Exam 3
2026/2027 (Newly Released)
Q1: According to the Gate Control Theory of pain, how does massage or rubbing an injured area
provide pain relief?
A. It stimulates large-diameter sensory fibers to close the "gate" in the spinal cord. [CORRECT]
B. It blocks the release of prostaglandins at the injury site.
C. It directly numbs the nerve endings in the skin.
D. It distracts the brain's cortex only.
Correct Answer: A
Rationale: The Gate Control Theory posits that stimulation of large-diameter nerve fibers
(through touch, massage, or vibration) can inhibit the transmission of pain signals (small-
diameter fibers) at the spinal cord level ("closing the gate").
Q2: A patient is asking for pain medication. The nurse notes the patient is sleeping soundly with
a respiratory rate of 10 breaths per minute. What is the nurse's priority action?
A. Administer the prescribed medication as requested.
B. Wake the patient and encourage deep breathing.
C. Hold the medication and reassess the patient in 1 hour. [CORRECT]
D. Apply oxygen and call the Rapid Response Team.
,Correct Answer: C
Rationale: A respiratory rate of 10 breaths per minute in a sleeping patient receiving opioids is at
the lower limit of safety but requires monitoring. Administering more opioid could precipitate
severe respiratory depression. The nurse should hold the dose, monitor, and allow the patient to
rest.
Q3: Which medication class is considered an "adjuvant" analgesic, specifically effective for
neuropathic pain (e.g., diabetic neuropathy)?
A. Non-steroidal anti-inflammatory drugs (NSAIDs)
B. Corticosteroids
C. Tricyclic antidepressants (e.g., Amitriptyline) [CORRECT]
D. Acetaminophen
Correct Answer: C
Rationale: Adjuvant medications are drugs primarily designed for other conditions but are
effective for pain. Tricyclic antidepressants (TCAs) and anticonvulsants (Gabapentin) are first-
line adjuvants for neuropathic pain.
Q4: A patient with chronic cancer pain is concerned about becoming addicted to their opioid
medication. What is the nurse's best response?
A. "Do not worry, addiction rarely happens in hospital settings."
B. "Addiction is a psychological craving; physical dependence is a predictable effect of
long-term use." [CORRECT]
C. "If you become addicted, we will stop the medication immediately."
D. "You should switch to non-opioids only to avoid this risk."
Correct Answer: B
Rationale: It is important to educate the patient on the difference between addiction
(psychological dependence and craving despite harm) and physical dependence (physiological
adaptation requiring tapering to stop). Physical dependence is expected with long-term opioid
use.
.
, Q5: When using a Numeric Rating Scale (0-10), what does a rating of "0" indicate to the nurse?
A. Mild discomfort
B. Pain that interferes with activities
C. Worst pain imaginable
D. No pain [CORRECT]
Correct Answer: D
Rationale: On the Numeric Rating Scale, 0 consistently represents "No Pain," while 10
represents "Worst Pain Imaginable."
Q6: Which non-pharmacological intervention uses a battery-powered device to deliver low-
voltage electrical currents through the skin for pain relief?
A. Acupuncture
B. TENS (Transcutaneous Electrical Nerve Stimulation) [CORRECT]
C. Biofeedback
D. Pet therapy
Correct Answer: B
Rationale: TENS units provide electrical stimulation that modulates pain perception based on
the Gate Control Theory and endorphin release.
Q7: A patient is prescribed an NSAID (Ibuprofen) for chronic pain. What adverse effect should
the nurse monitor for?
A. Constipation
B. Gastrointestinal bleeding or ulceration [CORRECT]
C. Respiratory depression
D. Sedation
Correct Answer: B
Rationale: NSAIDs inhibit prostaglandins, which protect the gastric mucosa. Long-term use
significantly increases the risk of GI bleeding and ulcers.
.