NCLEX questions Exam 2 Med Surg
] ]] ] ] ] ]
(with rationales) and Correct Answers
] ] ]] ] ]
(2026)
A ]73-year-
old ]patient ]who ]sustained ]a ]right ]hip ]fracture ]in ]a ]fall ]requests ]pain ]medication ]from ]the ]nurse. ]
Based ]on ]his ]injury, ]which ]type ]of ]pain ]is ]this ]patient ]most ]likely ]experiencing?
1) ]Phantom
]
2) ]Visceral
]
3) ]Deep ]somatic
]
4) ]Referred ]- ]correct ]answer: ]Answer:
]
3) ]Deep ]somatic
]
Rationale:
Deep ]somatic ]pain ]originates ]in ]ligaments, ]tendons, ]nerves, ]blood ]vessels, ]and ]bones. ]Therefore
, ]a ]hip ]fracture ]causes ]deep ]somatic ]pain. ]Phantom ]pain ]is ]pain ]that ]is ]perceived ]to ]originate ]fro
m ]a ]part ]that ]was ]removed ]during ]surgery. ]Visceral ]pain ]is ]caused ]by ]deep ]internal ]pain ]receptor
s ]and ]commonly ]occurs ]in ]the ]abdominal ]cavity, ]cranium, ]and ]thorax. ]Referred ]pain ]occurs ]in ]an ]
area ]that ]is ]distant ]to ]the ]original ]site.
Which ]pain ]management ]task ]can ]the ]nurse ]safely ]delegate ]to ]nursing ]assistive ]personnel?
1) ]Asking ]about ]pain ]during ]vital ]signs
]
2) ]Evaluating ]the ]effectiveness ]of ]pain ]medication
]
3) ]Developing ]a ]plan ]of ]care ]involving ]nonpharmacologic ]interventions
]
4) ]Administering ]over-the-counter ]pain ]medications ]- ]correct ]answer: ]Answer:
]
1) ]Asking ]about ]pain ]during ]vital ]signs
]
Rationale:
, The ]nurse ]can ]delegate ]the ]task ]of ]asking ]about ]pain ]when ]nursing ]assistive ]personnel ]
(NAP) ]obtain ]vital ]signs. ]The ]NAP ]must ]be ]instructed ]to ]report ]findings ]to ]the ]nurse ]without ]dela
y. ]The ]nurse ]should ]evaluate ]the ]effectiveness ]of ]pain ]medications ]and ]develop ]the ]plan ]of ]care. ]
Administering ]over-the-
counter ]and ]prescription ]medications ]is ]the ]responsibility ]of ]the ]registered ]nurse ]or ]licensed ]pra
ctical ]nurse.
Which ]factor ]in ]the ]patient's ]past ]medical ]history ]dictates ]that ]the ]nurse ]exercise ]caution ]when ]
administering ]acetaminophen ](Tylenol)?
1) ]Hepatitis ]B
2) ]Occasional ]alcohol ]use
3) ]Allergy ]to ]aspirin
4) ]Gastric ]irritation ]with ]bleeding ]- ]correct ]answer: ]Answer:
1) ]Hepatitis ]B
]
Rationale:
Even ]in ]recommended ]doses, ]acetaminophen ]can ]cause ]severe ]hepatotoxicity ]in ]patients ]with ]li
ver ]disease, ]such ]as ]hepatitis ]B. ]Patients ]who ]consume ]alcohol ]regularly ]should ]also ]use ]acetami
nophen ]cautiously. ]Those ]allergic ]to ]aspirin ]or ]other ]nonsteroidal ]anti-inflammatory ]drugs ]
(NSAIDs) ]can ]use ]acetaminophen ]safely. ]Acetaminophen ]rarely ]causes ]gastrointestinal ]
(GI) ]problems; ]therefore, ]it ]can ]be ]used ]for ]those ]with ]a ]history ]of ]gastric ]irritation ]and ]bleeding.
Which ]action ]should ]the ]nurse ]take ]before ]administering ]morphine ]4.0 ]mg ]intravenously ]to ]a ]pa
tient ]complaining ]of ]incisional ]pain?
1) ]Assess ]the ]patient's ]incision.
2) ]Clarify ]the ]order ]with ]the ]prescriber.
3) ]Assess ]the ]patient's ]respiratory ]status.
