FLORIDA BOARD OF NURSING PAIN
MANAGEMENT NURSING CERTIFICATION
EXAM WITH ACTUAL QUESTIONS AND
VERIFIED ANSWERS, PLUS EXPLAINED
RATIONALES/EXPERT VERIFIED FOR
GUARANTEED 100% PASS 2026/LATEST
UPDATE/INSTANT DOWNLOAD PDF
1. A 68-year-old patient is admitted after total knee arthroplasty.
Two hours after receiving IV opioid medication, the patient reports
pain of 8/10. The nurse observes that the patient is difficult to
arouse, has a respiratory rate of 8/min, oxygen saturation of 88%,
and pinpoint pupils. Which action should the nurse take FIRST?
A. Administer the next scheduled dose of opioid medication because the
pain remains severe
B. Place the patient in a supine position and reassess pain in 30 minutes
C. Hold further opioid administration, stimulate the patient, support
ventilation, and initiate appropriate emergency response
D. Administer an additional sedative to reduce anxiety associated with
the pain
Answer: C. Hold further opioid administration, stimulate the
patient, support ventilation, and initiate appropriate emergency
response
Rationale: The findings strongly suggest opioid-induced respiratory
depression, characterized by decreased level of consciousness,
bradypnea, hypoxemia, and miosis. Airway and breathing take priority
over the patient's reported pain score. The nurse should stop further
opioid administration, provide appropriate airway and ventilatory
1
,support, summon assistance, and administer naloxone according to
the clinical protocol/order. Administering additional opioids or
sedatives could worsen respiratory depression.
2. A patient with chronic low-back pain states, "My pain is always 7
out of 10, but I can still work, exercise, and take care of my family."
Which assessment principle is MOST appropriate?
A. The patient's reported pain score should be disregarded because
functional ability is preserved
B. The pain score should be accepted as subjective information and
interpreted together with functional status and clinical findings
C. Functional ability proves that the patient's pain is psychological
D. A pain score above 5 automatically requires opioid administration
Answer: B. The pain score should be accepted as subjective
information and interpreted together with functional status and
clinical findings
Rationale: Pain is inherently subjective. A patient may legitimately
report severe pain while maintaining substantial function. The nurse
should not invalidate the patient's report simply because objective
findings or functional limitations do not appear proportional to the
numerical rating. Comprehensive pain assessment incorporates
intensity, quality, location, timing, aggravating and relieving factors,
associated symptoms, and the effect of pain on function and quality of
life.
3. Which patient statement BEST demonstrates neuropathic pain?
A. "It feels like pressure in my chest when I climb stairs."
B. "My incision aches whenever I move."
2
,C. "My foot feels like it is burning and electricity is shooting through it."
D. "My knee hurts when I put weight on it."
Answer: C. "My foot feels like it is burning and electricity is
shooting through it."
Rationale: Neuropathic pain results from injury or dysfunction of the
somatosensory nervous system and is commonly described as burning,
shooting, electric, tingling, pins-and-needles, or painful sensitivity to
normally nonpainful stimuli. Nociceptive somatic pain is more
commonly aching, throbbing, or localized, whereas visceral pain may
be diffuse or poorly localized.
4. A patient with metastatic cancer reports severe pain despite
scheduled opioid therapy. The family says, "The medication should
be stopped because he is sleeping more." Which nursing response is
MOST appropriate?
A. "Sleepiness always means the patient has received too much opioid."
B. "Cancer-related pain should never be treated with opioids."
C. "We should assess sedation, respiratory status, pain control, disease
progression, and medication effects before determining whether therapy
should change."
D. "All opioids should immediately be discontinued."
Answer: C. "We should assess sedation, respiratory status, pain
control, disease progression, and medication effects before
determining whether therapy should change."
Rationale: Sedation can occur with opioid therapy, particularly during
initiation or dose escalation, but sedation alone does not automatically
mean that effective analgesia should be abandoned. The nurse should
assess respiratory rate, oxygenation, arousability, pain, medication
history, organ function, and other sedating medications. Cancer pain
3
, is not treated under the same acute-pain prescription limitations
applicable to certain acute pain prescriptions under Florida law.
5. Which assessment finding is MOST suggestive of opioid-induced
respiratory depression?
A. Respiratory rate of 20/min with anxiety
B. Respiratory rate of 8/min with increasing somnolence
C. Respiratory rate of 18/min with mild nausea
D. Respiratory rate of 22/min with incisional pain
Answer: B. Respiratory rate of 8/min with increasing somnolence
Rationale: Opioid-induced respiratory depression commonly presents
with depressed respiratory rate, reduced depth of breathing, increasing
sedation, hypoxemia, and potentially hypercapnia. Increasing
somnolence combined with marked bradypnea is particularly
concerning and requires immediate intervention.
6. A patient receiving long-term opioid therapy develops
constipation. Which intervention is MOST appropriate?
A. Encourage the patient to stop all opioid medication immediately
B. Explain that opioid-related constipation is common and initiate an
appropriate bowel regimen
C. Restrict oral fluids to decrease stool production
D. Encourage prolonged bed rest until bowel function returns
Answer: B. Explain that opioid-related constipation is common and
initiate an appropriate bowel regimen
Rationale: Opioids reduce gastrointestinal motility and secretions and
increase fluid absorption, frequently causing constipation. Unlike
some other opioid adverse effects, tolerance to constipation is limited.
