INSTRUCTIONS Managing pain in obese patients
* To take the test online, go to our secure website at http://www.nursingcenter.com/ce/NP.
* On the print form, record your answers in the test answer section of the CE enrollment form on page 33. Each question has only one correct answer. You may make copies of these forms.
* Complete the registration information and course evaluation. Mail the completed form and registration fee of $17.95 to: Lippincott Williams & Wilkins, CE Group, 2710 Yorktowne Blvd., Brick, NJ 08723. We will mail your certificate in 4 to 6 weeks. For faster service, include a fax number and we will fax your certificate within 2 business days of receiving your enrollment form.
* You will receive your CE certificate of earned contact hours and an answer key to review your results.There is no minimum passing grade.
* Registration deadline is December 31, 2013.
DISCOUNTS and CUSTOMER SERVICE
* Send two or more tests in any nursing journal published by Lippincott Williams & Wilkins together and deduct $0.95 from the price of each test.
* We also offer CE accounts for hospitals and other healthcare facilities on nursingcenter.com. Call 1-800-787-8985 for details.
Lippincott Williams & Wilkins, publisher of The Nurse Practitioner journal, will award 1.9 contact hours for this continuing nursing education activity.
Lippincott Williams & Wilkins is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center's Commission on Accreditation.
This activity is also provider approved by the California Board of Registered Nursing, Provider Number CEP 11749 for 1.9 contact hours. Lippincott Williams & Wilkins is also an approved provider of continuing nursing education by the District of Columbia and Florida #FBN2454.
Your certificate is valid in all states.
The ANCC's accreditation status of Lippincott Williams & Wilkins Department of Continuing Education refers only to its continuing nursing educational activities and does not imply Commission on Accreditation approval or endorsement of any commercial product.
Managing pain in obese patients
General Purpose: To familiarize the NP with pain management for obese patients. Learning Objectives: After reading the preceding article and taking this test, you should be able to: 1. State the prevalence, contributing factors, and characteristics of obesity. 2. Describe comorbidities related to obesity and pain. 3. Discuss methods of managing pain for obese patients.
1. Approximately how many people worldwide are obese?
a. 5 million
b. 50 million
c. 1 billion
d. 5 billion
2. Which statement about pain in the obese patient is correct?
a. Pain management can assist the patient to increase activity and lose weight.
b. Obesity-related pain can be managed by lifestyle changes.
c. Pain should take priority over treatment of other obesity-related diseases.
d. Most healthcare providers frequently address pain-related comorbidities such as low back pain.
3. Which BMI is classified as normal weight?
4. Which BMI is classified as Obese Class I?
5. Which physiologic change is related to increased adipose tissue?
a. increase in interleukin-6
b. decrease in tumor necrosis factor
c. decrease in C-reactive protein
d. increase in insulin sensitivity
6. The percentage of patients with fibromyalgia who are classified as obese is as much as
7. Which characteristic is not typical of fibromyalgia pain in the obese patient?
a. chronic pain
b. affects males more than females
c. hyperalgesia in at least 11 specific points
d. bilateral pain
8. Which statement about low back pain and weight loss is accurate?
a. Bariatric surgery has demonstrated a significant decrease in low back pain.
b. Low back pain is equally reduced by all weight loss strategies.
c. Weight loss usually reverses the effect on mechanical load bearing.
d. Comprehensive multidisciplinary nonsurgical programs are as effective as surgical programs for morbidly obese patients.
9. The two major risk factors for osteoarthritis are obesity and
a. male gender.
b. female gender.
c. calcium-rich diet.
d. lack of exercise.
10. Which of the following should be considered for pain management in an obese patient with a history of type 2 diabetes who is having moderate-to-severe pain?
a. a nonsteroidal anti-inflammatory drug
b. an opioid
11. Opioids for postoperative pain in most obese patients can generally be administered
a. only if other medications fail.
b. in smaller than usual doses.
c. in usual doses.
d. in larger than usual doses.
12. Which is the best combination for management of postoperative pain in the obese patient?
a. multimodal analgesia using regional and opioid-sparing modes
b. an opioid analgesic combined with a sedative
c. patient-controlled analgesia and continuous infusion
d. acupuncture and yoga
13. Recommendations for postoperative pain management for the obese patient include
a. head of bed elevation to 20 degrees.
b. endotracheal intubation.
c. oxygen saturation greater than 94% while asleep on 2 liters of oxygen.
d. end-tidal carbon dioxide monitoring.
14. Compared to a nonobese patient receiving epidural analgesia with a local anesthetic postsurgery, the obese patient will require
a. less local anesthetic.
b. the same local anesthetic.
c. slightly more local anesthetic.
d. significantly more local anesthetic.
15. Aromatherapy, using which of the following essential oils, has been shown to decrease the morphine dosage needed for postoperative pain?
16. Compared to nonobese patients, renal clearance in the morbidly obese patient is most likely to be
a. the same.