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Self-Assessment Answers for Section 1: Opioid Analgesics in the Management of Acute and Chronic Pain

1 . Which type of pain is characterized by aberrant signal processing in the peripheral or central nervous system?

A.Nociceptive pain

B.Acute pain

C.Neuropathic pain

D.Chronic non-cancer pain

2 . What term describes the phenomenon of pain being caused by a normally innocuous stimulus such as light touch?

A.Allodynia

B.Hyperalgesia

C.Hypoalgesia

D.Referred pain

3 . What is the likely physiological basis for opioid-induced hyperalgesia?

A.Upregulation of nociceptive pathways in peripheral and central nervous systems

B.Downregulation of nociceptive pathways in dorsal horn neurons

C.Increased release of substance-P in neuronal synapses of peripheral and central nervous system neurons

D.Disinhibition of neuropathic pain pathways in central nervous system

4 . Which statement best summarizes the CDC finding about opioids for chronic pain?

A.Opioid analgesics should be confined to use in patients with neuropathic, as opposed to nociceptive, pain syndromes

B.Chronic non-cancer pain can be effectively treated with immediate-release opioid agents, but should not be treated with long-acting or extended-release formulations

C.No evidence shows a long-term benefit of opioids in pain and function versus no opioids although extensive evidence shows the potential harms of opioids

D.Evidence supports the use of opioid analgesics for long-term non-cancer chronic pain except in patients with pre-existing substance use disorders

5 . Opioid pain medications should not be combined with _______________?

A.Benzodiazepines

B.Stimulant medications

C.SSRI antidepressants

D.Anti-hypertensive medications

6 . Which of the following topics should be routinely covered as part of patient education about opioid analgesics?

A.Background information about acute vs. chronic pain

B.Criteria for Opioid Use Disorder

C.Safe medication disposal

D.Difference between nociceptive and neuropathic pain

7 . Although the absolute risk for inducing opioid misuse or addiction due to prescriptions of opioids for acute pain is low, the large number of such prescriptions means that approximately how many people are at risk each year?

A.260,000

B.160,000

C.60,000

D.6,000

8 . Non-pharmacologic methods for treating acute pain are appropriate for which phase of healing?

A.Immediately after tissue trauma

B.> 48 hours after tissue trauma

C.Late healing phase for recovery of function

D.Immediately after tissue trauma as well as in late healing phase

9 . Long-acting (LA) and extended-release (ER) formulations of opioids should not be used for __________________?

A.Treating acute pain

B.Treating cancer pain

C.Treating end-of-life pain

D.Treating chronic non-cancer pain

10 . What is one suggestion for a way to augment opioid treatment in order to help improve a patient’s pain and function?

A.Use an every-other-day dosing pattern for the opioid, alternating with an NSAID analgesic

B.Rotate the route of administration every 6 weeks

C.Add a long-acting opioid to a prescription for an immediate-release opioid

D.Try concurrent non-pharmacologic approaches such as exercise or cognitive behavioral therapy

11 . Which of the following is an example of a functional goal?

A.Reduced anxiety about pain

B.Reduced need for rescue analgesia

C.Reduced daily dose of opioid analgesic

D.Walking around the block

12 . According to the Centers for Disease Control and Prevention, what amount of opioid analgesic is appropriate for most painful conditions?

A.2-day supply

B.3-day supply

C.5-day supply

D.7 day supply

13 . Which class of patients might require more frequent or intense monitoring when prescribed an opioid analgesic?

A.Young adults

B.Older adults

C.Female patients

D.Patients with hypertension

14 . Which of the following characteristics is typical of patients who are addicted to a pain medication?

A.Medication use improves quality of life

B.Follows practitioner-patient agreement for opioid use

C.Medication use continues or increases despite adverse effects

D.Has left-over medication at each visit

15 . Most experts agree that opioid dosages should not be increased to _______ without careful justification based on diagnosis and on an individualized assessment of benefits and risks.

A.= 50 MMED

B.= 60 MMED

C.= 80 MMED

D.= 90 MMED

16 . The availability of naloxone was increased in 2019 by an FDA decision that ____________.

A.Allowed naloxone to be sold over the counter

B.Approved a generic formulation of nasal-spray naloxone

C.Allowed registered nurses to prescribe naloxone

D.Provided government subsidy to increase production of naloxone

17 . Which of the following medications is a full mu-receptor agonist used to treat Opioid Use Disorder?

