MCQs

for EPM
Post course test – answer sheet for learners

Name:……………………………………………………… Date………………………

Circle True (T) or False (F) for EVERY statement.

Question 1
A 52-year-old man caught his right hand in machinery at work one hour ago. He has an open fracture
of his hand.
a. T F The pain type is acute, nociceptive, non-cancer pain.
b. T F An oral opioid is an appropriate pharmacological treatment.
c. T F The patient should be warned of the risk of addiction to opioids.
d. T F Suitable non-pharmacological treatments include reassurance at the same time as
medication is being given.
e. T F Analgesia should not be given until the surgeon has seen the patient.
f. T F Only a qualified doctor is able to assess this patient’s pain.
g. T F The patient needs to be asked about his pain.
h. T F Immobilisation is an important non-pharmacological treatment.
i. T F Paracetamol should not be given because it will not be strong enough.
j. T F After intravenous opioids have been given the respiratory rate should be monitored.

Question 2
A 54-year-old woman has just had a laparotomy for bowel obstruction secondary to cancer. Her
preoperative chest X-ray has shown probable secondaries. You see her on the surgical ward soon
after the operation. She complains of severe pain.
a. T F The pain type is chronic, nociceptive, cancer pain.
b. T F Anxiety is likely to be an important factor.
c. T F Reassurance that she has been cured is an appropriate non-pharmacological
treatment.
d. T F Opioids are contraindicated because they will delay return of normal bowel function.
e. T F Opioids should only be given for a few days to prevent addiction.
f. T F The pain type is acute, neuropathic, cancer pain
g. T F Reassurance that you are doing all you can to help is an appropriate non-
pharmacological treatment.
h. T F A surgeon needs to review the patient before analgesia is given.
i. T F Paracetamol is a useful part of the pharmacological treatment.
j. T F Intravenous opioids carry a risk of respiratory depression

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Mike O’Connor / Wayne Morris / Linda Huggins / Chris Orlikowski 10 May 2017
Question 3
A 75-year-old man has a 2 year history of lower back pain which sometimes radiates down his right
leg. He reports he had a back injury ‘years ago’ but his doctor cannot see anything unusual on
recent imaging.
a. T F The pain type is acute, neuropathic, non-cancer pain.
b. T F A three-month supply of a strong opioid such as oxycodone should be prescribed for
the patient to take home.
c. T F The patient looks calm, so the pain cannot be severe.
d. T F The patient should be asked about pain at rest, at night and when walking.
e. T F It is important to use both non-pharmacological and pharmacological treatments for
the pain.
f. T F Careful physical assessment should be done to identify any new pathology.
g. T F Chronic pain is not as severe as acute pain.
h. T F Other factors, such as how the pain is impacting on the patient’s life, should be
assessed.
i. T F For chronic back pain, bed rest for 6 weeks is a useful non-pharmacological
treatment.
j. T F A long-term NSAIM should be used for this patient.

Question 4
A 23 year-old woman has had a severe injury to her leg leading to a surgical below knee amputation
six months ago. She complains of pain in the missing foot.
a. T F The pain type is chronic, neuropathic, non-cancer pain.
b. T F She should be reassured that the pain is not really there.
c. T F Explanation is an appropriate non-pharmacological treatment.
d. T F Gabapentin is an appropriate pharmacological treatment
e. T F Strong opioids are an appropriate pharmacological treatment.
f. T F She may have phantom limb pain and stump pain.
g. T F Obtaining a limb prosthesis and encouraging mobilization is an appropriate
pharmacological treatment.
h. T F Other factors, such as how the pain is impacting on the patient’s life, should be
assessed.
i. T F Amitriptyline may be a useful non-pharmacological treatment.
j. T F Short acting opioids for flare ups of pain is an appropriate pharmacological
treatment.

Question 5
A 55-year-old woman has a 2 year history of breast cancer. It has recently with spread to her
spine. She has severe pain.
a. T F The pain type is acute, nociceptive, cancer pain.
b. T F Opioids are likely to be an important part of pharmacological treatment.
c. T F The patient should be warned that there is a high risk of addiction to opioids.
d. T F Reassurance that all will be well is an appropriate non-pharmacological treatment.
e. T F The family may report that the patient has pain rather than the patient.
f. T F Cancer patients always have pain.
g. T F The patient should be asked about her pain levels every time her regular
observations are done.
h. T F Combining different types of analgesics usually causes unacceptable side-effects.
i. T F Using morphine for this patient is likely to lead to addiction.
j. T F If the pain does not fully respond to morphine, the morphine dose should be
increased until the pain score is 0.

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Mike O’Connor / Wayne Morris / Linda Huggins / Chris Orlikowski 10 May 2017