BCCCP STUDY EXAM QUESTIONS AND

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BCCCP STUDY EXAM QUESTIONS AND

ANSWERS WITH COMPLETE SOLUTIONS

Question 1: 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)

• Upper limbs (no movement vs. permanently retracted)
• Compliance with ventilation (tolerating movement vs. unable

to control ventilation/fighting vent) >5

Question 2: 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)

• Muscle tension - flexion/extension of upper extremities

(relaxed vs. very tense or rigid)

• Compliance with ventilator (tolerating vs. fighting) OR

vocalization >=3

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Question 3: Fentanyl metabolic/drug interaction considerations

CORRECT ANSWER : Major substrate of 3A4

Question 4: Drug accumulation factors to consider with fentanyl

CORRECT ANSWER : Hepatic failure, high Vd

Question 5: Morphine metabolic/drug interaction considerations

CORRECT ANSWER: Glucuronidation

Question 6: Morphine major adverse effects

CORRECT ANSWER : Hypotension, bradycardia (from

histamine release)

Question 7: Morphine drug accumulation factors

CORRECT ANSWER : Hepatic failure, active metabolite

accumulates in renal failure

Question 8: Hydromorphone metabolic/drug interaction

considerations

CORRECT ANSWER : Glucuronidation

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Question 9: Hydromorphone drug accumulation factors

CORRECT ANSWER : Hepatic failure

Question 10: Methadone metabolic/drug interaction

considerations

CORRECT ANSWER : 3A4 and 2B6 major substrates

Question 11: Methadone significant adverse effects

CORRECT ANSWER : QTc prolongation, serotonin syndrome

Question 12: Methadone drug accumulation factors

CORRECT ANSWER : Long half-life, hepatic and renal failure

will delay clearance

Question 13: Remifentanyl clearance

CORRECT ANSWER : blood and tissue esterase (not dependent

on organ function)

Question 14: Which IV opioids will not cause bradycardia

CORRECT ANSWER : Hydromorphone, methadone

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Question 15: Which IV opioid will not cause hypotension

CORRECT ANSWER : methadone

Question 16: Which IV opioids carry a risk of serotonin

syndrome with other serotinergic agents

CORRECT ANSWER : fentanyl, morphine, methadone

Question 17: Which IV opioids can accumulate with liver failure

CORRECT ANSWER : fentanyl, morphine, hydromorphone,

methadone

Question 18: Which IV opioids can accumulate with renal

failure

CORRECT ANSWER : morphine, methadone

Question 19: How is propofol cleared

CORRECT ANSWER : Hepatic (caution in patients with hepatic

impairment or cirrhosis)

Question 20: How many calories and grams of fat does propofol

have