Q.1 Which scale is commonly used to assess pain in non-verbal critically ill patients?
Numeric Rating Scale (NRS)
Visual Analogue Scale (VAS)
Behavioral Pain Scale (BPS)
McGill Pain Questionnaire
Explanation - The Behavioral Pain Scale (BPS) is used for non-verbal ICU patients to assess pain based on facial expression, upper limb movements, and compliance with ventilation.
Correct answer is: Behavioral Pain Scale (BPS)
Q.2 Which opioid is preferred for continuous sedation in ICU patients with renal impairment?
Morphine
Fentanyl
Codeine
Hydromorphone
Explanation - Fentanyl is preferred in renal impairment because it has inactive metabolites and minimal accumulation compared to morphine.
Correct answer is: Fentanyl
Q.3 Which of the following is a common side effect of benzodiazepines used for sedation?
Bradycardia
Respiratory depression
Hypertension
Hyperthermia
Explanation - Benzodiazepines can depress the central nervous system, leading to respiratory depression, especially in critically ill patients.
Correct answer is: Respiratory depression
Q.4 The Richmond Agitation-Sedation Scale (RASS) score of 0 indicates:
Deep sedation
Moderate sedation
Alert and calm
Agitated
Explanation - RASS scores range from -5 (unarousable) to +4 (combative). A score of 0 indicates the patient is alert and calm.
Correct answer is: Alert and calm
Q.5 Which non-pharmacological method is effective in reducing ICU-related pain and anxiety?
Music therapy
Cold compress on limbs
High-intensity exercise
Restrictive bed rest
Explanation - Music therapy can reduce stress, anxiety, and perceived pain in critically ill patients, serving as an adjunct to pharmacological interventions.
Correct answer is: Music therapy
Q.6 Which drug class is commonly used for analgesia in mechanically ventilated patients?
NSAIDs
Opioids
Antihistamines
Beta-blockers
Explanation - Opioids, such as fentanyl or morphine, are preferred for analgesia in mechanically ventilated patients due to their potent pain control and sedative effects.
Correct answer is: Opioids
Q.7 Daily sedation interruption in ICU patients is done to:
Increase pain levels
Assess neurological function
Induce sleep
Prevent infection
Explanation - Daily sedation interruption allows assessment of neurological status, reduces over-sedation, and shortens mechanical ventilation duration.
Correct answer is: Assess neurological function
Q.8 Which analgesic should be used cautiously in patients with liver failure?
Acetaminophen
Fentanyl
Morphine
Hydromorphone
Explanation - Acetaminophen is metabolized in the liver, and excessive doses can lead to hepatotoxicity in patients with liver failure.
Correct answer is: Acetaminophen
Q.9 Propofol is primarily used in the ICU for:
Pain management
Sedation
Hypertension control
Seizure prevention
Explanation - Propofol is a sedative-hypnotic used for short-term sedation in ICU patients; it has rapid onset and short duration of action.
Correct answer is: Sedation
Q.10 Which of the following is an advantage of dexmedetomidine over benzodiazepines?
No risk of bradycardia
Less respiratory depression
Stronger analgesic effect
Longer duration of action
Explanation - Dexmedetomidine provides sedation with minimal respiratory depression compared to benzodiazepines, making it safer for ventilated patients.
Correct answer is: Less respiratory depression
Q.11 Which scale is used to assess pain in neonates?
NRS
FLACC
VAS
BPS
Explanation - The FLACC scale (Face, Legs, Activity, Cry, Consolability) is used to assess pain in infants and non-verbal children.
Correct answer is: FLACC
Q.12 Which opioid has a short half-life and is suitable for rapid titration in ICU?
Morphine
Fentanyl
Methadone
Codeine
Explanation - Fentanyl has a rapid onset and short half-life, making it suitable for titration in critically ill patients requiring analgesia.
Correct answer is: Fentanyl
Q.13 Non-pharmacological interventions for ICU sedation include:
Frequent repositioning
Noise reduction
Family presence
All of the above
Explanation - Non-pharmacological strategies such as repositioning, minimizing noise, and allowing family presence improve comfort and reduce sedation needs.
Correct answer is: All of the above
Q.14 Which adverse effect is associated with long-term propofol infusion?
Propofol infusion syndrome
Hepatic failure
Seizures
Hypothyroidism
Explanation - Propofol infusion syndrome is a rare but serious complication of prolonged high-dose propofol infusion, characterized by metabolic acidosis, rhabdomyolysis, and cardiac failure.
Correct answer is: Propofol infusion syndrome
Q.15 The primary goal of pain management in critically ill patients is:
Complete elimination of pain
Reduction of pain to tolerable levels
Avoiding all medications
Sedation only
Explanation - Pain management aims to reduce pain to a tolerable level while minimizing adverse effects and maintaining patient safety.
Correct answer is: Reduction of pain to tolerable levels
Q.16 Which route of opioid administration is preferred in critically ill patients unable to swallow?
Oral
Intravenous
Rectal
Transdermal patch
Explanation - IV administration allows rapid onset and easy titration, making it ideal for critically ill patients who cannot take medications orally.
Correct answer is: Intravenous
Q.17 Which scale is used to assess sedation depth in ICU patients?
RASS
VAS
NRS
FLACC
Explanation - The Richmond Agitation-Sedation Scale (RASS) assesses sedation depth ranging from +4 (combative) to -5 (unarousable).
Correct answer is: RASS
Q.18 Which of the following is a contraindication for NSAIDs in ICU patients?
Hypertension
Renal failure
Mild fever
Anemia
Explanation - NSAIDs can worsen renal function; they should be avoided in patients with existing renal failure.
Correct answer is: Renal failure
Q.19 Which intervention can reduce delirium in sedated ICU patients?
Deep sedation
Early mobilization
Continuous benzodiazepine infusion
Isolation from family
Explanation - Early mobilization reduces ICU delirium, improves recovery, and decreases duration of mechanical ventilation.
Correct answer is: Early mobilization
Q.20 Which medication is considered first-line for procedural pain in ICU?
Morphine
Fentanyl
Midazolam
Dexmedetomidine
Explanation - Fentanyl is fast-acting and effective for procedural pain, making it the first-line opioid in ICU settings.
Correct answer is: Fentanyl
Q.21 Which of the following is a sign of under-sedation in ICU patients?
Bradycardia
Hypertension
Agitation
Hypothermia
Explanation - Agitation, restlessness, or attempts to remove medical devices indicate under-sedation and inadequate comfort.
Correct answer is: Agitation
Q.22 Which opioid is safest in hemodynamically unstable ICU patients?
Morphine
Fentanyl
Codeine
Hydromorphone
Explanation - Fentanyl has minimal cardiovascular effects and is preferred in patients with unstable hemodynamics.
Correct answer is: Fentanyl
Q.23 Which of the following is a risk factor for over-sedation in ICU?
Older age
Multiple sedatives
Renal impairment
All of the above
Explanation - Older patients, those receiving multiple sedatives, or with renal impairment are at higher risk of over-sedation.
Correct answer is: All of the above
Q.24 Which sedative is associated with analgesic-sparing effects in ICU?
Dexmedetomidine
Midazolam
Lorazepam
Propofol
Explanation - Dexmedetomidine provides sedation while reducing the need for opioids, offering an analgesic-sparing effect.
Correct answer is: Dexmedetomidine
Q.25 Which assessment should be done before administering sedatives in ICU?
Pain assessment
Neurological evaluation
Hemodynamic status
All of the above
Explanation - Before sedative administration, clinicians must assess pain, neurological status, and hemodynamics to ensure safety and effectiveness.
Correct answer is: All of the above