ABPANC ABPANC Pain Management 2 — Questions and Answers
Question 1: A PACU patient reports severe incisional pain but has already received the maximum ordered opioid dose. Which non-pharmacological intervention is most appropriate?
- Encourage the patient to sleep it off
- Apply ice packs to the incision site as ordered (Correct answer)
- Administer an extra dose of opioid beyond the order
- Restrict all movement to reduce discomfort
Correct answer: Apply ice packs to the incision site as ordered
Ice application reduces inflammation and local pain signals and can be used as an adjunct to pharmacological management when the maximum opioid dose has been reached.
Question 2: What is the primary goal of a patient-controlled analgesia (PCA) pump in the perianesthesia setting?
- To eliminate the need for nurse assessment
- To allow patients to self-administer analgesic within prescribed limits (Correct answer)
- To replace epidural analgesia in all cases
- To deliver a continuous infusion without patient input
Correct answer: To allow patients to self-administer analgesic within prescribed limits
PCA allows patients to self-administer preset analgesic doses, improving pain control and patient satisfaction while maintaining safety through lockout intervals.
Question 3: Which finding in a patient on IV opioid PCA should prompt the nurse to stop the infusion immediately?
- Respiratory rate of 10 breaths/min with SpO2 of 88% (Correct answer)
- Pain score of 6/10
- Patient pressing the demand button every 15 minutes
- Mild drowsiness
Correct answer: Respiratory rate of 10 breaths/min with SpO2 of 88%
A respiratory rate of 10 with SpO2 of 88% indicates opioid-induced respiratory depression and hypoxia, requiring immediate cessation of the PCA and administration of naloxone.
Question 4: A perianesthesia nurse is educating a patient about the pain scale before surgery. Which statement best describes the purpose of preoperative pain education?
- To guarantee the patient will be pain-free postoperatively
- To set realistic expectations and improve postoperative pain reporting accuracy (Correct answer)
- To discourage opioid use after surgery
- To document that consent for anesthesia was obtained
Correct answer: To set realistic expectations and improve postoperative pain reporting accuracy
Preoperative pain education sets realistic expectations and teaches patients how to accurately use the pain scale, improving postoperative pain management outcomes.
Question 5: Which drug class is commonly used as part of a 'pre-emptive analgesia' strategy before surgical incision?
- Antihypertensives
- COX-2 inhibitors or NSAIDs (Correct answer)
- Beta-blockers
- H2 antagonists
Correct answer: COX-2 inhibitors or NSAIDs
COX-2 inhibitors and NSAIDs given pre-operatively reduce central sensitization and decrease postoperative opioid requirements.
Question 6: When documenting pain management in the PACU, which element is essential for a complete pain assessment record?
- Patient's dietary preferences
- Pain score, location, quality, and response to intervention (Correct answer)
- Surgeon's preference for analgesic agents
- Type of surgical drape used
Correct answer: Pain score, location, quality, and response to intervention
Complete pain documentation must include the pain score, location, quality, interventions given, and the patient's response to evaluate effectiveness.
ABPANC ABPANC Pain Management 2
A PACU patient reports severe incisional pain but has already received the maximum ordered opioid dose.
Which non-pharmacological intervention is most appropriate?