FLORIDA BOARD OF NURSING PALLIATIVE
NURSING CERTIFICATION EXAM ITH
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 with metastatic pancreatic cancer reports severe
abdominal pain rated 9/10 despite receiving scheduled oral morphine.
The patient is grimacing, guarding the abdomen, and states, “The
medicine isn't touching this pain anymore.” Which nursing action is
most appropriate initially?
A. Tell the patient that tolerance is expected and the medication will
eventually become effective.
B. Administer the prescribed breakthrough analgesic and perform a
comprehensive reassessment of the pain.
C. Withhold additional opioid medication because a pain score of 9/10
indicates possible addiction.
D. Encourage the patient to use distraction techniques instead of
requesting additional medication.
Answer: B.
Rationale: A patient with advanced illness and severe uncontrolled
pain requires prompt reassessment and appropriate breakthrough
analgesia when prescribed. The nurse should assess pain
characteristics, timing, severity, response to prior medication, adverse
effects, and possible new causes while implementing the prescribed
treatment. Opioid tolerance may occur, but it is not synonymous with
1
,addiction. Nonpharmacologic measures can supplement—not
replace—appropriate analgesia for severe cancer pain.
2.
A patient receiving high-dose opioids for advanced cancer develops
increasing somnolence, pinpoint pupils, and a respiratory rate of 7/min.
Which finding requires the nurse's most immediate intervention?
A. Mild constipation
B. Decreased appetite
C. Respiratory depression
D. Dry mouth
Answer: C.
Rationale: Respiratory depression is the most immediately life-
threatening opioid adverse effect listed. A respiratory rate of 7/min
with increasing sedation suggests potentially dangerous opioid toxicity.
The nurse should assess airway, breathing, oxygenation, level of
consciousness, recent opioid administration, and available orders for
opioid reversal while notifying the appropriate clinician. Constipation
and xerostomia are common opioid effects but are not immediately
life-threatening.
3.
A patient with terminal heart failure tells the nurse, “I know I'm dying,
but I'm terrified of what will happen when I can no longer breathe.”
Which response is most therapeutic?
A. “You shouldn't worry because your medications will prevent any
discomfort.”
B. “Try not to think about dying right now.”
2
,C. “Tell me more about what worries you most about becoming short of
breath.”
D. “Your family needs you to remain positive.”
Answer: C.
Rationale: Open-ended exploration allows the patient to identify the
specific source of anxiety and gives the nurse an opportunity to
provide individualized education and symptom management. Absolute
reassurance that symptoms will never occur is inappropriate because it
cannot be guaranteed. Avoiding the subject or demanding positivity
prevents meaningful communication and may increase isolation.
4.
A patient with end-stage pulmonary disease develops severe dyspnea at
rest. Oxygen saturation is 89% on room air. Which intervention is most
appropriate for immediate symptom relief?
A. Focus exclusively on increasing oxygen saturation to above 95%.
B. Position the patient upright and implement prescribed therapies for
dyspnea, including appropriate opioid therapy when ordered.
C. Restrict all oral fluids.
D. Encourage vigorous exercise to improve respiratory capacity.
Answer: B.
Rationale: Palliative management focuses on relieving the patient's
experience of breathlessness rather than treating an oxygen saturation
number alone. Upright positioning, airflow from a fan when
appropriate, calming communication, oxygen when clinically
indicated, and prescribed opioids may reduce the sensation of dyspnea.
The goal is comfort and function consistent with the patient's goals of
care.
3
, 5.
A family member asks the nurse, “Why are you giving morphine? Is it
being used to make my mother die faster?” Which response is best?
A. “Yes, morphine usually shortens life at the end of the illness.”
B. “No, morphine is completely harmless.”
C. “Morphine is commonly used to relieve pain and sometimes
breathlessness; we monitor the dose and the patient's response
carefully.”
D. “You should discuss that with the pharmacist.”
Answer: C.
Rationale: Opioids are frequently used in palliative care to relieve pain
and dyspnea. The nurse should explain the therapeutic purpose,
monitoring, titration, and distinction between symptom management
and intentionally causing death. Saying opioids are completely
harmless is inaccurate, while avoiding the question misses an
important educational and emotional need.
6.
A patient receiving opioids for several weeks reports no bowel
movement for four days, abdominal discomfort, and decreased appetite.
Which nursing intervention is most appropriate?
A. Explain that constipation is unavoidable during opioid therapy.
B. Initiate or advocate for a prescribed bowel regimen and assess for
complications.
C. Stop all opioids immediately.
D. Encourage the patient to consume only clear liquids.
Answer: B.
