Q.1 Which of the following is the most commonly used tool for assessing pain intensity in adult cancer patients?
Visual Analogue Scale (VAS)
Glasgow Coma Scale
Braden Scale
Morse Fall Scale
Explanation - The Visual Analogue Scale (VAS) is a simple, widely used tool to quantify pain intensity in adults, including cancer patients.
Correct answer is: Visual Analogue Scale (VAS)
Q.2 Which class of drugs is considered first-line for moderate to severe cancer pain?
Nonsteroidal anti-inflammatory drugs (NSAIDs)
Opioids
Antidepressants
Anticonvulsants
Explanation - Opioids, such as morphine, are the mainstay for managing moderate to severe cancer-related pain.
Correct answer is: Opioids
Q.3 Which of the following is a common side effect of opioid therapy in cancer patients?
Constipation
Hypertension
Hyperglycemia
Hypokalemia
Explanation - Constipation is a frequent and expected side effect of opioid use due to reduced gastrointestinal motility.
Correct answer is: Constipation
Q.4 What is the purpose of adjuvant analgesics in cancer pain management?
To treat side effects of opioids
To enhance pain relief when combined with opioids
To replace opioids completely
To sedate the patient
Explanation - Adjuvant analgesics like antidepressants or anticonvulsants are used alongside opioids to improve pain control, particularly for neuropathic pain.
Correct answer is: To enhance pain relief when combined with opioids
Q.5 Which route of opioid administration is preferred for continuous, long-term pain management in cancer patients?
Oral
Intramuscular
Transdermal
Subcutaneous bolus only
Explanation - Oral administration is preferred for long-term, continuous pain management due to convenience, reliability, and patient comfort.
Correct answer is: Oral
Q.6 Breakthrough pain in oncology patients is best described as:
Pain that occurs only during movement
Sudden, intense pain despite baseline pain control
Pain that occurs only at night
Pain relieved by NSAIDs alone
Explanation - Breakthrough pain refers to transient episodes of severe pain that occur even when baseline analgesia is adequate.
Correct answer is: Sudden, intense pain despite baseline pain control
Q.7 Which of the following is NOT an adjuvant analgesic?
Gabapentin
Amitriptyline
Morphine
Dexamethasone
Explanation - Morphine is an opioid, not an adjuvant analgesic; adjuvants include antidepressants, anticonvulsants, and corticosteroids used for pain control.
Correct answer is: Morphine
Q.8 Which non-pharmacological intervention is effective for reducing cancer-related pain?
Physical therapy
Cognitive behavioral therapy
Acupuncture
All of the above
Explanation - Non-pharmacological strategies such as physical therapy, cognitive behavioral therapy, and acupuncture can complement drug therapy to reduce pain.
Correct answer is: All of the above
Q.9 Which statement about opioid tolerance is correct?
Tolerance leads to addiction in all patients
Tolerance can require dose escalation for sustained pain relief
Tolerance makes opioids ineffective after 2 weeks
Tolerance prevents any side effects
Explanation - With long-term opioid use, tolerance may develop, requiring dose adjustments to maintain analgesic effectiveness.
Correct answer is: Tolerance can require dose escalation for sustained pain relief
Q.10 Which type of pain is most commonly associated with nerve injury in cancer patients?
Somatic pain
Neuropathic pain
Visceral pain
Psychogenic pain
Explanation - Neuropathic pain arises from nerve injury or dysfunction and is often described as burning, shooting, or tingling.
Correct answer is: Neuropathic pain
Q.11 Which assessment tool is recommended for evaluating pain in non-verbal cancer patients?
Numeric Rating Scale
FLACC Scale
Visual Analogue Scale
Brief Pain Inventory
Explanation - The FLACC (Face, Legs, Activity, Cry, Consolability) scale is designed to assess pain in patients who cannot self-report.
Correct answer is: FLACC Scale
Q.12 Fentanyl patches are primarily used for:
Short-term breakthrough pain
Chronic pain management
Acute post-operative pain
Pain during exercise only
Explanation - Fentanyl transdermal patches provide continuous opioid delivery and are suited for chronic, stable cancer pain.
