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1. Opioids are contraindicated in patients with all of the following comorbidities, EXCEPT?

A. Severe asthma B. Ongoing paralytic ileus C. History of gastrointestinal obstruction D. Gestational diabetes E. Unsure

2. DM is a 56-year-old female with degenerative disc disease who has been prescribed and using opioid medications to control her pain for the past several years. Recently, she has been experiencing breakthrough pain with her previously stable opioid regimen, and has required several dose increases. Which of the following opioid-related adverse effects is described in this scenario?

A. Opioid abuse B. Opioid addiction C. Opioid tolerance D. Opioid dependence E. Unsure

3. Concurrent administration of an oral opioid agonist and second-generation antihistamine is most likely to increase the risk of which of the following adverse events?

A. Reduced analgesic effects B. Severe constipation C. Ventricular arrhythmia D. Respiratory depression E. Unsure

4. Risk factors for opioid-induced respiratory depression (OIRD) include all of the following, EXCEPT:

A. Heart failure B. History of cancer C. Pancreatic disease D. Cardiorespiratory disease E. Unsure

5. A misunderstanding between a patient and their pharmacist regarding the instructions for use of an opioid prescription for a legitimate medical purpose increases the risk for which of the following adverse events?

A. Opioid misuse B. Opioid abuse C. Opioid addiction D. Opioid diversion E. Unsure

6. TD is a 75-year-old female who found several expired fentanyl patches while cleaning out her medicine cabinet. What is the most appropriate course of action for TD to take to avoid accidental opioid overdose?

A. Store the patches in a locked cabinet until a drug take-back program is available in her community B. Store the patches in a locked cabinet until the next time TD has severe pain and needs analgesia C. Dispose of the patches immediately by mixing them into coffee grounds and throwing them in the trash D. Dispose of the patches immediately by flushing them down the toilet E. Unsure

7. KR is a 64-year-old woman who presents with increasing abdominal cramping and nausea for several days. She says her last bowel movement was 6 days ago and her symptoms started when she began an opioid analgesic 2 weeks ago for postprocedural pain in association with a knee replacement surgery. KR has tried to quit taking the opioid analgesics altogether, but she only makes it about halfway through the morning before the pain becomes unbearable. What is the best course of action for KR?

A. Decrease the dose of her current opioid therapy B. Increase the dose of her current opioid therapy C. Start a stimulant laxative D. Start a peripherally acting μ-opioid receptor antagonist (PAMORA) E. Unsure

8. HG is 30-year-old man who is brought into the emergency department after being found on the train unresponsive. He is lethargic and does not answer questions. His heart rate is 60 beats per minute, and respiratory rate is 8 breaths per minute and shallow. His pupils are pinpoint and not reactive. There are multiple intravenous track marks on his arms. One dose of intravenous naloxone is given and after a 5-minute wait, there is no response. What is the most appropriate course of action for HG?

A. Providing another dose of intravenous naloxone B. Providing intravenous methylnaltrexone C. Forcefully trying to stimulate HG until he responds D. Attempting to make HG vomit E. Unsure

9. All of the following actions can help mitigate opioid-related adverse effects, EXCEPT?

A. Changing to an extended-release (ER) formulation B. Giving smaller doses more frequently C. Giving larger doses less frequently D. Rotating to another opioid E. Unsure

10. Which of the following recommendations are found in the 2016 Centers for Disease Control and Prevention (CDC) guidelines for prescribing opioids for chronic pain?

A. Extended-release (ER) opioids are preferred when starting opioid therapy for chronic pain B. If the risks of opioid therapy start to outweigh the benefits, opioid therapy should be discontinued immediately C. State prescription drug monitoring program (PDMP) data should be reviewed at least every 3 months D. Opioid doses greater than 90 oral morphine equivalents (OME) per day should be used in cases of moderate-to-severe pain E. Unsure

Maintenance is scheduled for 05/16/2024 5:00 PM EST - 05/17/2024 5:00 AM EST.

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1. Opioids are contraindicated in patients with all of the following comorbidities, EXCEPT?

3. Concurrent administration of an oral opioid agonist and second-generation antihistamine is most likely to increase the risk of which of the following adverse events?

4. Risk factors for opioid-induced respiratory depression (OIRD) include all of the following, EXCEPT:

5. A misunderstanding between a patient and their pharmacist regarding the instructions for use of an opioid prescription for a legitimate medical purpose increases the risk for which of the following adverse events?

6. TD is a 75-year-old female who found several expired fentanyl patches while cleaning out her medicine cabinet. What is the most appropriate course of action for TD to take to avoid accidental opioid overdose?

9. All of the following actions can help mitigate opioid-related adverse effects, EXCEPT?

10. Which of the following recommendations are found in the 2016 Centers for Disease Control and Prevention (CDC) guidelines for prescribing opioids for chronic pain?

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Maintenance is scheduled for 05/16/2024 5:00 PM EST - 05/17/2024 5:00 AM EST.

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1. Opioids are contraindicated in patients with all of the following comorbidities, EXCEPT?

3. Concurrent administration of an oral opioid agonist and second-generation antihistamine is most likely to increase the risk of which of the following adverse events?

4. Risk factors for opioid-induced respiratory depression (OIRD) include all of the following, EXCEPT:

5. A misunderstanding between a patient and their pharmacist regarding the instructions for use of an opioid prescription for a legitimate medical purpose increases the risk for which of the following adverse events?

6. TD is a 75-year-old female who found several expired fentanyl patches while cleaning out her medicine cabinet. What is the most appropriate course of action for TD to take to avoid accidental opioid overdose?

9. All of the following actions can help mitigate opioid-related adverse effects, EXCEPT?

10. Which of the following recommendations are found in the 2016 Centers for Disease Control and Prevention (CDC) guidelines for prescribing opioids for chronic pain?

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