Certified Hospice and Palliative Assistant (CHPNA) Practice Test

When calculating a breakthrough dose orally, what percentage of the 24-hour dose should be used?

1. 5% to 10%

2. 10% to 20%

3. 20% to 30%

4. 30% to 50%

The correct answer is: 10% to 20%

When calculating a breakthrough dose for a patient who requires additional pain control while on continuous opioid therapy, it is standard to use 10% to 20% of the total daily dose of the opioid. This percentage is appropriate because it recognizes the need for adequate relief from acute pain episodes without risking overdose or excessive sedation. The rationale behind this range is rooted in pharmacological principles, which indicate that the breakthrough dose should be sufficient to manage the episodes of pain effectively, while also considering the patient's existing opioid regimen. By using a percentage between 10% and 20%, healthcare providers ensure that the breakthrough dose serves as a manageable yet effective means of providing additional relief based on the patient's current level of opioid therapy. Utilizing this approach helps to balance pain management needs while minimizing the potential for adverse effects associated with opioid medications.