Correct answer is: Chronic pain management
Q.13 Which factor increases the risk of under-treatment of pain in oncology patients?
Fear of addiction
Patient age
Cultural beliefs
All of the above
Explanation - Concerns about addiction, patient age, and cultural beliefs can all contribute to inadequate pain management.
Correct answer is: All of the above
Q.14 Which opioid is preferred in renal impairment due to its safer metabolite profile?
Morphine
Hydromorphone
Codeine
Oxycodone
Explanation - Hydromorphone has fewer active metabolites than morphine, making it safer in patients with renal dysfunction.
Correct answer is: Hydromorphone
Q.15 Which concept describes the stepwise approach to cancer pain management using NSAIDs, then weak opioids, then strong opioids?
WHO Pain Ladder
Pain Triangle
Opioid Cascade
Analgesic Pyramid
Explanation - The WHO Pain Ladder provides a structured approach to escalating analgesics based on pain severity.
Correct answer is: WHO Pain Ladder
Q.16 Which is a major psychological contributor to perceived pain intensity in oncology patients?
Anxiety
Age
Tumor location
NSAID use
Explanation - Psychological factors such as anxiety and depression can amplify pain perception and affect pain management outcomes.
Correct answer is: Anxiety
Q.17 Which lab parameter should be monitored during long-term opioid therapy?
Serum calcium
Liver and kidney function tests
Blood glucose
Hemoglobin A1c
Explanation - Opioid metabolism and excretion depend on liver and kidney function; monitoring ensures safe long-term use.
Correct answer is: Liver and kidney function tests
Q.18 Which is an example of a weak opioid?
Codeine
Morphine
Fentanyl
Hydromorphone
Explanation - Codeine is considered a weak opioid and is often used for mild to moderate pain, sometimes combined with NSAIDs.
Correct answer is: Codeine
Q.19 Which statement about patient-controlled analgesia (PCA) is correct?
It allows patients to self-administer opioids safely within prescribed limits
It eliminates the risk of overdose completely
It is only used in pediatric oncology
It is a non-pharmacological technique
Explanation - PCA empowers patients to control their pain relief with safety limits programmed to prevent overdose.
Correct answer is: It allows patients to self-administer opioids safely within prescribed limits
Q.20 Which type of cancer pain often responds poorly to opioids alone and may require adjuvant therapy?
Visceral pain
Neuropathic pain
Somatic pain
Acute pain post-surgery
Explanation - Neuropathic pain often needs adjuvants like anticonvulsants or antidepressants in addition to opioids for effective control.
Correct answer is: Neuropathic pain
Q.21 Which is the best practice for rotating opioids in patients experiencing side effects or inadequate analgesia?
Opioid rotation
Discontinuation of opioids
Switching to NSAIDs only
Increasing current opioid dose indefinitely
Explanation - Opioid rotation involves switching to a different opioid to achieve better pain control or reduce adverse effects.
Correct answer is: Opioid rotation
Q.22 Which of the following is a risk when using high-dose opioids in cancer patients?
Respiratory depression
Constipation
Sedation
All of the above
Explanation - High-dose opioids can cause respiratory depression, sedation, and constipation, requiring careful monitoring and supportive care.
Correct answer is: All of the above
Q.23 Which scale measures multidimensional aspects of cancer pain, including intensity, interference, and relief?
Brief Pain Inventory (BPI)
VAS
Numeric Rating Scale
FLACC
Explanation - The BPI evaluates multiple dimensions of pain, providing a comprehensive assessment for cancer patients.
Correct answer is: Brief Pain Inventory (BPI)
Q.24 Which intervention is essential when starting long-term opioid therapy to prevent constipation?
Laxatives or stool softeners
High-dose NSAIDs
Antidepressants
PCA devices
Explanation - Preventive use of laxatives or stool softeners is recommended because constipation is common with opioid therapy.
Correct answer is: Laxatives or stool softeners