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ATI Med Surg Proctored Exam -
Comprehensive Practice Question Bank
220 Multiple-Choice Questions with
Detailed Rationales
PAIN MANAGEMENT (Questions 1-10)
1. The nurse is assessing a patient with metastatic bone cancer pain.
Which question will provide the most information about the patient's
pain experience?
• A. "How long have you had this pain?"
• B. "How would you describe your pain?"
• C. "How much medication do you take for the pain?"
• D. "How many times a day do you take medication for the pain?"
CORRECT ANSWER: B
Rationale: Asking the patient to describe the pain provides
comprehensive information about quality, intensity, location, and
characteristics. The PQRST (Provocation, Quality, Region/Radiation,
Severity, Timing) assessment begins with asking the patient to describe
,2
the pain. Options A, C, and D focus only on duration or medication use,
which provide limited information about the overall pain experience.
2. A patient using a fentanyl (Duragesic) patch for chronic cancer pain
suddenly reports rapid-onset pain at level 9 (0-10 scale). How should
the nurse document this type of pain?
• A. Somatic pain
• B. Referred pain
• C. Neuropathic pain
• D. Breakthrough pain
CORRECT ANSWER: D
Rationale: Breakthrough pain is a transient exacerbation of pain that
occurs despite around-the-clock analgesic therapy. It is characterized by
rapid onset, severe intensity, and short duration. Somatic pain
originates from skin, muscle, or bone; referred pain is perceived at a
site distant from the origin; neuropathic pain results from nerve
damage.
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3. The nurse teaches a student nurse about the action of ibuprofen.
Which statement by the student indicates effective teaching?
• A. "The drug decreases pain impulses in the spinal cord."
• B. "The drug decreases sensitivity of the brain to painful stimuli."
• C. "The drug decreases production of pain-sensitizing chemicals."
• D. "The drug decreases the modulating effect of descending
nerves."
CORRECT ANSWER: C
Rationale: Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID)
that works by inhibiting cyclooxygenase (COX) enzymes, thereby
decreasing prostaglandin synthesis. Prostaglandins are pain-sensitizing
chemicals that promote inflammation and pain. Options A, B, and D
describe mechanisms of other analgesic classes.
4. A patient with chronic cancer pain receiving imipramine (Tofranil) in
addition to long-acting morphine reports adequate pain control.
Which statement indicates this?
• A. "I'm not anxious at all."
• B. "I sleep 8 hours every night."
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• C. "I feel much less depressed since taking Tofranil."
• D. "The pain is manageable and I can accomplish my desired
activities."
CORRECT ANSWER: D
Rationale: The goal of pain management is to achieve functional
improvement, not just pain reduction. The patient's ability to
accomplish desired activities indicates adequate pain control. While
options A, B, and C may be positive outcomes, they do not directly
indicate pain control effectiveness.
5. A patient with chronic back pain uses imagery and hypnosis for pain
control. The spouse asks how these work. Which response by the
nurse is best?
• A. "The strategies work by affecting the perception of pain."
• B. "These techniques block the pain pathways of the nerves."
• C. "Both strategies prevent transmission of painful stimuli to the
brain."
• D. "The therapies slow the release of chemicals in the spinal cord
that cause pain."
ATI Med Surg Proctored Exam -
Comprehensive Practice Question Bank
220 Multiple-Choice Questions with
Detailed Rationales
PAIN MANAGEMENT (Questions 1-10)
1. The nurse is assessing a patient with metastatic bone cancer pain.
Which question will provide the most information about the patient's
pain experience?
• A. "How long have you had this pain?"
• B. "How would you describe your pain?"
• C. "How much medication do you take for the pain?"
• D. "How many times a day do you take medication for the pain?"
CORRECT ANSWER: B
Rationale: Asking the patient to describe the pain provides
comprehensive information about quality, intensity, location, and
characteristics. The PQRST (Provocation, Quality, Region/Radiation,
Severity, Timing) assessment begins with asking the patient to describe
,2
the pain. Options A, C, and D focus only on duration or medication use,
which provide limited information about the overall pain experience.
2. A patient using a fentanyl (Duragesic) patch for chronic cancer pain
suddenly reports rapid-onset pain at level 9 (0-10 scale). How should
the nurse document this type of pain?
• A. Somatic pain
• B. Referred pain
• C. Neuropathic pain
• D. Breakthrough pain
CORRECT ANSWER: D
Rationale: Breakthrough pain is a transient exacerbation of pain that
occurs despite around-the-clock analgesic therapy. It is characterized by
rapid onset, severe intensity, and short duration. Somatic pain
originates from skin, muscle, or bone; referred pain is perceived at a
site distant from the origin; neuropathic pain results from nerve
damage.
,3
3. The nurse teaches a student nurse about the action of ibuprofen.
Which statement by the student indicates effective teaching?
• A. "The drug decreases pain impulses in the spinal cord."
• B. "The drug decreases sensitivity of the brain to painful stimuli."
• C. "The drug decreases production of pain-sensitizing chemicals."
• D. "The drug decreases the modulating effect of descending
nerves."
CORRECT ANSWER: C
Rationale: Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID)
that works by inhibiting cyclooxygenase (COX) enzymes, thereby
decreasing prostaglandin synthesis. Prostaglandins are pain-sensitizing
chemicals that promote inflammation and pain. Options A, B, and D
describe mechanisms of other analgesic classes.
4. A patient with chronic cancer pain receiving imipramine (Tofranil) in
addition to long-acting morphine reports adequate pain control.
Which statement indicates this?
• A. "I'm not anxious at all."
• B. "I sleep 8 hours every night."
, 4
• C. "I feel much less depressed since taking Tofranil."
• D. "The pain is manageable and I can accomplish my desired
activities."
CORRECT ANSWER: D
Rationale: The goal of pain management is to achieve functional
improvement, not just pain reduction. The patient's ability to
accomplish desired activities indicates adequate pain control. While
options A, B, and C may be positive outcomes, they do not directly
indicate pain control effectiveness.
5. A patient with chronic back pain uses imagery and hypnosis for pain
control. The spouse asks how these work. Which response by the
nurse is best?
• A. "The strategies work by affecting the perception of pain."
• B. "These techniques block the pain pathways of the nerves."
• C. "Both strategies prevent transmission of painful stimuli to the
brain."
• D. "The therapies slow the release of chemicals in the spinal cord
that cause pain."
