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Test bank pharmaco.docx NURSING NGR 5035 Chapter 46-53

Test bank NURSING NGR 5035 Chapter 46-53 Chapter 46: Upper Respiratory Infections: Otitis Media and Otitis Externa Multiple Choice Identify the choice that best completes the statement or answers the question. ____ 1. Caleb is an adult with an upper respiratory infection (URI). Treatment for his URI would include: A. Amoxicillin B. Diphenhydramine C. Phenylpropanolamine D. Topical oxymetazoline ____ 2. Rose is a 3 year old with an upper respiratory infection (URI). Treatment for her URI would include: A. Amoxicillin B. Diphenhydramine C. Pseudoephedrine D. Nasal saline spray ____ 3. Patients who should be cautious about using decongestants for an upper respiratory infection include: A. School-age children B. Patients with asthma C. Patients with cardiac disease D. Patients with allergies ____ 4. Jaheem is a 10 year old with sinusitis. Treatment for a child with sinusitis is: A. Amoxicillin B. Azithromycin C. Cephalexin D. Levofloxacin ____ 5. Jacob has been diagnosed with sinusitis. He is the parent of a child in daycare. Treatment for sinusitis in an adult who has a child in daycare is: A. Azithromycin 500 mg q day for 5 days B. Amoxicillin 1 gram QID C. Ciprofloxacin 500 mg BID D. Cephalexin 500 mg QID ____ 6. The length of treatment for sinusitis should be: A. 7 days B. 10 days C. 14 days D. 7 days beyond when symptoms cease ____ 7. Patient education for a patient who is prescribed antibiotics for sinusitis includes: A. Use of nasal saline washes B. Use of inhaled corticosteroids C. Avoiding the use of ibuprofen while ill D. Use of laxatives to treat constipation ____ 8. Myles is a 2 year old who has been diagnosed with acute otitis media. He is afebrile and has not been treated with antibiotics recently. First-line treatment for his otitis media would include: A. Azithromycin B. Amoxicillin C. Ceftriaxone D. Trimethoprim/sulfamethoxazole ____ 9. Alyssa is a 15 month old who has been on amoxicillin for 2 days for acute otitis media. She is still febrile and there is no change in her tympanic membrane examination. What would be the plan of care for her? A. Continue the amoxicillin for the full 10 days. B. Change the antibiotic to azithromycin. C. Change the antibiotic to amoxicillin/clavulanate. D. Change the antibiotic to trimethoprim/sulfamethoxazole. ____ 10. A child that may warrant “watchful waiting” instead of prescribing an antibiotic for acute otitis media includes patients who: A. Are low risk with temperature less than 39oC or 102.2oF B. Have reliable parents with transportation C. Are older than age 2 years D. All of the above ____ 11. Whether prescribing an antibiotic for a child with acute otitis media or not, the parents should be educated about: A. Using decongestants to provide faster symptom relief B. Providing adequate pain relief for at least the first 24 hours C. Using complementary treatments for acute otitis media, such as garlic oil D. Administering an antihistamine/decongestant combination (Dimetapp) so the child can sleep better ____ 12. First-line therapy for a patient with acute otitis externa (swimmer’s ear) and an intact tympanic membrane includes: A. Swim-Ear drops B. Ciprofloxacin and hydrocortisone drops C. Amoxicillin D. Gentamicin ophthalmic drops Chapter 47: Urinary Tract Infections Multiple Choice Identify the choice that best completes the statement or answers the question. ____ 1. The treatment goals when treating urinary tract infection (UTI) include: A. Eradication of infecting organism B. Relief of symptoms C. Prevention of recurrence of UTI D. All of the above ____ 2. Sally is a 16-year-old female with a urinary tract infection. She is healthy, afebrile, with no use of antibiotics in the previous 6 months and no drug allergies. An appropriate first-line antibiotic choice for her would be: A. Azithromycin B. Trimethoprim/sulfamethoxazole C. Ceftriaxone D. Levofloxacin ____ 3. Jamie is a 24-year-old female with a urinary tract infection. She is healthy, afebrile, and her only drug allergy is sulfa, which gives her a rash. An appropriate first-line antibiotic choice for her would be: A. Azithromycin B. Trimethoprim/sulfamethoxazole C. Ceftriaxone D. Ciprofloxacin ____ 