NCLEX QUESTIONS FOR
FUNDAMENTALS OF NURSING
WITH RATIONALE 2026\2027
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 from a part that was removed during
surgery. Visceral pain is caused by deep internal pain receptors 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 delay. 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 practical 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 liver disease, such as hepatitis B. Patients who consume
alcohol regularly should also use acetaminophen 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 patient 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:
3) Assess the patient's respiratory status.
RATIONALE :
Before administering an opioid analgesic, such as morphine, the nurse should
assess the patient's respiratory status because opioid analgesics can cause
, respiratory depression. It is not necessary to clarify the order with the
physician because morphine 4 mg IV is an appropriate dose. It is not necessary
to monitor the patient's heart rate.
Which action should the nurse take when preparing patient-controlled
analgesia for a postoperative patient?
1) Caution the patient to limit the number of times he presses the dosing
button.
2) Ask another nurse to double-check the setup before patient use.
3) Instruct the patient to administer a dose only when experiencing pain.
4) Provide clear, simple instructions for dosing if the patient is cognitively
impaired. - CORRECT ANSWER -Answer:
2) Ask another nurse to double-check the setup before patient use.
RATIONALE :
As a safeguard to reduce the risk for dosing errors, the nurse should request
another nurse to double-check the setup before patient use. The nurse should
reassure the patient that the pump has a lockout feature that prevents him
from overdosing even if he continues to push the dose administration button.
The nurse should also instruct the patient to administer a dose before
potentially painful activities, such as walking. Patient-controlled analgesia is
contraindicated for those who are cognitively impaired.
FUNDAMENTALS OF NURSING
WITH RATIONALE 2026\2027
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 from a part that was removed during
surgery. Visceral pain is caused by deep internal pain receptors 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 delay. 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 practical 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 liver disease, such as hepatitis B. Patients who consume
alcohol regularly should also use acetaminophen 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 patient 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:
3) Assess the patient's respiratory status.
RATIONALE :
Before administering an opioid analgesic, such as morphine, the nurse should
assess the patient's respiratory status because opioid analgesics can cause
, respiratory depression. It is not necessary to clarify the order with the
physician because morphine 4 mg IV is an appropriate dose. It is not necessary
to monitor the patient's heart rate.
Which action should the nurse take when preparing patient-controlled
analgesia for a postoperative patient?
1) Caution the patient to limit the number of times he presses the dosing
button.
2) Ask another nurse to double-check the setup before patient use.
3) Instruct the patient to administer a dose only when experiencing pain.
4) Provide clear, simple instructions for dosing if the patient is cognitively
impaired. - CORRECT ANSWER -Answer:
2) Ask another nurse to double-check the setup before patient use.
RATIONALE :
As a safeguard to reduce the risk for dosing errors, the nurse should request
another nurse to double-check the setup before patient use. The nurse should
reassure the patient that the pump has a lockout feature that prevents him
from overdosing even if he continues to push the dose administration button.
The nurse should also instruct the patient to administer a dose before
potentially painful activities, such as walking. Patient-controlled analgesia is
contraindicated for those who are cognitively impaired.
