NCLEX-RN Pharmacology Pain &
Inflammation Exam Questions
20 ATI NGN-Style MCQs with Rationales
Nursing Pharmacology Test Bank
Question 1
Clinical Scenario
A 45-year-old woman is admitted with severe postoperative
pain 2 hours after an open abdominal hysterectomy. She rates
her pain as 8/10 despite scheduled acetaminophen. The
provider prescribes morphine sulfate 2 mg IV every 2 hours as
needed for severe pain. Assessment findings include:
respiratory rate 10 breaths/min, oxygen saturation 92% on
room air, blood pressure 116/72 mm Hg, heart rate 72/min, and
the patient is difficult to arouse but responds to verbal
stimulation.
,Question Stem
Which action should the nurse take first?
A. Administer the prescribed morphine to improve pain control.
B. Administer naloxone as prescribed for suspected opioid-
induced respiratory depression.
C. Encourage the patient to use relaxation techniques before
medication administration.
D. Reassess the patient's pain level in 30 minutes.
Correct Answer
Correct Answer: B. Administer naloxone as prescribed for
suspected opioid-induced respiratory depression.
Detailed Rationale
The patient's respiratory rate of 10 breaths/min, decreased
oxygen saturation, and excessive sedation indicate opioid-
induced respiratory depression, the most serious adverse effect
associated with opioid analgesics such as morphine. Protecting
airway, breathing, and circulation (ABCs) takes priority over pain
management. Naloxone is a competitive opioid antagonist that
rapidly reverses opioid-induced respiratory depression and
excessive sedation. After administration, the nurse should
closely monitor respiratory status because naloxone has a
,shorter duration of action than morphine, making recurrent
respiratory depression possible.
Option A is incorrect because administering additional
morphine would likely worsen respiratory depression and could
become life-threatening.
Option C is inappropriate as nonpharmacologic pain
interventions do not address the immediate safety concern of
impaired ventilation.
Option D delays treatment of a potentially critical condition.
Reassessment is important but only after immediate
intervention to stabilize the patient.
Nurses should routinely assess respiratory rate, oxygen
saturation, sedation level, and pain before administering IV
opioids. Holding opioid administration and notifying the
provider may also be appropriate depending on institutional
protocols.
Learning Objectives
After completing this question, the learner should be able to:
• Recognize opioid-induced respiratory depression.
• Prioritize airway and breathing over pain management.
• Identify the appropriate use of naloxone.
• Monitor patients after opioid reversal.
, Medication Safety Focus: Adverse Effect Monitoring
Question 2
Clinical Scenario
A 67-year-old man with osteoarthritis has been taking ibuprofen
800 mg orally three times daily for the past 6 months. His
medical history includes hypertension, chronic kidney disease
stage 3, and type 2 diabetes mellitus. Laboratory results today
include serum creatinine 2.0 mg/dL (baseline 1.3 mg/dL), BUN
38 mg/dL, and potassium 5.3 mEq/L. He reports decreased
urine output and fatigue.
Question Stem
Which finding should the nurse identify as most likely related to
long-term ibuprofen therapy?
A. Acute kidney injury
B. Hyperthyroidism
C. Hypoglycemia
D. Pulmonary embolism
Correct Answer
Correct Answer: A. Acute kidney injury
Detailed Rationale
Inflammation Exam Questions
20 ATI NGN-Style MCQs with Rationales
Nursing Pharmacology Test Bank
Question 1
Clinical Scenario
A 45-year-old woman is admitted with severe postoperative
pain 2 hours after an open abdominal hysterectomy. She rates
her pain as 8/10 despite scheduled acetaminophen. The
provider prescribes morphine sulfate 2 mg IV every 2 hours as
needed for severe pain. Assessment findings include:
respiratory rate 10 breaths/min, oxygen saturation 92% on
room air, blood pressure 116/72 mm Hg, heart rate 72/min, and
the patient is difficult to arouse but responds to verbal
stimulation.
,Question Stem
Which action should the nurse take first?
A. Administer the prescribed morphine to improve pain control.
B. Administer naloxone as prescribed for suspected opioid-
induced respiratory depression.
C. Encourage the patient to use relaxation techniques before
medication administration.
D. Reassess the patient's pain level in 30 minutes.
Correct Answer
Correct Answer: B. Administer naloxone as prescribed for
suspected opioid-induced respiratory depression.
Detailed Rationale
The patient's respiratory rate of 10 breaths/min, decreased
oxygen saturation, and excessive sedation indicate opioid-
induced respiratory depression, the most serious adverse effect
associated with opioid analgesics such as morphine. Protecting
airway, breathing, and circulation (ABCs) takes priority over pain
management. Naloxone is a competitive opioid antagonist that
rapidly reverses opioid-induced respiratory depression and
excessive sedation. After administration, the nurse should
closely monitor respiratory status because naloxone has a
,shorter duration of action than morphine, making recurrent
respiratory depression possible.
Option A is incorrect because administering additional
morphine would likely worsen respiratory depression and could
become life-threatening.
Option C is inappropriate as nonpharmacologic pain
interventions do not address the immediate safety concern of
impaired ventilation.
Option D delays treatment of a potentially critical condition.
Reassessment is important but only after immediate
intervention to stabilize the patient.
Nurses should routinely assess respiratory rate, oxygen
saturation, sedation level, and pain before administering IV
opioids. Holding opioid administration and notifying the
provider may also be appropriate depending on institutional
protocols.
Learning Objectives
After completing this question, the learner should be able to:
• Recognize opioid-induced respiratory depression.
• Prioritize airway and breathing over pain management.
• Identify the appropriate use of naloxone.
• Monitor patients after opioid reversal.
, Medication Safety Focus: Adverse Effect Monitoring
Question 2
Clinical Scenario
A 67-year-old man with osteoarthritis has been taking ibuprofen
800 mg orally three times daily for the past 6 months. His
medical history includes hypertension, chronic kidney disease
stage 3, and type 2 diabetes mellitus. Laboratory results today
include serum creatinine 2.0 mg/dL (baseline 1.3 mg/dL), BUN
38 mg/dL, and potassium 5.3 mEq/L. He reports decreased
urine output and fatigue.
Question Stem
Which finding should the nurse identify as most likely related to
long-term ibuprofen therapy?
A. Acute kidney injury
B. Hyperthyroidism
C. Hypoglycemia
D. Pulmonary embolism
Correct Answer
Correct Answer: A. Acute kidney injury
Detailed Rationale