4. Juanita is a 28-year-old pregnant woman at 38 weeks gestation who is diagnosed with a lower urinary tract infection. She is healthy with no drug allergies. Appropriate first-line therapy for her UTI would be: A. Azithromycin B. Trimethoprim/sulfamethoxazole C. Amoxicillin D. Ciprofloxacin ____ 5. Which of the following patients may be treated with a 3-day course of therapy for their urinary tract infection? A. Juanita, a 28-year-old pregnant woman B. Sally, a 16-year-old healthy adolescent C. Jamie, a 24-year-old female D. Suzie, a 26-year-old diabetic ____ 6. Nicole is a 4-year-old female with a febrile urinary tract infection. She is generally healthy and has no drug allergies. Appropriate initial therapy for her UTI would be: A. Azithromycin B. Trimethoprim/sulfamethoxazole C. Ceftriaxone D. Ciprofloxacin ____ 7. Monitoring for a healthy, non-pregnant adult patient being treated for a urinary tract infection is: A. Symptom resolution in 48 hours B. Follow-up urine culture at completion of therapy C. “Test of cure” urinary analysis at completion of therapy D. Follow-up urine culture 2 months after completion of therapy ____ 8. Monitoring for a child who has had a urinary tract infection is: A. Symptom resolution in 48 hours B. Follow-up urine culture at completion of therapy C. “Test of cure” urinary analysis at completion of therapy D. Follow-up urine culture 2 months after completion of therapy ____ 9. Monitoring for a pregnant woman who has had a urinary tract infection is: A. Symptom resolution in 48 hours B. Follow-up urine culture at completion of therapy C. “Test of cure” urinary analysis at completion of therapy D. Follow-up urine culture every 2 weeks until delivery ____ 10. Along with an antibiotic prescription, lifestyle education for a non-pregnant adult female who has had a urinary tract infection includes: A. Increasing her intake of Vitamin C containing orange juice B. Voiding 10 to 15 minutes after intercourse C. Avoiding ingesting urinary irritants, such as asparagus D. All of the above ____ 11. Lisa is a healthy non-pregnant adult woman who recently had a UTI. She is asking about drinking cranberry juice to prevent a recurrence of the UTI. The correct answer to give her would be: A. “Sixteen ounces per day of cranberry juice cocktail will prevent UTIs.” B. “100% cranberry juice or cranberry juice extract may decrease UTIs in some patients.” C. “There is no evidence that cranberry juice helps prevent UTIs.” D. “Cranberry juice only works to prevent UTIs in children.” Chapter 48: Women as Patients Multiple Choice Identify the choice that best completes the statement or answers the question. ____ 1. Prescribing for women during their childbearing years requires constant awareness of the possibility of: A. Pregnancy unless the women is on birth control B. Risk for silent bacterial or viral infections of the genitalia C. High risk for developmental disorders in their infants D. Decreased risk for abuse during this time ____ 2. Intimate partner violence is a serious public health problem. It should be screened for: A. At every encounter with the health care system B. When a women is being seen for symptoms of depression C. Throughout pregnancy D. If a sexually transmitted disease is diagnosed ____ 3. Because of their longer life expectancy, women are more likely than men to experience a disabling condition. Common conditions in older women that can produce disability include: A. Depression B. Panic disorders C. Dementia D. All of the above ____ 4. Gender differences between men and women in pharmacokinetics include: A. More rapid gastric emptying so that drugs absorbed in the stomach have less exposure to absorption sites B. Higher proportion of body fat so that lipophilic drugs have relatively greater volumes of distribution C. Increased levels of bile acids so that drugs metabolized in the intestine have higher concentrations D. Slower organ blood flow rates to that drugs tend to take longer to be excreted ____ 5. Which of the following drug classes is associated with significant differences in metabolism based on gender? A. Beta blockers B. Antibiotics C. Serotonin reuptake inhibitors D. ACE inhibitors ____ 6. Since 40% of bone accrual occurs during adolescence, building bone during this time is critical. Ways to improve bone accrual in adolescents include: A. Use of bisphosphonates early if DEXA scans show limited bone accrual B. Encouraging a daily dietary intake of 1300 mg of calcium and 400 IU of vitamin D C. Avoiding all birth control methods that include progesterone D. Fostering the intake of iron mainly in green and leafy vegetables ____ 7. The physiologic anemia of pregnancy can be treated with: A. Drinking to cups per day of stinging nettle tea with cinnamon and honey B. Taking ferrous sulfate tablets with citrus juices C. Both A and B D. Neither A nor B ____ 8. Hot flashes are often a concern during menopause. Which of the following may help in reducing them? A. Drink one caffeinated liquid per day B. Take progesterone supplementation C. Exercise 20 to 40 minutes/day D. Increase intake of carrots, yams, and soy products ____ 9. Factors common in women that can affect adherence to a treatment regimen include all of the following EXCEPT: A. Number of drug taken: Women tend to take less drugs but over longer periods of time B. Fear that medications can cause disease: Information obtained from social networks may be inaccurate for a specific woman C. Nutritional status: Worries about possible weight gain from a given drug may result in non-adherence D. Religious differences: A patient’s belief system that is not congruent with the treatment regimen presents high risk for nonadherence. ____ 10. Dysmenorrhea is one of the most common gynecological complaints in young women. The first line of drug treatment for this disorder is: A. Oral contraceptive pills B. Caffeine C. NSAIDs D. Aspirin ____ 11. Premenstrual dysphoric disorder (PMDD) occurs in a fairly small number of patients. Theories of the pathology behind PMDD that are supported in research include: A. Altered sensitivity in the serontonic system B. Inhibition of the cyclooxygenase system C. Fluctuations of the gonadal hormones D. All of these are theories supported by research ____ 12. Treatment of PMDD that affects all or most of the symptoms includes: A. Tryptophan up to 6 g/d B. Vitamin E 200 to 400 mg/d C. Evening primrose oil 500 mg/d D. Fluoxetine 20 mg/d ____ 13. Women are now the fastest growing population with HIV infection and AIDS. HIV infected women: A. Are less likely to become pregnant or to carry a pregnancy to term B. Have higher rates of cervical dysplasia and HPV concurrent infections C. Are most often over 35 years of age D. Most often come from Asian and Caucasian ethnic groups ____ 14. Maternal-to-child transmission of HIV infection during pregnancy may be prevented by: A. Use of antiviral drugs such as zidovudine B. Use of condoms during intercourse C. Both A and B D. Neither A nor B ____ 15. Erroneous information about LGBTQ individuals can lead to failure to give accurate advice to them as patients. Which of the following statements are true about lesbians: A. Lesbians cannot contract a sexually transmitted infection form their female partner B. Screening for cervical cancer is not required C. Lesbians as a group are less likely to have health care insurance D. Like women in general, lesbians are more likely than gay men to seek care for health related issues Chapter 49: Men as Patients Multiple Choice Identify the choice that best completes the statement or answers the question. ____ 1. The factor that has the greatest effect on males developing male sexual characteristics is: A. Cultural beliefs B. Effective male role models C. Adequate intake of testosterone in the diet D. Androgen production ____ 2. When assessing a male for hypogonadism prior to prescribing testosterone replacement, serum testosterone levels are drawn: A. Without regard to time of day B. First thing in the morning C. Late afternoon D. In the evening ____ 3. Some research supports that testosterone replacement therapy may be indicated in which of the following diagnoses in men? A. Age-related decrease in cognitive functioning B. Metabolic syndrome C. Decreased muscle mass in aging men D. All of the above ____ 4. The goal of testosterone replacement therapy is: A. Absence of all hypogonadism symptoms B. Testosterone levels in the mid-normal range 1 week after an injection C. Testosterone levels in the mid-normal range just prior to the next injection