4) ]Monitor ]the ]patient's ]heart ]rate. ]- ]correct ]answer: ]Answer:
] ]] ] ] ] ]
(with rationales) and Correct Answers
] ] ]] ] ]
(2026)
A ]73-year-
old ]patient ]who ]sustained ]a ]right ]hip ]fracture ]in ]a ]fall ]requests ]pain ]medication ]from ]the ]nurse. ]
Based ]on ]his ]injury, ]which ]type ]of ]pain ]is ]this ]patient ]most ]likely ]experiencing?
1) ]Phantom
]
2) ]Visceral
]
3) ]Deep ]somatic
]
4) ]Referred ]- ]correct ]answer: ]Answer:
]
3) ]Deep ]somatic
]
Rationale:
Deep ]somatic ]pain ]originates ]in ]ligaments, ]tendons, ]nerves, ]blood ]vessels, ]and ]bones. ]Therefore
, ]a ]hip ]fracture ]causes ]deep ]somatic ]pain. ]Phantom ]pain ]is ]pain ]that ]is ]perceived ]to ]originate ]fro
m ]a ]part ]that ]was ]removed ]during ]surgery. ]Visceral ]pain ]is ]caused ]by ]deep ]internal ]pain ]receptor
s ]and ]commonly ]occurs ]in ]the ]abdominal ]cavity, ]cranium, ]and ]thorax. ]Referred ]pain ]occurs ]in ]an ]
area ]that ]is ]distant ]to ]the ]original ]site.
Which ]pain ]management ]task ]can ]the ]nurse ]safely ]delegate ]to ]nursing ]assistive ]personnel?
1) ]Asking ]about ]pain ]during ]vital ]signs
]
2) ]Evaluating ]the ]effectiveness ]of ]pain ]medication
]
3) ]Developing ]a ]plan ]of ]care ]involving ]nonpharmacologic ]interventions
]
4) ]Administering ]over-the-counter ]pain ]medications ]- ]correct ]answer: ]Answer:
]
1) ]Asking ]about ]pain ]during ]vital ]signs
]
Rationale:
, The ]nurse ]can ]delegate ]the ]task ]of ]asking ]about ]pain ]when ]nursing ]assistive ]personnel ]
(NAP) ]obtain ]vital ]signs. ]The ]NAP ]must ]be ]instructed ]to ]report ]findings ]to ]the ]nurse ]without ]dela
y. ]The ]nurse ]should ]evaluate ]the ]effectiveness ]of ]pain ]medications ]and ]develop ]the ]plan ]of ]care. ]
Administering ]over-the-
counter ]and ]prescription ]medications ]is ]the ]responsibility ]of ]the ]registered ]nurse ]or ]licensed ]pra
ctical ]nurse.
Which ]factor ]in ]the ]patient's ]past ]medical ]history ]dictates ]that ]the ]nurse ]exercise ]caution ]when ]
administering ]acetaminophen ](Tylenol)?
1) ]Hepatitis ]B
2) ]Occasional ]alcohol ]use
3) ]Allergy ]to ]aspirin
4) ]Gastric ]irritation ]with ]bleeding ]- ]correct ]answer: ]Answer:
1) ]Hepatitis ]B
]
Rationale:
Even ]in ]recommended ]doses, ]acetaminophen ]can ]cause ]severe ]hepatotoxicity ]in ]patients ]with ]li
ver ]disease, ]such ]as ]hepatitis ]B. ]Patients ]who ]consume ]alcohol ]regularly ]should ]also ]use ]acetami
nophen ]cautiously. ]Those ]allergic ]to ]aspirin ]or ]other ]nonsteroidal ]anti-inflammatory ]drugs ]
(NSAIDs) ]can ]use ]acetaminophen ]safely. ]Acetaminophen ]rarely ]causes ]gastrointestinal ]
(GI) ]problems; ]therefore, ]it ]can ]be ]used ]for ]those ]with ]a ]history ]of ]gastric ]irritation ]and ]bleeding.
Which ]action ]should ]the ]nurse ]take ]before ]administering ]morphine ]4.0 ]mg ]intravenously ]to ]a ]pa
tient ]complaining ]of ]incisional ]pain?
1) ]Assess ]the ]patient's ]incision.
2) ]Clarify ]the ]order ]with ]the ]prescriber.
3) ]Assess ]the ]patient's ]respiratory ]status.
4) ]Monitor ]the ]patient's ]heart ]rate. ]- ]correct ]answer: ]Answer:
