patient C. Administer oxygen only D. Insert nasogastric tube
A. Ensure airway equipment is ready
139
What effect does ketamine have on blood pressure? A. Causes hypotension B. No effect C. May elevate BP D. Causes bradycardia
C. May elevate BP
140
Which medication is commonly used in field care for long bone fractures? A. Acetaminophen B. Ketamine C. Ibuprofen D. Glucose
B. Ketamine
141
Which pain med is preferred for pediatric fever with discomfort? A. Fentanyl B. Ibuprofen C. Acetaminophen D. Morphine
C. Acetaminophen
142
Which route is fastest for pain relief in EMS without requiring IV access? A. IN B. PO C. IM D. Rectal
A. IN
143
Which is a potential adverse effect of IN fentanyl? A. Tachypnea B. Hyperventilation C. Hypoventilation D. Hypertension
C. Hypoventilation
144
Which pain med is most appropriate for a patient with abdominal pain and no trauma? A. Ketamine B. Acetaminophen C. Ibuprofen D. Fentanyl
B. Acetaminophen
145
When using ketamine, how long should vitals be monitored post-administration? A. Until pain relief B. 5 minutes C. At least 10 minutes D. 30 seconds
C. At least 10 minutes
146
Which of the following medications is contraindicated in patients with active GI bleeding? A. Acetaminophen B. Ketamine C. Ibuprofen D. Fentanyl
C. Ibuprofen
147
Which medication used for pain also has sedative effects? A. Ibuprofen B. Ketamine C. Acetaminophen D. Aspirin
B. Ketamine
148
Which patient should be evaluated by base contact before additional pediatric dosing of pain meds? A. 14-year-old with leg fracture B. 17-year-old with wrist pain C. Any under 18 years D. Only infants under 6 months
C. Any under 18 years
149
Which pain medication is most appropriate for a cooperative adult with a dislocated shoulder and normal vitals? A. Midazolam B. Ibuprofen C. IN fentanyl D. Diazepam
C. IN fentanyl
150
Which medication may cause nausea as a side effect and should be given slowly? A. Morphine B. Acetaminophen C. Ketamine D. Ibuprofen
A. Morphine
151
Question (Front)
Answer (Back)
152
What is a known effect of morphine on the cardiovascular system? A. Vasoconstriction B. Hypotension C. Hypertension D. Tachycardia
B. Hypotension
153
Which analgesic is appropriate for initial use in minor pediatric pain? A. Ketamine B. Acetaminophen C. Fentanyl D. Nitroglycerin
B. Acetaminophen
154
What is the preferred method of pain management in a combative patient with suspected extremity fracture? A. IN ketamine B. IN fentanyl C. Oral acetaminophen D. IV ibuprofen
A. IN ketamine
155
What is the maximum frequency of IV fentanyl administration for adults? A. Every 2 minutes B. Every 3 minutes C. Every 5 minutes D. Every 10 minutes
C. Every 5 minutes
156
What precaution must be taken when administering ketamine in the field? A. No airway equipment needed B. Administer while supine only C. Monitor for emergence reactions D. Follow with atropine
C. Monitor for emergence reactions
157
Which of the following is the least invasive method of pediatric pain control? A. IV ketamine B. IN fentanyl C. PO acetaminophen D. IM morphine
C. PO acetaminophen
158
Which of the following pain meds is administered in 0.5 mg/kg increments in pediatrics? A. Ibuprofen B. Ketamine C. Fentanyl D. Acetaminophen
B. Ketamine
159
What is the main advantage of using acetaminophen in elderly patients? A. Increased sedation B. Lower GI risk compared to NSAIDs C. Faster onset than opioids D. Decreases BP
B. Lower GI risk compared to NSAIDs
160
Which analgesic may worsen liver function when overused? A. Ibuprofen B. Fentanyl C. Acetaminophen D. Ketamine
C. Acetaminophen
161
Which of the following medications is acceptable for use during STEMI management if BP allows? A. Ibuprofen B. Morphine C. Acetaminophen D. Ketorolac
B. Morphine
162
Which analgesic may help reduce opioid use when given early in mild-to-moderate pain? A. Ketamine B. Acetaminophen C. Ibuprofen D. Both B and C
D. Both B and C
163
Which pain med route is often used in young children who refuse PO meds? A. IV B. IN C. Rectal D. IM
C. Rectal
164
What is the reason ketamine is often preferred in trauma over opioids? A. Reduces inflammation B. Enhances perfusion C. Preserves airway reflexes and breathing D. Decreases BP
C. Preserves airway reflexes and breathing
165
What is the dose range of oral ibuprofen for pediatric pain? A. 4–6 mg/kg B. 6–10 mg/kg C. 10–15 mg/kg D. 15–20 mg/kg
B. 6–10 mg/kg
166
Which of the following should be avoided in patients with history of severe asthma triggered by NSAIDs? A. Acetaminophen B. Ibuprofen C. Ketamine D. Fentanyl
B. Ibuprofen
167
Which pain management drug is contraindicated in children < 6 months? A. Acetaminophen B. Ibuprofen C. Ketamine D. Fentanyl
B. Ibuprofen
168
Which pain medication has an NMDA receptor antagonist mechanism of action? A. Ketamine B. Morphine C. Acetaminophen D. Ibuprofen
A. Ketamine
169
What is a sign of effective pain relief after medication? A. Slight increase in heart rate B. Change in respiratory pattern C. Verbal report of reduced pain score D. Reduced temperature
