Share this article on:

Prescribing opioids in primary care: Avoiding perils and pitfalls

doi: 10.1097/01.NPR.0000450821.67133.c8
CE Connection

For more than 134 additional continuing education articles related to advance practice nursing topics, go to\CE.

Earn CE credit online: Go to and receive a certificate within minutes.

Back to Top | Article Outline

INSTRUCTIONS Prescribing opioids in primary care: Avoiding perils and pitfalls


  • To take the test online, go to our secure website at
  • On the print form, record your answers in the test answer section of the CE enrollment form on page 38. 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 $21.95 to: Lippincott Williams & Wilkins, CE Group, 74 Brick Blvd., Bldg. 4, Suite 206, 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 June 30, 2016.
Back to Top | Article Outline


  • 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 Call 1-800-787-8985 for details.
Back to Top | Article Outline


Lippincott Williams & Wilkins, publisher of The Nurse Practitioner journal, will award 2.3 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 2.3 contact hours. Lippincott Williams & Wilkins is also an approved provider of continuing nursing education by the District of Columbia and Florida #50–1223.

Your certificate is valid in all states. This activity has been assigned 2.3 pharmacology credits.

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.

Prescribing opioids in primary care: Avoiding perils and pitfalls

General Purpose: To provide information about and recommendations for safely prescribing opioids for chronic noncancer pain. Learning Objectives: After reading the article and taking this test, you should be able to: 1. Describe the significance of effective pain management. 2. Identify ways to decrease risk of opioid misuse. 3. State procedures for safely prescribing opioids.

  1. The 2001 Joint Commission pain standards addressed
    1. medical board policies on safe prescribing.
    2. abuse of pain medications.
    3. safety and efficacy of specific drugs.
    4. undertreatment of pain.
  2. The Office of National Drug Control Policy implemented strategies to
    1. expand prescribing privileges.
    2. treat pain more effectively.
    3. reduce prescription drug abuse.
    4. streamline pain medication distribution.
  3. The first step in pain management planning is
    1. nonpharmacologic intervention.
    2. patient education.
    3. comprehensive assessment.
    4. risk management.
  4. Chronic pain is usually defined as pain persisting
    1. despite treatment.
    2. past the period of expected healing.
    3. without provocation.
    4. for more than 2 months.
  5. It is estimated that 50% of people in chronic pain experience
    1. depression and anxiety.
    2. social isolation.
    3. addiction.
    4. undertreatment.
  6. Opioids should only be initiated after assessment, diagnosis, and
    1. a failed trial of NSAIDs.
    2. surgical intervention.
    3. exercise and rehabilitation.
    4. misuse risk evaluation.
  7. The FDA-approved REMS include
    1. information about all opioid formulations.
    2. a patient counseling document about safety.
    3. mandatory education for prescribers.
    4. manufacturer responsibility for monitoring drug distribution.
  8. Which of the following validated opioid risk assessment tools is considered to be superior?
    1. Diagnosis, Intractability, Risk, Efficacy Score
    2. Opioid Risk Tool
    3. Screener and Opioid Assessment for Patients with Pain–Revised
    4. Opioid Addiction Risk Assessment
  9. For patients with active substance use disorders, opioid therapy
    1. is always contraindicated.
    2. should not be undertaken in an outpatient setting.
    3. is recommended only for cancer or end-of-life care.
    4. should be managed by a pain management specialist.
  10. The PADT assesses all the following except
    1. activities of daily living.
    2. risk of addiction.
    3. adverse reactions.
    4. aberrant behavior.
  11. Oral opioid therapy is discontinued by 22% of individuals due to
    1. lack of pain relief.
    2. adverse reactions.
    3. resolution of symptoms.
    4. cost.
  12. The gold standard choice for urine drug testing is
    1. gas chromatography/mass spectrometry.
    2. scheduled enzyme immunoassay.
    3. random dipstick immunoassays.
    4. urinalysis.
  13. Which resource helps identify patients who obtain medication from multiple sources?
    1. Current Opioid Misuse Measure
    2. PDMP
    3. Opioid Risk Tool
    4. REMS
  14. Moderate dose opioid therapy is a daily morphine equivalent of
    1. 10 to 30 mg.
    2. 31 to 40 mg.
    3. 41 to 90 mg.
    4. 91 to 120 mg.
  15. Which baseline test should be done before prescribing methadone?
    1. complete blood count
    2. urinalysis
    3. pulmonary function tests
    4. electrocardiogram
  16. Steps taken to safely prescribe opioids include all of the following
    1. checking the PDMP or pharmacy records.
    2. knowing and avoiding the opioids most commonly abused in the particular region.
    3. dispensing immediate release rather than extended release tablets.
    4. dispensing the smallest number of capsules possible to achieve the necessary dose.
  17. According to the article, 54% of the time, opioids used for nonmedical purposes were
    1. prescribed by primary care providers.
    2. obtained free from family and friends.
    3. taken from pain management clinics.
    4. purchased from “dealers.”
  18. Discontinuing opioid therapy should involve
    1. an individualized plan.
    2. adhering to a standardized taper protocol.
    3. tapering by 10% weekly.
    4. referral to a substance abuse treatment program.


© 2014 Lippincott Williams & Wilkins