Continuing Education Exam

1.	If a patient is not verbally complaining of pain, what should the 
caregiver do?

a. 	Continue to treat the patient, but only assess pain if the patient verbally complains.
b. 	Perform a pain assessment on the patient to determine his or her level of pain.
c. 	Note in the patient's chart that he or she was not complaining of pain.
d. 	Start the patient on the lowest dose of pain medication possible.	

2.	What are two methods for assessing an adult patient's pain?

a. 	Using one's clinical judgment to recognize pain and the Rubin Pain 
Measurement scale
b. 	The FLACC scale and the NIPS scale 
c.	The Wong-Baker FACES scale and the numeric pain rating scale
d. 	Medical anticipation and the Rubin Pain Measurement scale

3. 	Which of the following types of patients express pain in a familiar manner?

a. 	An infant
b. 	A deaf person
c. 	A 40 year old male	
d. 	A non-English speaking patient who speaks through a translator

4. 	What is one goal of documenting pain? 

a. 	To compare pain levels of different ailments in patients
b. 	The patient can use the documentation to prove he or she was not given appropriate pain medication.
c. 	After a handoff, new staff will know if pain has increased or decreased.
d. 	The caregiver can use the documentation to build a case if necessary to transfer the patient to a psych unit.

5. 	When discharging a patient, who should receive education on the patient’s pain management?

a. 	The patient only
b. 	The patient’s caregiver only
c. 	The patient and any family or caregivers involved in the patient’s care
d. 	No one. The written discharge instructions are clear enough.

6. 	When assessing pain, it is important to keep in mind:

a. 	Children tend to complain more often about pain.
b. 	There are no standard tools to assess pain.
c. 	Patients who do not complain of pain should not be asked about pain.
d. 	Every patient has a right to pain management.

7.  	What information about a patient’s pain should be communicated during 
a handoff?

a. 	Only the pain medications the patient is taking
b. 	Initial pain assessment, reassessment and treatment plan
c. 	How many times the patient rings the call button
d. 	How the patient rates his or her pain compared to what other patients with similar symptoms usually rate 

8.	The goal of pain management is:

a. 	To document charts accurately
b. 	To reduce or stop a patient’s pain
c. 	To stop patients from using their call buttons too much
d. 	To give the patient an accurate amount of attention

9.  	What is one way that a caregiver can help lower the pain levels in a patient who has already been medicated? 

a. 	If the patient is already receiving the maximum dosage of a medication that is safe for the patient, there is nothing else that can be done.
b. 	Consult another caregiver of the same specialty. 
c. 	Try to talk to the patient while he or she is experiencing pain and comfort them with words.	
d. 	Use staff from other departments within the hospital, such as pharmacy and/or rehabilitation. These staff members may know different drug combinations or treatment techniques.

10. Upon discharge,

a. 	Pain treatment, including medication, should stop.
b. 	Pain management instructions should only be given to the patient’s primary 
care doctor.
c. 	Caregivers should create an effective pain relief plan, and the patient and his or her family should be educated about the patient’s pain management.
d. 	Medication lists and discharge instructions should be given out as usual, but pain management at home is the responsibility of the patient and should not be discussed.

11. What is the Joint Commission's stance on giving larger doses of 
pain medication?

a. 	The Joint Commission urges against overmedicating patients, thinking it is better to give patients smaller dosages than risk an addiction problem.
b. 	The Joint Commission says patients have a right to be as pain-free as is 
safely possible. 
c. 	The Joint Commission has no official stance on the matter.	
d. 	The Joint Commission has guidelines on pain medication based on weight and age that must be adhered to closely.

12. Should caregivers discuss how to manage a patient's pain with 
the patient?

a. 	The patient’s pain management should only be discussed between those healthcare professionals who are caring for the patient.
b. 	Nurses and anyone who takes the role of the patient’s caregiver should be the only people to discuss the patient’s pain management.
c. 	The patient should be involved in and educated about the treatment of his or her pain.
d. 	It depends whether the patient is in chronic pain.

13. What is a reason for educating a patient’s family and/or caregiver about his or her pain management?

a.	Most family members and/or caregivers will demand to have pain management explained anyway.
b. 	Family members and caregivers often have anxiety over a patient’s pain, and often times, family members serve as caregivers. Not explaining the pain management process could heighten anxieties of everyone involved, delay recovery for the patient, and put the patient at risk for pain.
c. 	A patient should not be involved in their own pain management as it might encourage overmedication, so family members and/or caregivers need to know about his or her pain management.
d. 	Family members and/or caregivers should not be involved in the patient’s pain management.

14.	Which of the following answers provides elements of the most complete pain management process?

a. 	Asking the patient about pain every day and adjusting treatment to meet the patient’s needs
b. 	Initial screen and assessment, patient education, consideration of treatment, and documentation
c. 	Initial screen and assessment of pain, continual reassessment of pain, consideration of treatment, patient and family education, and documentation
d. 	Asking the patient about pain levels and documenting them periodically

15.	When should pain management be discussed with the patient?

a. 	Upon admission
b. 	During the patient’s stay and at discharge
c. 	Only when a patient’s pain is interfering with his or her recovery
d. 	When a patient complains of pain

16. How should a patient with chronic pain have his or her pain managed?

a.	Chronic pain sufferers should have an initial assessment and continual reassessment, along with treatment if deemed necessary, just like other patients.
b. 	Chronic pain sufferers could become addicted to pain medication, so pain should be assessed and documented but treatment should not be considered.
c.	Because the patient has most likely already been treated for pain and on pain medication, there should be no pain management.
d. 	Because the patient constantly suffers from pain, an assessment is unnecessary but a treatment for pain should be provided.

17. Which of the following topics is outside of the scope of a typical conversation about his or her pain management?

a. 	What the Joint Commission stipulates needs to be covered during patient education
b. 	Goals of pain management
c. 	Treatment side effects
d. 	Medication schedules and how quickly pain management techniques should work
	
18. Who would be served best for pain using the zero to 10 scale? 

a. 	A toddler who just learned to speak
b. 	An elderly man with dementia
c. 	A non-English speaker
d. 	A chronic pain sufferer who sometimes experiences breakthrough pain

19.	What is important to keep in mind as you, the caregiver, document a reassessment of pain?

a. 	The patient is watching, and most likely judging your ability to manage his or 
her pain.
b. 	Each nursing shift will make important pain management decisions using this information, therefore it's important to be as accurate and descriptive as possible.
c. 	The Joint Commission may audit your chart and scrutinize your assessment.
d. 	Patients typically overestimate their pain.

20. When using the Wong-Baker scale, what is used to depict a patient's 
pain level?

a. 	smiley faces
b. 	colors 
c. 	animals	
d. 	letters, similar to being graded in school