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BCCCP STUDY EXAM QUESTIONS AND ANSWERS WITH COMPLETE SOLUTIONS
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What types of things does the Behavioral Pain Scale (BPS) assess and what score indicates significant pain? correct answer: 1. Facial expression (relaxed vs. grimacing) 2. Upper limbs (no movement vs. permanently retracted) 3. Compliance with ventilation (tolerating movement vs. unable to contro...

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  • September 19, 2023
  • 78
  • 2023/2024
  • Exam (elaborations)
  • Questions & answers

Subjects

  • bcccp
  • bcccp study exam questions and answers with comple
  • what types of things does the behavioral pain scal

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BCCCP STUDY EXAM QUESTIONS AND
ANSWERS WITH COMPLETE
SOLUTIONS
What types of things does the Behavioral Pain Scale (BPS)
assess and what score indicates significant pain? correct answer:
1. Facial expression (relaxed vs. grimacing)
2. Upper limbs (no movement vs. permanently retracted)
3. Compliance with ventilation (tolerating movement vs. unable
to control ventilation/fighting vent)

>5

What types of things does the Critical-Care Pain Observation
Tool (CPOT) assess and what score indicates significant pain?
correct answer: 1. Body movements (absence of movement vs.
restlessness)
2. Muscle tension - flexion/extension of upper extremities
(relaxed vs. very tense or rigid)
3. Compliance with ventilator (tolerating vs. fighting) OR
vocalization

>=3

Fentanyl metabolic/drug interaction considerations correct
answer: Major substrate of 3A4

Drug accumulation factors to consider with fentanyl correct
answer: Hepatic failure, high Vd

,Morphine metabolic/drug interaction considerations correct
answer: Glucuronidation

Morphine major adverse effects correct answer: Hypotension,
bradycardia (from histamine release)

Morphine drug accumulation factors correct answer: Hepatic
failure, active metabolite accumulates in renal failure

Hydromorphone metabolic/drug interaction considerations
correct answer: Glucuronidation

Hydromorphone drug accumulation factors correct answer:
Hepatic failure

Methadone metabolic/drug interaction considerations correct
answer: 3A4 and 2B6 major substrates

Methadone significant adverse effects correct answer: QTc
prolongation, serotonin syndrome

Methadone drug accumulation factors correct answer: Long
half-life, hepatic and renal failure will delay clearance

Remifentanyl clearance correct answer: blood and tissue
esterase (not dependent on organ function)

Which IV opioids will not cause bradycardia correct answer:
Hydromorphone, methadone

,Which IV opioid will not cause hypotension correct answer:
methadone

Which IV opioids carry a risk of serotonin syndrome with other
serotinergic agents correct answer: fentanyl, morphine,
methadone

Which IV opioids can accumulate with liver failure correct
answer: fentanyl, morphine, hydromorphone, methadone

Which IV opioids can accumulate with renal failure correct
answer: morphine, methadone

How is propofol cleared correct answer: Hepatic (caution in
patients with hepatic impairment or cirrhosis)

How many calories and grams of fat does propofol have correct
answer: 1.1 kcal/mL or 0.1 g/mL

What are some clinical characteristics of PRIS correct answer:
metabolic acidosis, acute renal failure, cardiovascular collapse,
cardiac arrhythmias, rhabdo, myoglobinuria, hyperkalemia,
hyperTG, elevated CK

Which sedative may have weak opiate-sparing antinociceptive
effects correct answer: Precedex

Recommended duration of Precedex correct answer: Package
insert recommends therapy for 24 hours or less, RCTs have used
it up to 5-7 days, and safety beyond 7 days is not well
established

, Lorazepam vs. midazolam clearance and volume of distribution
correct answer: Lorazepam: hepatic clearance by conjugation to
inactive compounds, moderate to high Vd
Midazolam: hepatic clearance by glucuronidation to an active
metabolite which is renally cleared, large Vd

What to do with sedation and analgesia during an SAT correct
answer: Hold continuous sedative and analgesic infusions and
bolus opioids for breakthrough pain (continuous opioid
infusions allowed to continue while stopping sedatives if
presence of active pain)

What to do with sedation and analgesia if SAT fails correct
answer: Bolus opioids before restarting infusion. Re initiate
sedative infusion, if necessary, at half the previous dose and
titrate to goal

If a patient is delirious, which classes of medications should be
scrutinized for need and appropriate dosage? correct answer: 1.
Anticholinergics
2. BZDs
3. Opiates
4. Antipsychotics
5. Antispasmodics
6. Anticonvulsants
7. Corticosteroids

What are precipitants of delirium to keep in mind and try to treat
correct answer: 1. Infection
2. Dehydration or malnutrition

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