ASPMN - Wisconsin Chapter - American Society for Pain Management Nursing
 
PRN Post Test Results April 2009
 
Top ten questions most frequently answered incorrectly:
  1. Nondrug interventions such as distraction and imagery used alone can often relieve pain. False.In moderate to severe pain a nondrug intervention alone would not be adequate.This question did not differentiate the level of pain so both answers could be correct.
  2. Physical dependence to opioids is characterized by the following: sweating, yawning, and nausea when the opioid is abruptly discontinued. Be careful not to confuse this with tolerance which implies the need for higher doses or addiction which is impaired control.
  3. A behavioral scale designed for pediatrics such as the FLACC can be used to assess pain in adults. False.Scales should be used on the populations they are studied on to maintain validity of the instruments.
  4. Benzodiazepines are not effective pain relievers unless pain is due to muscle spasm. True. Benzodiazepines have no analgesic properties.  They actually sedate people so they may not complain about pain even though they still experience pain.
  5. Which of the following doses of morphine would be approximately equianalgesic to 1.5 mg of IV hydromorphone? 30 mg of oral morphine. IV hydromorphone is approximately 20 times more potent than oral morphine.
  6. The unique property of gabapentin compared with other anticonvulsant drugs is that it is: not metabolized. Because gabapentin is excreted unchanged by the kidney, dosage must be modified with impaired renal function.
  7. Hydroxyzine (Vistaril) and promethazine (Phenergan) have prominent analgesic properties. False. Phenergan and Vistaril are antihistamines and are useful for treating what antihistamines treat.
  8. As compared to naproxen and other non-selective NSAIDs the selective COX-2 inhibitor celecoxib is: less likely to irritate the stomach.Celecoxib is  more selective for COX-2 inhibition.This selectivity allows celecoxib to reduce inflammation which causes pain while minimizing gastrointestinal side effects.
  9. Respiratory rate is a reliable indicator of respiratory depression. False. It is the quality of the respiration that determines ventilation not just the rate.  A person with a respiratory rate of 30 taking shallow breaths may be compromised.
  10. Elders with mild cognitive impairment can often use verbal pain intensity rating scales. True.  Even patients with mild to moderate cognitive impairment can often be assessed with simple pain intensity scales (e.g., 0-10, mild-moderate-severe). 
 
 
The April 2009 Results are In!

There were 59 completed Institutional Needs Assessment forms from our PRNs.  However, there were 78 nurses that were involved in the PRN program, with some choosing to jointly complete the Needs Assessment form. 

The three major areas that presented opportunities for improvement were:
1. Accountability for pain management is clearly defined.
2. Information about analgesics and non-pharmacological interventions is readily available to clinicians.
3. Staff have ongoing educational opportunities in pain management.

You can view the completed results by clicking on the following link.


 


PRN Learning Needs Assessment Results April 2009

The top 6 topics that you identified as educational topics for the future were:

  1. Working with physicians in addressing pain management needs for individual patients
  2. Managing pain in patients who are opioid tolerant
  3. Creating unit based educational pain programs
  4. Equianalgesic dosing of opioids
  5. Patient safety and opioid use
  6. Pain management and geriatrics

This information will be used in planning future programs for PRNs.
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