A.Methadone

B.Buprenorphine

C.Extended-release naltrexone

D.Naloxone

18 . Which of the following medications can be self-administered by patients with a medication obtained from a regular pharmacy?

A.Methadone

B.Buprenorphine

C.Extended-release naltrexone

D.Naloxone

19 . For which of the following must clinicians obtain a special waiver from the DEA prior to being able to prescribe the medication?

A.Methadone

B.Buprenorphine

C.Extended-release naltrexone

D.Naloxone

20 . Which of the following is a possible reason for prescribing naloxone to a patient who has been prescribed an opioid analgesic?

A.The patient is taking a dose of an opioid < 50 MMED

B.The patient has recently been released from prison

C.The patient has history of hypertension

D.The patient has a concurrent prescription for an SSRI antidepressant

Self-Assessment Answers for Section 2: Infection Control in Healthcare Settings

21 . The transmission of infectious agents from reservoir to infected host from a portal of exit to a portal of entry is called ____________?

A.Horizontal transmission

B.The reservoir/portal/host paradigm

C.The chain of infection

D.The infectious vector sequence

22 . A fomite is _____________?

A.An infectious single-celled organism

B.An inanimate object that can passively carry a pathogen

C.A type of bacterium transmitted by mosquitos

D.Any organism that can passively host an infectious agent

23 . The term “inoculum” refers to ___________.

A.The amount of a pathogen to which a host is exposed

B.The type of pathogen to which a host is exposed

C.The amount of antibiotic required to kill 99% of a given species of bacteria

D.The amount of a vaccine required to protect a host from a target pathogen

24 . Healthcare workers should consider all used injection supplies to be potentially contaminated because _____________?

A.Infection control policies are based on the assumption that used supplies are always contaminated

B.Sometimes healthcare workers do not adhere to proper hand hygiene procedures

C.Infectious agents may be present without causing clouding or other visible evidence

D.Infectious agents are always present to some degree in used injection supplies

25 . A passive safety feature _____________?

A.Requires no action by the user

B.Renders sharps less hazardous when activated by the user

C.Reduces the risk of pathogen transmission on fomites

D.Minimizes exposure to infectious agents during accidental spills of potentially infected bodily fluids

26 . Transporting a patient in a wheelchair generally requires which kind of personal protective equipment for the healthcare worker?

A.Gloves

B.Mask covering nose and mouth

C.Face shield

D.None

27 . Special procedures are recommended for the disinfection and/or sterilization of equipment used on which types of patients?

A.Patients with untreated HIV

B.Patients with known or suspected prion disease

C.Patients with highly-contagious staph infections

D.Patients with suspected Ebola virus

28 . Which agent is most effective for reducing the number of microbes on hands and is the preferred method for decontaminating hands that are not visibly soiled?

A.Antiseptic soaps

B.Non-antimicrobial soaps

C.Alcohol-based hand sanitizers

D.Surgical hand scrub

29 . If a respirator is used during contact with a patient with a contagious illness, it should be removed ______________.

A.After leaving the patient room and closing the door

B.When instructed to do so by the senior clinician on duty

C.After hands have been disinfected

D.Before leaving the room and after all contact with patient is completed

30 . Disinfectants are antimicrobial agents appropriate for ______________?

A.Antisepsis of both skin and non-organic surfaces

B.Skin antisepsis

C.Animate and inanimate objects

D.Inanimate objects only

31 . Unlike sterilization, disinfection is not____________?

A.Sporicidal

B.Germicidal

C.Fungicidal

D.Virucidal

32 . The definition of a semi-critical device is ____________?

A.A device that contacts mucous membranes or non-intact skin and requires at least high-level disinfection after use

B.A device that enters sterile tissue or the vascular system and requires at least high-level disinfection after use

C.A device that contacts mucous membranes or non-intact skin and requires sterilization after use

D.A device that contacts intact skin but not mucous membranes and requires at least high-level disinfection after use

33 . When sepsis is suspected, within what time period should antibiotics be initiated?

A.24 hours

B.4 hours

C.1 hour

D.Antibiotics should not be administered with suspected sepsis

34 . The most common manifestation of sepsis is _______________.

A.Diarrhea

B.Fever

C.Elevated white blood count

D.Tachycardia

35 . Which of the following is a recommended method of preventing sepsis?

A.Screening blood supplies for sepsis-contamination

B.Wearing face masks or shields when treating patients with suspected sepsis

C.Following proper equipment disinfection procedures

D.Promptly treating urinary tract infections

2020 New York Medical Licensure Program

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