1. Examples of nociceptive pain include which of the following:
A. Irritable bowel syndrome, pelvic pain syndrome, interstitial cystitis
B. Rheumatoid arthritis, gout, neck and back pain with structural pathology
C. Acute herpes zoster, postoperative pain, radiculopathy
D. All of the above
2. When assessing patients in pain, the main focus should be on:
A. Eliminating side effects of pain medications
B. Reducing dosages of pain medications
C. Restoring the patient's functional status
D. Looking for signs of medication misuse/abuse/diversion
3. The treatment goals associated with acute pain include:
A. Facilitate recovery from the underlying injury, surgery, or disease
B. Control and reduce pain to acceptable level
C. Restore physical, emotional, and social function
D. Improve quality of life
E. A and B
F. B and D
4. Nonpharmacologic therapies for pain:
A. Have greater efficacy than pharmacologic therapies
B. May include interventional approaches
C. Do not include exercise because exercise stimulates the endorphin chemicals
D. Are best provided as part of the thousands of interdisciplinary programs in the US
5. The most effective and safe way to manage pain with medication is:
A. NSAIDs and antidepressants
B. Anticonvulsants
C. Immediate-release opioids
D. As part of a multimodal plan of care
6. When chronic opioid therapy is initiated:
A. Alternative analgesics should be discontinued
B. An ER/LA formulation should be used
C. A treatment agreement, consent, and urine drug test are required
D. Low doses of immediate release formulations are preferable
7. Looking at pharmacogenetic variability and response, what percentage of the general population has phenotype variability?
A. 5%-8%
B. 10%-15%
C. 25%-35%
D. 40%-60%
8. How would you proceed if you inherited a patient prescribed both a benzodiazepine for sleep and high-dose opioids after 9 spine surgeries?
A. Continue both as prescribed
B. Reduce the dosages of both medications
C. Discontinue the opioid or benzodiazepine therapy
D. Consider an alternative medication, such as an anticonvulsant or low-dose trazodone
9. In converting patients from one extended-release opioid to another extended-release opioid:
A. Use conversion tables to determine the exact starting dose of the new opioid
B. Adjust the dose of the new opioid every 24 hours
C. Start the new ER opioid at a lower dose or dose as if the patient is opioid naïve
D. Never use IR opioids during an opioid rotation
10. Co-prescribing of take-home naloxone should be considered for patients:
A. Taking high doses of opioids (≥MME per day)
B. With a legitimate medical need for analgesia, coupled with suspected/confirmed substance abuse
C. Undergoing opioid rotation
D. Discharged from emergency medical care following opioid intoxication/poisoning
E. All of the above
11. Which of the following is true?
A. All aberrant behaviors are signs of addiction
B. All aberrant behaviors are signs of abuse
C. All patients on opioids eventually show signs of aberrant behaviors
D. All people with an opioid addiction misuse/abuse opioids
12. Patient/provider counseling strategies include all of the following except :
A. Cognitive behavioral therapy
B. Motivational interviewing
C. CAP counseling
D. Individual counseling
E. Community reinforcement approach