MCQ Quiz: Assessment & Management of Acute Pain

Acute pain is the body’s normal, time-limited response to injury, surgery, or illness. Its effective management is crucial for patient comfort, recovery, and preventing the transition to chronic pain. A systematic approach to the assessment and treatment of acute pain, as covered in the Patient Care 3 curriculum “, is a key skill for every pharmacist. This quiz will test your knowledge on the principles of acute pain assessment, non-pharmacologic interventions, and the application of multimodal, opioid-sparing analgesic strategies.

1. Acute pain is best described as:

• a. Pain that persists for more than 6 months.
• b. A normal, predicted physiological response to a noxious stimulus that is typically recent in onset and limited in duration.
• c. Pain caused by nerve damage.
• d. Pain that does not respond to any medication.

Answer: b. A normal, predicted physiological response to a noxious stimulus that is typically recent in onset and limited in duration.

2. A pharmacist asks a patient, “On a scale of 0 to 10, with 0 being no pain and 10 being the worst pain imaginable, what is your pain level right now?” This is an example of using the:

• a. PQRST Mnemonic
• b. Wong-Baker FACES Scale
• c. Numeric Rating Scale (NRS)
• d. McGill Pain Questionnaire

Answer: c. Numeric Rating Scale (NRS)

3. The “P” in the PQRST pain assessment mnemonic can stand for:

• a. Palliative or Provocative factors.
• b. Quality
• c. Region
• d. Severity

Answer: a. Palliative or Provocative factors.

4. What is the first-line pharmacologic treatment for mild acute pain (e.g., a score of 2/10)?

• a. A strong opioid like morphine.
• b. A non-opioid analgesic like acetaminophen or an NSAID.
• c. An adjuvant analgesic like gabapentin.
• d. A muscle relaxant.

Answer: b. A non-opioid analgesic like acetaminophen or an NSAID.

5. “Multimodal analgesia” is the practice of:

• a. Using only one type of pain medication.
• b. Using multiple pain medications that work by different mechanisms to improve pain relief and reduce side effects.
• c. Using only non-pharmacologic treatments.
• d. Using only opioid medications.

Answer: b. Using multiple pain medications that work by different mechanisms to improve pain relief and reduce side effects.

6. The “Introduction to Pain and Treatment Options” is a specific learning module in which course?

• a. PHA5878C Patient Care 3
• b. PHA5104 Sterile Compounding
• c. PHA5703 Pharmacy Law and Ethics
• d. PHA5787C Patient Care 5

Answer: a. PHA5878C Patient Care 3

7. For an acute musculoskeletal injury like an ankle sprain, RICE therapy is recommended. The “C” stands for:

• a. Cold
• b. Continue
• c. Compression
• d. Caution

Answer: c. Compression

8. The maximum recommended daily dose of over-the-counter ibuprofen for an adult is:

• a. 4000 mg
• b. 2400 mg
• c. 1200 mg
• d. 650 mg

Answer: c. 1200 mg

9. The primary goal of managing acute pain is to:

• a. Eliminate all sensation of pain completely.
• b. Provide adequate pain relief to allow for functional recovery (e.g., participation in physical therapy).
• c. Prevent the patient from becoming addicted to opioids.
• d. Use the lowest possible dose of medication, regardless of pain severity.

Answer: b. Provide adequate pain relief to allow for functional recovery (e.g., participation in physical therapy).

10. Which side effect of opioid therapy requires a proactive bowel regimen to prevent?

• a. Sedation
• b. Nausea
• c. Respiratory depression
• d. Constipation

Answer: d. Constipation

11. The “Pharmacology of Analgesics” is a specific topic within the Patient Care 3 curriculum.

• a. True
• b. False

Answer: a. True

12. For a patient with severe acute pain (e.g., 9/10) immediately following a major surgery, which dosing strategy is most appropriate for the first 24-48 hours?

• a. As-needed (PRN) oral acetaminophen.
• b. Scheduled (“around-the-clock”) IV opioid analgesia.
• c. A topical lidocaine patch.
• d. As-needed (PRN) oral ibuprofen.

Answer: b. Scheduled (“around-the-clock”) IV opioid analgesia.

13. A key principle of opioid-sparing pain management is:

• a. To use opioids as the first and only line of treatment.
• b. To maximize the use of non-opioid analgesics and non-pharmacologic therapies to reduce the total amount of opioid needed.
• c. To avoid opioids altogether, even in severe pain.
• d. To use the highest possible dose of opioids.

Answer: b. To maximize the use of non-opioid analgesics and non-pharmacologic therapies to reduce the total amount of opioid needed.

14. A patient should be counseled that taking NSAIDs with food may:

• a. Increase the risk of GI bleeding.
• b. Decrease the risk of GI upset.
• c. Improve the speed of absorption.
• d. Increase the analgesic effect.