D. Avoidance of high serum testosterone levels during therapy ____ 5. While on testosterone replacement, hemoglobin and hematocrit levels should be monitored. Levels suggestive of excessive erythrocytosis or abuse are: A. Hemoglobin 14 g/dl or hematocrit 39% B. Hemoglobin 11.5 g/dl or hematocrit 31% C. Hemoglobin 13 g/dl or hematocrit 38% D. Hemoglobin 17.5 g/dl or hematocrit 54% ____ 6. Monitoring of an older male patient on testosterone replacement includes: A. Oxygen saturation levels at every visit B. Serum cholesterol and lipid profile every 3 to 6 months C. Digital rectal prostate screening exam at 3 and 6 months after starting therapy D. Bone mineral density at 3 months and 6 months after starting therapy ____ 7. When prescribing phosphodiesterase type 5 (PDE-5) inhibitors such as sildenafil (Viagra) patients should be screened for use of: A. Statins B. Nitrates C. Insulin D. Opioids ____ 8. Men who are prescribed phosphodiesterase type 5 (PDE-5) inhibitors for erectile dysfunction should be educated regarding the adverse effects of the drug which include: A. Hearing loss B. Hypotension C. Delayed ejaculation D. Dizziness ____ 9. Male patients who should not be prescribed phosphodiesterase type 5 (PDE-5) inhibitors include: A. Diabetics B. Those who have had an acute myocardial infarction in the past 6 months C. Patients who are deaf D. Patients under age 60 years of age ____ 10. Monitoring of male patients who are using phosphodiesterase type 5 (PDE-5) inhibitors includes: A. Serum fasting glucose levels B. Cholesterol and lipid levels C. Blood pressure D. Complete blood count Chapter 50: Pediatric Patients Multiple Choice Identify the choice that best completes the statement or answers the question. ____ 1. The Pediatric Research Equity Acts requires: A. All children be provided equal access to drug research trials B. Children to be included in the planning phase of new drug development C. That pediatric drug trials guarantee children of multiple ethnic groups are included D. All applications for new active ingredients, new indications, new dosage forms, or new routes of administration require pediatric studies ____ 2. The Best Pharmaceuticals for Children Act: A. Includes a pediatric exclusivity rule which extends the patent on drugs studied in children B. Establishes a committee that writes guidelines for pediatric prescribing C. Provides funding for new drug development aimed at children D. Encourages manufacturers specifically to develop pediatric formulations ____ 3. The developmental variation in Phase I enzymes has what impact on pediatric prescribing? A. None, Phase I enzymes are stable throughout childhood. B. Children should always be prescribed lower than adult doses per weight due to low enzyme activity until puberty. C. Children should always be prescribed higher than adult doses per weight due to high enzyme activity. D. Prescribing dosages will vary based on the developmental activity of each enzyme, at times requiring lower than adult doses and other times higher than adult doses based on the age of the child. ____ 4. Developmental variation in renal function has what impact on prescribing for infants and children? A. Lower doses of renally excreted drugs may be prescribed to infants younger than age 6 months. B. Higher doses of water soluble drugs may need to be prescribed due to increased renal excretion. C. Renal excretion rates have no impact on prescribing. D. Parents need to be instructed on whether drugs are renally excreted or not. ____ 5. Topical corticosteroids are prescribed cautiously in young children due to: A. They may cause an intense hypersensitivity reaction B. Hypothalamic-pituitary-adrenal (HPA) axis suppression C. Corticosteroids are less effective in young children D. Young children may accumulate corticosteroids leading to toxic levels ____ 6. Liza is breastfeeding her 2-month-old son and has an infection that requires an antibiotic. What drug factors influence the effect of the drug on the infant? A. Maternal drug levels B. Half-life C. Lipid-solubility D. All of the above ____ 7. Drugs that are absolutely contraindicated in lactating women include: A. Selective serotonin reuptake inhibitors B. Antiepileptic drugs such as carbamazepine C. Antineoplastic drugs such as methotrexate