6. Self-assessment questions

We suggest you note down the correct answers and when you’ve finished, click on each option to reveal the feedback and whether or not your response is correct

Question 1

Which of the following statements is correct?

1

2 3 4

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Question 2

Which one of the following statements about gastrointestinal effects of opioids is correct?

5 6

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Question 3

Which of the following central nervous system adverse effect is most likely with an opioid given by mouth for controlling acute postoperative pain? Choose the single best answer.

7

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Question 4

4. Pairs of drugs are listed below. Choose a pair most likely to help in dealing with opioid-induced bradycardia and bronchoconstriction.

8 9

10 11

12

13 14

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Question 5

Three days ago, Dr MA, a 78-year-old retired physicist was started on morphine sulfate tablets 5 mg every 4 hours for severe pain. His pain is now well controlled but he is drowsy and gets a headrush when he sits or stands up. He is especially troubled by opioid-induced pruritus. Which of the following might help relieve the itching?

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Question 6

Sets of withdrawal symptoms are described below. Study each set carefully and select the set most likely to be associated with opioid withdrawal.

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Question 7

Which one or more of the following actions help to reduce the risk of opioid dependence?

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Question 8

Which one of the following is likely to increase the risk of constipation when given with an opioid?

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Question 9

Which of the following features is suggestive of an opioid overdose?

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Question 10

Ms ZH, aged 26 years, was brought in a comatose state to the accident and emergency department by her companions. Her blood pressure was low and her breathing was slow and shallow. Close questioning of her companions established that she had been abusing opioids for some months and had taken ‘a handful’ of capsules containing oxycodone 3–4 hours ago. Which of the following statements is correct? Choose the single best answer.

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Question 11

Tramadol accounts for over a third of opioid prescriptions dispensed in the community. Which one or more of the following are likely adverse effects of tramadol:

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Question 12

Following day surgery to repair a nasal injury, Mr JK, a minicab driver has been prescribed a three-day course of co-codamol 30/500 tablets. You are asked to advise him about his medicine. Which of the following is suitable advice?


  1. Addiction is compulsive substance-seeking behaviour, sometimes also termed ‘substance abuse’; it can involve impaired control over drug use, craving, compulsive use, and continued use despite harm from the substance. Addiction, which can involve genetic, psychosocial and environmental factors, is quite distinct from physical and psychological dependence
  2. Dependence is a state that develops as a result of repeated use of a certain chemical substance (eg alcohol, benzodiazepine, opioid, or even medicines for reducing blood pressure). It represents the resetting of homeostasis because of the persisting presence of the chemical substance
  3. Any use of an illegal drug or use of a medicine for a non-therapeutic purpose (eg to alter state of consciousness or to seek a ‘high’)
  4. Tolerance follows repetitive exposure to a drug, leading to a reduction of the pharmacological effect of that drug
  5. Reduction or blocking of the effects of parasympathetic nerves; antimuscarinic effects include dry mouth, difficulty swallowing, blurred vision, confusion, palpitations, constipation, and urine retention
  6. A substance that binds to a receptor but produces no effect and inhibits an agonist from binding to the receptor
  7. Exaggerated sensitivity to a normally painful stimulus
  8. Reduction or blocking of the effects of parasympathetic nerves; antimuscarinic effects include dry mouth, difficulty swallowing, blurred vision, confusion, palpitations, constipation, and urine retention
  9. Narrowing of the airways (bronchioles), reducing the flow of air into the lungs; asthma is characterised by bronchoconstriction
  10. A substance that binds to a receptor but produces no effect and inhibits an agonist from binding to the receptor
  11. Narrowing of the airways (bronchioles), reducing the flow of air into the lungs; asthma is characterised by bronchoconstriction
  12. Narrowing of the airways (bronchioles), reducing the flow of air into the lungs; asthma is characterised by bronchoconstriction
  13. Reduction or blocking of the effects of parasympathetic nerves; antimuscarinic effects include dry mouth, difficulty swallowing, blurred vision, confusion, palpitations, constipation, and urine retention
  14. Narrowing of the airways (bronchioles), reducing the flow of air into the lungs; asthma is characterised by bronchoconstriction