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Retired NBME Step 2 CK Form 6 Answers

step2ck_form6/Block 3/Question#3 (reveal difficulty score)
A 64-year-old woman has moderately severe ...
Patient-controlled intravenous morphine ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–
tags: pharm inc

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submitted by โˆ—keyseph(99)
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Since this patient is 1 day out of surgery, PO medications are not recommended, since this patient is very likely to have decreased bowel movements from abdominal surgery.

Moderate/severe postoperative pain is usually managed with short-acting opioids, since long-acting opioids have a higher risk of overdose and misuse. Based on the answer choices, patient-controlled IV morphine fits this criteria.

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jmorga75  You're right about the Long acting, but the journal of pain actually suggests PO pain meds as soon as possible postoperatively. Also, first time around i think i read Acetaminophen/Codeine the first time around instead of aspirin-codeine. I would think that this patient is still a bleeding risk and should avoid aspirin, but i may be wrong. https://www.jpain.org/action/showPdf?pii=S1526-5900%2815%2900995-5 +



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submitted by โˆ—charcot_bouchard(574)
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BDX, Naloxene all are self explanatory.

Aspirin cant be given due to bleeding risk.

Pain is moderate to severe. there goes ibuprofen...they are for mild to mod.

Fentanyl to dangerous. transcutaneous patch means long duration of action which is needed for cancer pain that wont go away ever.

so u give morphine....patient controlled.

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submitted by โˆ—tinylilron(57)
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Can anyone explain the correct answer for this one?

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