D. All of the above ____ 8. Zia is a 4 month old with otitis media. Education of his parents regarding administering oral antibiotics to an infant includes: A. How to administer an oral drug using a medication syringe B. Mixing the medication with a couple ounces of formula and putting it in a bottle C. Discontinuing the antibiotic if diarrhea occurs D. Calling for an antibiotic change if the infant chokes and sputters during administration ____ 9. To increase adherence in pediatric patients a prescription medication should: A. Have a short half-life B. Be the best tasting of the effective drugs C. Be the least concentrated form of the medication D. Be administered 3 or 4 times a day ____ 10. Janie is a 5-month-old breastfed infant with a fever. Treatment for her fever may include: A. “Baby” aspirin B. Acetaminophen suppository C. Ibuprofen suppository D. Alternating acetaminophen and ibuprofen Chapter 51: Geriatric Patients Multiple Choice Identify the choice that best completes the statement or answers the question. ____ 1. Principles of prescribing for older adults include: A. Avoiding prescribing any newer high-cost medications B. Starting at a low dose and increasing the dose slowly C. Keeping total dose at lower therapeutic range D. All of the above ____ 2. Sadie is a 90-year-old patient who requires a new prescription. What changes in drug distribution with aging would influence prescribing for Sadie? A. Increased volume of distribution B. Decreased lipid solubility C. Decreased plasma proteins D. Increased muscle to fat ratio ____ 3. Glen is an 82 year old who needs to be prescribed a new drug. What changes in elimination should be taken into consideration when prescribing for Glen? A. Increased GFR will require higher doses of some renally excreted drugs B. Decreased tubular secretion of medication will require dosage adjustments C. Thin skin will cause increased elimination via sweat D. Decreased lung capacity will lead to measurable decreases in lung excretion of drugs ____ 4. A medication review of an elderly person’s medications involves: A. Asking the patient to bring a list of current prescription medications to the visit B. Having the patient bring all of their prescription, over-the-counter, and herbal medication to the visit C. Asking what other providers are writing prescriptions for them D. All of the above ____ 5. Steps to avoid polypharmacy include: A. Prescribing two or fewer drugs from each drug class B. Reviewing a complete drug history every 12 to 18 months C. Encouraging the elderly patient to coordinate their care with all of their providers D. Evaluating for duplications in drug therapy and discontinuing any duplications ____ 6. Robert is a 72 year old who has hypertension and angina. He is at risk for common medication practices seen in the elderly including: A. Use of another person’s medications B. Hoarding medications C. Changing his medication regimen without telling his provider D. All of the above ____ 7. To improve positive outcomes when prescribing for the elderly the nurse practitioner should: A. Assess cognitive functioning in the elder B. Encourage the patient to take a weekly “drug holiday” to keep drug costs down C. Encourage the patient to cut drugs in half with a knife to lower costs D. All of the above ____ 8. When an elderly diabetic patient is constipated the best treatment options include: A. Mineral oil B. Bulk-forming laxatives such as psyllium C. Stimulant laxatives such as senna D. Stool softeners such as docusate ____ 9. Delta is an 88 year old who has mild low back pain. What guidelines should be followed when prescribing pain management for Delta? A. Keep the dose of oxycodone low to prevent development of tolerance B. Acetaminophen is the first-line drug of choice C. Avoid prescribing NSAIDs D. Add in a short-acting benzodiazepine for a synergistic effect on pain ____ 10. Robert is complaining of poor sleep. Medications that may contribute to sleep problems in the elderly include: A. Diuretics B. Trazodone C. Clonazepam D. Levodopa Chapter 52:Chronic Illness and Long-Term Care Multiple Choice Identify the choice that best completes the statement or answers the question. ____ 1. Patients with chronic illness may struggle with adherence to their treatment