Answer: b. Decrease the risk of GI upset.

15. Counseling patients on self-care for pain is a key objective for student pharmacists.

• a. True
• b. False

Answer: a. True

16. Which of the following is NOT a characteristic of acute pain?

• a. It serves a protective biological purpose.
• b. It is usually of recent onset.
• c. It often persists long after the initial injury has healed.
• d. The intensity often correlates with the degree of tissue damage.

Answer: c. It often persists long after the initial injury has healed.

17. The “Self-Care for Pain and Fever” lecture is part of the Patient Care 3 curriculum.

• a. True
• b. False

Answer: a. True

18. Acetaminophen has which of the following properties?

• a. Analgesic and anti-inflammatory
• b. Analgesic and antipyretic
• c. Anti-inflammatory and antipyretic
• d. Analgesic, anti-inflammatory, and antipyretic

Answer: b. Analgesic and antipyretic

19. A patient is prescribed a combination product containing oxycodone and acetaminophen. What is the most important counseling point regarding safety?

• a. To take the medication with grapefruit juice.
• b. To be aware of the total daily dose of acetaminophen from all sources to avoid overdose.
• c. To take the medication on an empty stomach.
• d. That this medication has no side effects.

Answer: b. To be aware of the total daily dose of acetaminophen from all sources to avoid overdose.

20. An active learning session on pain management is part of the Patient Care 3 course.

• a. True
• b. False

Answer: a. True

21. A patient with a history of severe chronic kidney disease should avoid which class of OTC analgesics for acute pain?

• a. Acetaminophen
• b. NSAIDs
• c. All OTC analgesics are safe.
• d. Aspirin

Answer: b. NSAIDs

22. “Patient-Controlled Analgesia” (PCA) is a delivery method for:

• a. IV opioid therapy, typically used for post-operative pain.
• b. Oral NSAIDs.
• c. Topical lidocaine.
• d. Physical therapy.

Answer: a. IV opioid therapy, typically used for post-operative pain.

23. The “Medicinal Chemistry of Analgesics” is a lecture within the Patient Care 3 curriculum.

• a. True
• b. False

Answer: a. True

24. An active learning session on pain is part of which course?

• a. PHA5878C Patient Care 3
• b. PHA5163L Professional Skills Lab 3
• c. PHA5781 Patient Care I
• d. PHA5782C Patient Care 2

Answer: a. PHA5878C Patient Care 3

25. A pharmacist’s role in assessing acute pain includes:

• a. Listening to the patient’s self-report of pain.
• b. Using a validated pain scale.
• c. Asking about the characteristics of the pain (PQRST).
• d. All of the above.

Answer: d. All of the above.

26. The most appropriate initial treatment for a severe migraine headache in the emergency department would be:

• a. Oral ibuprofen
• b. IV fluids and a combination of agents like an IV NSAID, an antiemetic, and possibly a triptan or dihydroergotamine.
• c. An oral opioid.
• d. Acetaminophen alone.

Answer: b. IV fluids and a combination of agents like an IV NSAID, an antiemetic, and possibly a triptan or dihydroergotamine.

27. Heat therapy is generally recommended for what type of acute pain?

• a. Acute inflammation from a sprain (in the first 24 hours).
• b. Muscle stiffness and soreness.
• c. A burn.
• d. It is never recommended.

Answer: b. Muscle stiffness and soreness.

28. An active learning session on pain is part of which course module?

• a. Module 1: Introduction to Pain and Treatment Options
• b. Module 3: Dyslipidemia
• c. Module 5: Acute Coronary Syndrome
• d. Module 8: Introduction to Pulmonary Disease

Answer: a. Module 1: Introduction to Pain and Treatment Options

29. The most significant dose-limiting adverse effect of opioids is:

• a. Constipation
• b. Nausea
• c. Respiratory depression
• d. Pruritus (itching)

Answer: c. Respiratory depression

30. The “Pharmacotherapy of Pain” is a lecture within the Patient Care 3 curriculum.

• a. True
• b. False

Answer: a. True

31. A patient is being discharged from the hospital after surgery. A key part of their pain management plan is:

• a. A long-term prescription for IV morphine.
• b. A clear plan for tapering off opioid medications as the acute pain resolves.
• c. A recommendation to use heat on the surgical incision.
• d. A prescription for two different opioids to be taken together.

Answer: b. A clear plan for tapering off opioid medications as the acute pain resolves.

32. The concept that pain is a subjective experience means:

• a. The pain is not real.
• b. All patients experience and report pain differently.
• c. Pain cannot be treated.
• d. Only the healthcare provider can determine the level of pain.

Answer: b. All patients experience and report pain differently.

33. What is the role of a pharmacist when they receive a prescription for an opioid for acute pain that seems to be for an excessive quantity?

