NCLEX-RN Pharmacology Exam
Questions & Answers |
Pain and Inflammation |
20 NGN-Style Practice Questions with
Rationales |
ATI Pharmacology Made Easy Review
Question 1
Clinical Scenario
A 67-year-old woman with osteoarthritis reports persistent
bilateral knee pain rated 7/10 despite using acetaminophen as
directed. The provider prescribes ibuprofen 400 mg orally three
times daily with food. Her medical history includes
hypertension, stage 2 chronic kidney disease, and
gastroesophageal reflux disease (GERD). Current medications
include lisinopril, hydrochlorothiazide, and omeprazole. Vital
signs are stable. Serum creatinine is 1.3 mg/dL (baseline 1.1
mg/dL).
Question Stem
,Which assessment finding should the nurse identify as the
highest priority before administering the first dose of
ibuprofen?
A. Blood pressure of 138/82 mm Hg
B. Increase in serum creatinine from baseline
C. Pain score of 7/10
D. History of gastroesophageal reflux disease
Correct Answer
B. Increase in serum creatinine from baseline
Detailed Rationale
Nonsteroidal anti-inflammatory drugs (NSAIDs) such as
ibuprofen inhibit cyclooxygenase (COX) enzymes, decreasing
prostaglandin synthesis. While this reduces pain and
inflammation, prostaglandins also help maintain renal blood
flow, particularly in older adults and patients with kidney
disease. An increase in serum creatinine suggests declining
renal function, making additional renal injury a priority concern
before NSAID administration. The nurse should notify the
provider and evaluate whether an alternative analgesic is more
appropriate.
,Option A: Although hypertension requires monitoring because
NSAIDs may increase blood pressure, a reading of 138/82 mm
Hg is not the most urgent finding.
Option C: Pain management is important, but patient safety
takes precedence when evidence suggests worsening kidney
function.
Option D: GERD increases the risk for gastrointestinal irritation,
but the patient is taking a proton pump inhibitor, and renal
impairment presents a more immediate safety concern.
Nurses should monitor renal function, urine output, blood
pressure, and signs of fluid retention throughout NSAID
therapy. Patient teaching should emphasize avoiding
dehydration and reporting decreased urine output, swelling, or
sudden weight gain.
Learning Objectives
After completing this question, the learner should be able to:
• Recognize renal risk factors associated with NSAID therapy.
• Prioritize assessment findings before administering
NSAIDs.
• Identify appropriate monitoring parameters for patients
receiving ibuprofen.
Medication Safety Focus
, Monitoring
Question 2
Clinical Scenario
A 45-year-old man is admitted with acute gout affecting the
right great toe. The provider prescribes colchicine. Before
administration, the nurse reviews the patient's history. Current
medications include atorvastatin and clarithromycin for
community-acquired pneumonia. Laboratory results reveal
normal liver function tests and a serum creatinine of 0.9 mg/dL.
Question Stem
Which nursing action is most appropriate?
A. Administer colchicine as prescribed.
B. Request an increased dose of colchicine.
C. Notify the provider about the concurrent clarithromycin
therapy.
D. Hold atorvastatin and administer colchicine.
Correct Answer
C. Notify the provider about the concurrent clarithromycin
therapy.
Detailed Rationale
Questions & Answers |
Pain and Inflammation |
20 NGN-Style Practice Questions with
Rationales |
ATI Pharmacology Made Easy Review
Question 1
Clinical Scenario
A 67-year-old woman with osteoarthritis reports persistent
bilateral knee pain rated 7/10 despite using acetaminophen as
directed. The provider prescribes ibuprofen 400 mg orally three
times daily with food. Her medical history includes
hypertension, stage 2 chronic kidney disease, and
gastroesophageal reflux disease (GERD). Current medications
include lisinopril, hydrochlorothiazide, and omeprazole. Vital
signs are stable. Serum creatinine is 1.3 mg/dL (baseline 1.1
mg/dL).
Question Stem
,Which assessment finding should the nurse identify as the
highest priority before administering the first dose of
ibuprofen?
A. Blood pressure of 138/82 mm Hg
B. Increase in serum creatinine from baseline
C. Pain score of 7/10
D. History of gastroesophageal reflux disease
Correct Answer
B. Increase in serum creatinine from baseline
Detailed Rationale
Nonsteroidal anti-inflammatory drugs (NSAIDs) such as
ibuprofen inhibit cyclooxygenase (COX) enzymes, decreasing
prostaglandin synthesis. While this reduces pain and
inflammation, prostaglandins also help maintain renal blood
flow, particularly in older adults and patients with kidney
disease. An increase in serum creatinine suggests declining
renal function, making additional renal injury a priority concern
before NSAID administration. The nurse should notify the
provider and evaluate whether an alternative analgesic is more
appropriate.
,Option A: Although hypertension requires monitoring because
NSAIDs may increase blood pressure, a reading of 138/82 mm
Hg is not the most urgent finding.
Option C: Pain management is important, but patient safety
takes precedence when evidence suggests worsening kidney
function.
Option D: GERD increases the risk for gastrointestinal irritation,
but the patient is taking a proton pump inhibitor, and renal
impairment presents a more immediate safety concern.
Nurses should monitor renal function, urine output, blood
pressure, and signs of fluid retention throughout NSAID
therapy. Patient teaching should emphasize avoiding
dehydration and reporting decreased urine output, swelling, or
sudden weight gain.
Learning Objectives
After completing this question, the learner should be able to:
• Recognize renal risk factors associated with NSAID therapy.
• Prioritize assessment findings before administering
NSAIDs.
• Identify appropriate monitoring parameters for patients
receiving ibuprofen.
Medication Safety Focus
, Monitoring
Question 2
Clinical Scenario
A 45-year-old man is admitted with acute gout affecting the
right great toe. The provider prescribes colchicine. Before
administration, the nurse reviews the patient's history. Current
medications include atorvastatin and clarithromycin for
community-acquired pneumonia. Laboratory results reveal
normal liver function tests and a serum creatinine of 0.9 mg/dL.
Question Stem
Which nursing action is most appropriate?
A. Administer colchicine as prescribed.
B. Request an increased dose of colchicine.
C. Notify the provider about the concurrent clarithromycin
therapy.
D. Hold atorvastatin and administer colchicine.
Correct Answer
C. Notify the provider about the concurrent clarithromycin
therapy.
Detailed Rationale
