Pain management practices vary among NPs. The following survey pertains to both clinical practice and attitude regarding pain management. After the survey results are returned and analyzed, we will provide the results in a short article. Please answer all the questions even if your state prescriptive rights limit your ability to prescribe Schedule II medications. This survey is available online at http://www.nursingcenter.com/painsurvey2008. You can also photocopy and fax to 215-367-2147, or mail to The Nurse Practitioner Pain Management Survey, 323 Norristown Rd., Suite 200, Ambler, PA 19002. The deadline for responses is July 18, 2008.
I. True or False
1. Depression is common in patients who have chronic pain.
[white square] True
[white square] False
2. Increases in function may be a better measure of pain medication efficacy in chronic pain patients than decreased pain intensity.
[white square] True
[white square] False
3. When a chronic pain patient continues to complain of severe pain, yet he or she can work, the healthcare provider should believe his or her report of pain.
[white square] True
[white square] False
4. All patients have the same physiologic response to opioid pain medications.
[white square] True
[white square] False
5. Nonsteroidal anti-inflammatory drugs are a good nonopioid option for all patients with minor pain complaints or inflammatory pain.
[white square] True
[white square] False
6. Combining a nonopioid medication such as ibuprofen with an opioid can provide better pain relief and decrease the amount of opioid needed to control pain.
[white square] True
[white square] False
7. Neuropathic pain may need to be treated with a combination of medications, such as opioids and antidepressants or antiepileptic medications.
[white square] True
[white square] False
8. If the healthcare provider suspects a patient is lying about his or her pain, a placebo can be used to see if the pain is real.
[white square] True
[white square] False
9. When you get a positive urine screen for an illicit drug in a patient who has a pain management agreement with your clinic, care can be discontinued.
[white square] True
[white square] False
10. Older patients should use weaker pain medications such as acetaminophen and acetaminophen-codeine.
[white square] True
[white square] False
11. When a patient cannot take codeine or hydrocodone-acetaminophen (Vicodin) but needs an opioid, the next best choice is propoxyphene-acetaminophen (Darvocet).
[white square] True
[white square] False
12. Patients who need patient-controlled analgesia should always have a continuous infusion for consistent pain relief.
[white square] True
[white square] False
13. It is important to teach patients with long-term pain coping skills and distraction techniques.
[white square] True
[white square] False
14. The suicide rate for patients with chronic pain is no higher than other patients in the same age group without chronic pain.
[white square] True
[white square] False
II. Use the information below to answer the following questions.
Addiction is a chronic neurobiologic disease characterized by the four C's: craving for the substance, compulsive use, a lack of control, and continued use despite harm. Dependency is when a patient is accustomed to the regular use of the medication. Tolerance is a reduction in medication effect.