regimen. Intelligent non-adherence occurs when the patient: A. May not understand the specifics of his or her medication regimen B. Cannot afford to pay for all the medications in his or her regimen C. Occasionally misses doses of medications due to forgetfulness D. Chooses to discontinue or alter his or her medication regimen ____ 2. Steps the provider can take to improve medication adherence in the chronically ill patient include: A. Tell the patient to take the medications as prescribed for optimum health B. Assess adherence either through self-report or laboratory values C. Encourage the patient to take the medications regularly D. If noncompliant with the medication regimen, ask if the patient values good health ____ 3. The Beers Criteria is used to: A. Determine appropriate prescribing in the elderly B. Set guidelines for prescribing sedatives for the elderly C. Assess potentially inappropriate medications in the elderly D. Provide regulation in the prescribing of potentially dangerous medications ____ 4. The Beers Criteria recommend which muscle relaxant for use in the elderly? A. Methocarbamol (Robaxin) B. Carisoprodol (Soma) C. Cyclobenzaprine (Flexeril) D. None of the above ____ 5. According to the Beers Criteria list, the elderly should be cautiously prescribed fluoxetine (Prozac) due to: A. Excessive drowsiness B. Long half-life C. Dry mouth and constipation D. Decreased renal excretion ____ 6. The Beers Criteria states mineral oil is not recommended to be used in the elderly due to: A. Lack of efficacy in this age group B. Concern for oil leakage from the anus C. Potential for aspiration of oil D. Concern for CNS and extrapyramidal effects ____ 7. Many elderly patients use diphenhydramine (Benadryl) as a sleep aid. The Beers Criteria recommends against the use of diphenhydramine in the elderly due to: A. Lack of efficacy in the elderly B. It may cause confusion C. It may induce depression D. Orthostatic hypotension ____ 8. The most common prescribing error in long-term care facilities is: A. The wrong drug is prescribed B. The wrong dose of medication is prescribed C. Medications are administered at the wrong time D. Drugs with known interaction are prescribed Chapter 53: Pain Management: Acute & Chronic Pain Multiple Choice Identify the choice that best completes the statement or answers the question. ____ 1. Different areas of the brain are involved in specific aspects of pain. The reticular and limbic systems in the brain influence: A. The sensory aspects of pain B. The discriminative aspects of pain C. The motivational aspects of pain D. The cognitive aspects of pain ____ 2. Patients need to be questioned about all pain sites because: A. Patients tend to report the most severe or important in their perception B. Pain tolerance generally decreases with repeated exposure C. The reported pain site is usually the most important to treat D. Pain may be referred from a different site to the one reported ____ 3. The chemicals that promote the spread of pain locally include: A. Serotonin B. Norepinephrine C. Enkephalin D. Neurokinin A ____ 4. Narcotics are exogenous opiates. They act by: A. Inhibiting pain transmission in the spinal cord B. Attaching to receptors in the afferent neuron to inhibit the release of substance P C. Blocking neurotransmitters in the midbrain D. Increasing beta-lipoprotein excretion from the pituitary ____ 5. Age is a factor in different responses to pain. Which of the following age-related statements about pain is NOT true? A. Preterm and newborn infants do not yet have functional pain pathways. B. Painful experiences and prolonged exposure to analgesic drugs during pregnancy may permanently alter neuronal organization in the child. C. Increases in pain threshold in older adults may be related to peripheral neuropathies and changes in skin thickness D. Decreases in pain tolerance are evident in older adults ____ 6. Which of the following statements is true about acute pain? A. Somatic pain comes from body surfaces and is only sharp and well-localized. B. Visceral pain comes from the internal organs and is most responsive to acetaminophen and opiates. C. Referred pain is present in a distant site for the pain source and is based on activation of the same spinal segment as the actual