4
MANAGEMENT NURSING CERTIFICATION
EXAM WITH ACTUAL QUESTIONS AND
VERIFIED ANSWERS, PLUS EXPLAINED
RATIONALES/EXPERT VERIFIED FOR
GUARANTEED 100% PASS 2026/LATEST
UPDATE/INSTANT DOWNLOAD PDF
1. A 68-year-old patient is admitted after total knee arthroplasty.
Two hours after receiving IV opioid medication, the patient reports
pain of 8/10. The nurse observes that the patient is difficult to
arouse, has a respiratory rate of 8/min, oxygen saturation of 88%,
and pinpoint pupils. Which action should the nurse take FIRST?
A. Administer the next scheduled dose of opioid medication because the
pain remains severe
B. Place the patient in a supine position and reassess pain in 30 minutes
C. Hold further opioid administration, stimulate the patient, support
ventilation, and initiate appropriate emergency response
D. Administer an additional sedative to reduce anxiety associated with
the pain
Answer: C. Hold further opioid administration, stimulate the
patient, support ventilation, and initiate appropriate emergency
response
Rationale: The findings strongly suggest opioid-induced respiratory
depression, characterized by decreased level of consciousness,
bradypnea, hypoxemia, and miosis. Airway and breathing take priority
over the patient's reported pain score. The nurse should stop further
opioid administration, provide appropriate airway and ventilatory
1
,support, summon assistance, and administer naloxone according to
the clinical protocol/order. Administering additional opioids or
sedatives could worsen respiratory depression.
2. A patient with chronic low-back pain states, "My pain is always 7
out of 10, but I can still work, exercise, and take care of my family."
Which assessment principle is MOST appropriate?
A. The patient's reported pain score should be disregarded because
functional ability is preserved
B. The pain score should be accepted as subjective information and
interpreted together with functional status and clinical findings
C. Functional ability proves that the patient's pain is psychological
D. A pain score above 5 automatically requires opioid administration
Answer: B. The pain score should be accepted as subjective
information and interpreted together with functional status and
clinical findings
Rationale: Pain is inherently subjective. A patient may legitimately
report severe pain while maintaining substantial function. The nurse
should not invalidate the patient's report simply because objective
findings or functional limitations do not appear proportional to the
numerical rating. Comprehensive pain assessment incorporates
intensity, quality, location, timing, aggravating and relieving factors,
associated symptoms, and the effect of pain on function and quality of
life.
3. Which patient statement BEST demonstrates neuropathic pain?
A. "It feels like pressure in my chest when I climb stairs."
B. "My incision aches whenever I move."
2
,C. "My foot feels like it is burning and electricity is shooting through it."
D. "My knee hurts when I put weight on it."
Answer: C. "My foot feels like it is burning and electricity is
shooting through it."
Rationale: Neuropathic pain results from injury or dysfunction of the
somatosensory nervous system and is commonly described as burning,
shooting, electric, tingling, pins-and-needles, or painful sensitivity to
normally nonpainful stimuli. Nociceptive somatic pain is more
commonly aching, throbbing, or localized, whereas visceral pain may
be diffuse or poorly localized.
4. A patient with metastatic cancer reports severe pain despite
scheduled opioid therapy. The family says, "The medication should
be stopped because he is sleeping more." Which nursing response is
MOST appropriate?
A. "Sleepiness always means the patient has received too much opioid."
B. "Cancer-related pain should never be treated with opioids."
C. "We should assess sedation, respiratory status, pain control, disease
progression, and medication effects before determining whether therapy
should change."
D. "All opioids should immediately be discontinued."
Answer: C. "We should assess sedation, respiratory status, pain
control, disease progression, and medication effects before
determining whether therapy should change."
Rationale: Sedation can occur with opioid therapy, particularly during
initiation or dose escalation, but sedation alone does not automatically
mean that effective analgesia should be abandoned. The nurse should
assess respiratory rate, oxygenation, arousability, pain, medication
history, organ function, and other sedating medications. Cancer pain
3
, is not treated under the same acute-pain prescription limitations
applicable to certain acute pain prescriptions under Florida law.
5. Which assessment finding is MOST suggestive of opioid-induced
respiratory depression?
A. Respiratory rate of 20/min with anxiety
B. Respiratory rate of 8/min with increasing somnolence
C. Respiratory rate of 18/min with mild nausea
D. Respiratory rate of 22/min with incisional pain
Answer: B. Respiratory rate of 8/min with increasing somnolence
Rationale: Opioid-induced respiratory depression commonly presents
with depressed respiratory rate, reduced depth of breathing, increasing
sedation, hypoxemia, and potentially hypercapnia. Increasing
somnolence combined with marked bradypnea is particularly
concerning and requires immediate intervention.
6. A patient receiving long-term opioid therapy develops
constipation. Which intervention is MOST appropriate?
A. Encourage the patient to stop all opioid medication immediately
B. Explain that opioid-related constipation is common and initiate an
appropriate bowel regimen
C. Restrict oral fluids to decrease stool production
D. Encourage prolonged bed rest until bowel function returns
Answer: B. Explain that opioid-related constipation is common and
initiate an appropriate bowel regimen
Rationale: Opioids reduce gastrointestinal motility and secretions and
increase fluid absorption, frequently causing constipation. Unlike
some other opioid adverse effects, tolerance to constipation is limited.
4