• a. To dispense it without question.
• b. To refuse to fill the prescription.
• c. To use their professional judgment and contact the prescriber to confirm the indication and intended duration.
• d. To tell the patient to only take half the dose.

Answer: c. To use their professional judgment and contact the prescriber to confirm the indication and intended duration.

34. Pain management is considered a key topic in which course?

• a. PHA5878C Patient Care 3
• b. PHA5784C Patient Care 4
• c. PHA5787C Patient Care 5
• d. PHA5781 Patient Care I

Answer: a. PHA5878C Patient Care 3

35. A patient should be counseled to take a maximum of how many tablets of extra-strength acetaminophen (500 mg) per day?

• a. 4 tablets
• b. 6 tablets
• c. 8 tablets
• d. 10 tablets

Answer: b. 6 tablets

36. A key part of assessing acute pain is to differentiate it from:

• a. Chronic pain
• b. Neuropathic pain
• c. Both a and b
• d. Neither a nor b

Answer: c. Both a and b

37. The goal of using around-the-clock (ATC) dosing for acute post-operative pain is to:

• a. Use more opioids.
• b. Maintain a steady level of analgesia and prevent severe breakthrough pain.
• c. Make the nurse’s job more difficult.
• d. Comply with a legal requirement.

Answer: b. Maintain a steady level of analgesia and prevent severe breakthrough pain.

38. The Pain & Fever Self-Care module is part of the Patient Care I course.

• a. True
• b. False

Answer: a. True

39. A patient with acute gouty arthritis would benefit most from which analgesic?

• a. Acetaminophen
• b. An NSAID like indomethacin or naproxen.
• c. Aspirin
• d. A topical lidocaine patch.

Answer: b. An NSAID like indomethacin or naproxen.

40. An active learning session covering pain management is part of which course?

• a. PHA5878C Patient Care 3
• b. PHA5163L Professional Skills Lab 3
• c. PHA5781 Patient Care I
• d. PHA5782C Patient Care 2

Answer: a. PHA5878C Patient Care 3

41. Which of the following is NOT an advantage of multimodal analgesia?

• a. Improved pain relief.
• b. Reduced opioid consumption.
• c. Decreased side effects.
• d. Increased risk of respiratory depression.

Answer: d. Increased risk of respiratory depression.

42. The “T” in the PQRST pain assessment mnemonic stands for:

• a. Treatment
• b. Timing (onset, duration, frequency)
• c. Type
• d. Tenderness

Answer: b. Timing (onset, duration, frequency)

43. A pharmacist’s role in acute pain management is critical for ensuring:

• a. Safe and effective analgesic use.
• b. Prevention of medication errors.
• c. Counseling on appropriate expectations.
• d. All of the above.

Answer: d. All of the above.

44. For acute dental pain, what is a highly effective OTC regimen?

• a. Acetaminophen alone.
• b. Aspirin alone.
• c. A combination of ibuprofen and acetaminophen.
• d. Diphenhydramine.

Answer: c. A combination of ibuprofen and acetaminophen.

45. Which of the following best describes visceral pain?

• a. Sharp and well-localized.
• b. Burning and tingling.
• c. Often described as deep, cramping, or aching and is poorly localized.
• d. Occurs only on the skin.

Answer: c. Often described as deep, cramping, or aching and is poorly localized.

46. A patient is transitioning from IV morphine to oral morphine. The pharmacist knows that the oral dose will be ____ than the IV dose due to ____.

• a. lower, increased efficacy.
• b. higher, significant first-pass metabolism.
• c. the same, perfect bioavailability.
• d. lower, poor absorption.

Answer: b. higher, significant first-pass metabolism.

47. The pharmacology of analgesics is a key topic in the Patient Care 3 curriculum.

• a. True
• b. False

Answer: a. True

48. An active learning session on pain is part of which course module?

• a. Module 1: Introduction to Pain and Treatment Options
• b. Module 2: Hypertension
• c. Module 4: Ischemic Heart Disease
• d. Module 7: Arrhythmias

Answer: a. Module 1: Introduction to Pain and Treatment Options

49. The overall management of acute pain should be:

• a. A “one-size-fits-all” protocol.
• b. An individualized plan based on the type and severity of pain and patient-specific factors.
• c. Focused only on opioid therapy.
• d. Determined by the patient’s insurance plan.

Answer: b. An individualized plan based on the type and severity of pain and patient-specific factors.

50. The ultimate reason to learn about the assessment and management of acute pain is to:

• a. Relieve suffering, improve patient function, and prevent the development of chronic pain.
• b. Pass the pain management exam.
• c. Be able to recommend the strongest opioid.
• d. Avoid counseling patients about pain.

Answer: a. Relieve suffering, improve patient function, and prevent the development of chronic pain.