There is a high risk of respiratory depression with ...

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There is a high risk of respiratory depression with administration of an opiate medication in patients with:
 
  A. Chronic obstructive pulmonary disease
  B. Congestive heart failure
  C. Obstructive sleep apnea
  D. A and C

Question 2

To evaluate pain, the following objective scales are used:
 
  A. Visual analog scale (VAS)
  B. Verbal rating scale (VRS)
  C. McGill questionnaire
  D. All of the above

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Answer to Question 1

ANS: D
According to JAHCO's Sentinel Event Database (Zhani 2012), opioid analgesics rank among the drugs most frequently associated with adverse drug events. Opioids, such as morphine, oxycodone, and methadone, can slow breathing to dangerous levels and cause other problems, such as dizziness, nausea, and falls. JAHCO cites reasons for such adverse events, including dosing errors, improper monitoring of patients, and interactions with other drugs. Patients who have OSA, are obese, or are very ill may be at higher risk for harm from opioids. Patients with severe COPD are vulnerable to respiratory failure with opiates.

Answer to Question 2

ANS: D
There are many ways to measure severity of pain. The most commonly used are: the numerical rating scales (NRS), with which the patient rates the pain on an 11, 21, or 101 point range (010, 020, 0100, for instance); the visual analog scale (VAS), with which the paitient notes a point corresponding to the degree of pain along a 10-centimeter scale with poles of no pain at all to worst possible pain; and verbal rating scales (VRS), with which patients are asked to use verbal descriptors such as no pain, mild pain, considerable pain, and most severe pain. There are a number of more detailed options, such as the Pain Faces Scale for pediatric patients and the McGill Pain Questionnaire, which includes sensory and emotional aspects of pain as well as a pain diagram.

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