pain site. D. Acute neuropathic pain is caused by lack of blood supply to the nerves in a given area. ____ 7. One of the main drug classes used to treat acute pain is NSAIDs. They are used because: A. They have less risk for liver damage than acetaminophen B. Inflammation is a common cause of acute pain C. They have minimal GI irritation D. Regulation of blood flow to the kidney is not affected by these drugs ____ 8. Opiates are used mainly to treat moderate to severe pain. Which of the following is NOT true about these drugs? A. All opiates are scheduled drugs which require a DEA license to prescribe. B. Opiates stimulate only mu receptors for the control of pain. C. Most of the adverse effects of opiates are related to mu receptor stimulation. D. Naloxone is an antagonist to opiates. ____ 9. If interventions to resolve the cause of pain (RICE) are insufficient, pain medications are given based on the severity of pain. Drugs are given in which order of use? A. NSAIDs, opiates, corticosteroids B. Low-dose opiates, salicylates, increased dose of opiates C. Opiates, non-opiates, increased dose of non-opiate D. Non-opiate, increased dose of non-opiate, opiate ____ 10. The goal of treatment of acute pain is: A. Pain at a tolerable level where patient may return to activities of daily living B. Reduction of pain with a minimum of drug adverse effects C. Reduction or elimination of pain with minimum adverse reactions D. Adequate pain relief without constipation or nausea from the drugs ____ 11. Which of the following statements is true about age and pain? A. Use of drugs that depend heavily on the renal system for excretion may require dosage adjustments in very young children. B. Among the NSAIDs, indomethacin is the preferred drug because of lower adverse effects profiles than other NSAIDs. C. Older adults who have dementia probably do not experience much pain due to loss of pain receptors in the brain. D. Acetaminophen is especially useful in both children and adults because it has no effect on platelets and has fewer adverse effects than NSAIDs. ____ 12. Pain assessment to determine adequacy of pain management is important for all patients. This assessment is done to: A. Determine if the diagnosis of source of pain is correct B. Determine if the current regimen is adequate or different combinations of drugs and non-drug therapy are required C. Determine if the patient is willing and able to be an active participant in his or her pain management D. All of the above ____ 13. Pathological similarities and differences between acute pain and chronic pain include: A. Both have decreased levels of endorphins B. Chronic pain has a predominance of C-neuron stimulation C. Acute pain is most commonly associated with irritation of peripheral nerves D. Acute pain is diffuse and hard to localize ____ 14. A treatment plan for management of chronic pain should include: A. Negotiation with the patient to set personal goals for pain management B. Discussion of ways to improve sleep and stress C. An exercise program to improve function and fitness D. All of the above ____ 15. Chronic pain is a complex problem. Some specific strategies to deal with it include: A. Telling the patient to “let pain be your guide” to using treatment therapies B. Prescribing pain medication on a “PRN” basis to keep down the amount used C. Scheduling return visits on a regular basis rather than waiting for poor pain control to drive the need for an appointment D. All of the above ____ 16. Chemical dependency assessment is integral to the initial assessment of chronic pain. Which of the following raises a “red flag” about potential chemical dependency? A. Use of more than one drug to treat the pain B. Multiple times when prescriptions are lost with requests to refill C. Preferences for treatments that include alternative medicines D. Presence of a family member who has abused drugs ____ 17. The Pain Management Contract is appropriate for: A. Patients with a history of chemical dependency or possible inappropriate use of pain medications B. All patients with chronic pain who will require long-term use of opiates C. Patients who have a complex drug regimen D. Patients who see multiple providers for pain control

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