C. Verbal report of reduced pain score
170
Which opioid is preferred for EMS field use due to rapid onset and short duration? A. Hydromorphone B. Fentanyl C. Morphine D. Codeine
B. Fentanyl
171
What is the pediatric dose for oral acetaminophen? A. 10 mg/kg B. 12 mg/kg C. 15 mg/kg D. 20 mg/kg
C. 15 mg/kg
172
Which route is least desirable for pain med administration in EMS? A. IN B. PO C. IV D. Rectal
D. Rectal
173
Which symptom indicates a need to stop opioid administration? A. Nausea B. Anxiety C. Bradypnea D. Sweating
C. Bradypnea
174
What is a key concern when giving repeated opioid doses in short intervals? A. Hypertension B. Respiratory depression C. Sedation only D. Nausea only
B. Respiratory depression
175
What is the safest opioid choice for pain in a patient with unknown allergy history? A. Morphine B. Fentanyl C. Codeine D. None of the above
B. Fentanyl
176
What is a risk of administering NSAIDs to a dehydrated patient? A. Liver failure B. Renal injury C. Arrhythmia D. Nausea
B. Renal injury
177
Which pain medication does not require IV, IM, or IN access for administration? A. Acetaminophen PO B. Fentanyl C. Morphine D. Ketamine
A. Acetaminophen PO
178
Which drug should be avoided in children with dehydration and fever? A. Acetaminophen B. Ketamine C. Ibuprofen D. Fentanyl
C. Ibuprofen
179
What is a potential side effect of repeated ketamine doses? A. Hypotension B. Bradycardia C. Emergence reactions D. Constipation
C. Emergence reactions
180
Which of the following medications can be administered IN, IV, IM, or IO? A. Acetaminophen B. Ketamine C. Fentanyl D. Ibuprofen
C. Fentanyl
181
Which vital sign must be monitored continuously when administering opioids? A. Temperature B. Respiratory rate C. Blood sugar D. Cap refill
B. Respiratory rate
182
What is a potential side effect of NSAIDs in elderly patients? A. Constipation B. Tachycardia C. GI bleeding D. Hallucinations
C. GI bleeding
183
Which pain medication is safest for a patient with a history of GI ulcers? A. Ketamine B. Fentanyl C. Ibuprofen D. Aspirin
B. Fentanyl
184
Which pediatric route of acetaminophen is useful when IV and PO are unavailable? A. IM B. Rectal C. IN D. SubQ
B. Rectal
185
Which of the following is the preferred treatment for procedural pain such as cardioversion? A. Acetaminophen B. Fentanyl C. Ketamine D. Ibuprofen
C. Ketamine
186
What is the purpose of EtCO2 monitoring during opioid administration? A. Check for CO2 poisoning B. Monitor perfusion C. Assess respiratory adequacy D. Estimate glucose
C. Assess respiratory adequacy
187
Which symptom is most associated with fentanyl overdose? A. Hypertension B. Rash C. Bradycardia and apnea D. Muscle rigidity
C. Bradycardia and apnea
188
Which pain med should be avoided in patients with hepatic failure? A. Ibuprofen B. Fentanyl C. Acetaminophen D. Ketamine
C. Acetaminophen
189
What is the primary reason ketamine is used for pain control in EMS? A. Sedation B. Euphoria C. Maintains respiratory drive D. Increases BP
C. Maintains respiratory drive
190
Which pain medication is both an analgesic and antipyretic? A. Fentanyl B. Acetaminophen C. Ketamine D. Ibuprofen
B. Acetaminophen
191
Which pain medication is contraindicated in head injury with AMS? A. Ketamine B. Acetaminophen C. Ibuprofen D. Midazolam
A. Ketamine
192
What is the preferred pain medication for a pediatric burn patient unable to take oral meds? A. Fentanyl IN B. Ibuprofen PO C. Acetaminophen PO D. Midazolam IM
A. Fentanyl IN
193
Which of the following is a benefit of ketamine compared to opioids? A. Lower BP B. No hallucinations C. Does not suppress breathing D. Causes constipation
C. Does not suppress breathing
194
What is the proper IN dose of fentanyl for an adult with moderate pain? A. 10 mcg B. 25 mcg C. 50 mcg D. 75 mcg
C. 50 mcg
195
Which medication is typically avoided in trauma with suspected internal bleeding? A. Acetaminophen B. Ketamine C. Fentanyl D. Ibuprofen
D. Ibuprofen
196
Which route provides the most consistent onset for analgesia in EMS? A. Oral B. IN C. IV D. IM
C. IV
197
What effect does ketamine have on heart rate and blood pressure? A. Lowers both B. Raises both C. No change D. Only lowers heart rate
B. Raises both
198
Which of the following is true about fentanyl? A. Long-acting opioid B. No risk of respiratory depression C. Rapid onset and short duration D. Requires oral administration
C. Rapid onset and short duration
199
Which drug should you avoid in patients with poor liver function? A. Fentanyl B. Acetaminophen C. Ketamine D. Ibuprofen
B. Acetaminophen
200
Which of these is a common non-opioid medication for mild pain in the EMS setting? A. Ibuprofen B. Ketamine C. Fentanyl D. Hydromorphone
A. Ibuprofen
201
Which route is acceptable for ketamine administration in pediatric patients in the field? A. IV B. IN C. IM D. All of the above
D. All of the above