4
NURSING CERTIFICATION EXAM ITH
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 with metastatic pancreatic cancer reports severe
abdominal pain rated 9/10 despite receiving scheduled oral morphine.
The patient is grimacing, guarding the abdomen, and states, “The
medicine isn't touching this pain anymore.” Which nursing action is
most appropriate initially?
A. Tell the patient that tolerance is expected and the medication will
eventually become effective.
B. Administer the prescribed breakthrough analgesic and perform a
comprehensive reassessment of the pain.
C. Withhold additional opioid medication because a pain score of 9/10
indicates possible addiction.
D. Encourage the patient to use distraction techniques instead of
requesting additional medication.
Answer: B.
Rationale: A patient with advanced illness and severe uncontrolled
pain requires prompt reassessment and appropriate breakthrough
analgesia when prescribed. The nurse should assess pain
characteristics, timing, severity, response to prior medication, adverse
effects, and possible new causes while implementing the prescribed
treatment. Opioid tolerance may occur, but it is not synonymous with
1
,addiction. Nonpharmacologic measures can supplement—not
replace—appropriate analgesia for severe cancer pain.
2.
A patient receiving high-dose opioids for advanced cancer develops
increasing somnolence, pinpoint pupils, and a respiratory rate of 7/min.
Which finding requires the nurse's most immediate intervention?
A. Mild constipation
B. Decreased appetite
C. Respiratory depression
D. Dry mouth
Answer: C.
Rationale: Respiratory depression is the most immediately life-
threatening opioid adverse effect listed. A respiratory rate of 7/min
with increasing sedation suggests potentially dangerous opioid toxicity.
The nurse should assess airway, breathing, oxygenation, level of
consciousness, recent opioid administration, and available orders for
opioid reversal while notifying the appropriate clinician. Constipation
and xerostomia are common opioid effects but are not immediately
life-threatening.
3.
A patient with terminal heart failure tells the nurse, “I know I'm dying,
but I'm terrified of what will happen when I can no longer breathe.”
Which response is most therapeutic?
A. “You shouldn't worry because your medications will prevent any
discomfort.”
B. “Try not to think about dying right now.”
2
,C. “Tell me more about what worries you most about becoming short of
breath.”
D. “Your family needs you to remain positive.”
Answer: C.
Rationale: Open-ended exploration allows the patient to identify the
specific source of anxiety and gives the nurse an opportunity to
provide individualized education and symptom management. Absolute
reassurance that symptoms will never occur is inappropriate because it
cannot be guaranteed. Avoiding the subject or demanding positivity
prevents meaningful communication and may increase isolation.
4.
A patient with end-stage pulmonary disease develops severe dyspnea at
rest. Oxygen saturation is 89% on room air. Which intervention is most
appropriate for immediate symptom relief?
A. Focus exclusively on increasing oxygen saturation to above 95%.
B. Position the patient upright and implement prescribed therapies for
dyspnea, including appropriate opioid therapy when ordered.
C. Restrict all oral fluids.
D. Encourage vigorous exercise to improve respiratory capacity.
Answer: B.
Rationale: Palliative management focuses on relieving the patient's
experience of breathlessness rather than treating an oxygen saturation
number alone. Upright positioning, airflow from a fan when
appropriate, calming communication, oxygen when clinically
indicated, and prescribed opioids may reduce the sensation of dyspnea.
The goal is comfort and function consistent with the patient's goals of
care.
3
, 5.
A family member asks the nurse, “Why are you giving morphine? Is it
being used to make my mother die faster?” Which response is best?
A. “Yes, morphine usually shortens life at the end of the illness.”
B. “No, morphine is completely harmless.”
C. “Morphine is commonly used to relieve pain and sometimes
breathlessness; we monitor the dose and the patient's response
carefully.”
D. “You should discuss that with the pharmacist.”
Answer: C.
Rationale: Opioids are frequently used in palliative care to relieve pain
and dyspnea. The nurse should explain the therapeutic purpose,
monitoring, titration, and distinction between symptom management
and intentionally causing death. Saying opioids are completely
harmless is inaccurate, while avoiding the question misses an
important educational and emotional need.
6.
A patient receiving opioids for several weeks reports no bowel
movement for four days, abdominal discomfort, and decreased appetite.
Which nursing intervention is most appropriate?
A. Explain that constipation is unavoidable during opioid therapy.
B. Initiate or advocate for a prescribed bowel regimen and assess for
complications.
C. Stop all opioids immediately.
D. Encourage the patient to consume only clear liquids.
Answer: B.
4
