NUR 317 EXAM 2 2026/2027 – QUESTIONS, STUDY GUIDE &
PRACTICE REVIEW
Pain has been defined as "whatever the person experiencing the pain says it is, existing
whenever the patient says it does." This definition is problematic for the nurse when caring
which type of patient? - Correct answer ✔✔ A patient with decreased cognitive function
One the first postoperative day following a bowel resection, the pt complains of abdominal and
incision pain rated at 9 on a scale of 0 to 10. Postoperative orders include morphine 4 mg IV q4h
for pain and may repeat morphine 4 mg IV for breakthrough pain. The nurse determines that it
has been only 1 3/4 hours since the last dose of morphine and wants to wait a little longer.
What effect does the nurse's actions have on the patient? - Correct answer ✔✔ indicates that
the nurse understands the adage of "start low and go slow" in administering analgesics
Once generated, what may block the transmission of an action potential along a peripheral
nerve fiber to the dorsal root of the spinal cord? - Correct answer ✔✔ The action potential must
cross several synapses, points at which the impulse may be blocked by drugs.
A pt comes to the clinic with a complaint of a dull pain in the anterior and posterior neck. On
exam, the nurse notes that the pt has full ROM of the neck and no throat redness or enlarged
head or neck lymph nodes. What will be the nurse's next appropriate assessment indicated by
these findings? - Correct answer ✔✔ palpation of the liver
While caring or an unconscious pt, the nurse discovers a stage 2 pressure ulcer on the pt's heel.
During care of the ulcer, what is the nurse's understanding of the pt's perception of pain? -
Correct answer ✔✔ the area should be treated as a painful lesion, using gentle cleansing and
dressing
Amitriptyline is prescribed for a pt with chronic pain from fibromyalgia. When the nurse
explains that this drug is an antidepressant, the pt states that she is in pain, not depressed.
,What is the nurse's best response to the pt? - Correct answer ✔✔ some antidepressant drugs
relieve pain by releasing neurotransmitters that prevent pain impulses from reaching the brain
A pt with trigeminal neuralgia has moderate to severe burning and shooting pain. In helping the
pt to manage the pain, the nurse recognizes what about this type of pain? - Correct answer ✔✔
includes tx with adjuvant analgesics
A patient with advanced colorectal cancer has continuous, poorly localized ab pain at an
intensity of 5 on a scale of 0 to 10. How does the nurse teach the pt to use pain meds? - Correct
answer ✔✔ on an around the clock schedule
A patient who has been taking ibuprofen and imipramine (Tofranil) for control of cancer pain is
having increased pain. What would the nurse recommend to the HCP as an appropriate change
in the med plan? - Correct answer ✔✔ add PO oxycodone to the other meds
A pt with chronic cancer related pain has started using MS Contin for pain control and has
developed common side effects of the drug. The nurse reassures the pt that tolerance will
develop to most of the side effects but that continued tx will most likely be required for what? -
Correct answer ✔✔ Constipation
A post-op 68 y/o opioid naive pt is receiving morphine by PCA for post-op pain. What is the
rationale for not initiating the PCA analgesic with a basal dose of analgesic as well? - Correct
answer ✔✔ Adverse resp outcomes
Which measures or drugs may be effective in controlling pain in the physiologic pain process of
transduction? (SATA) - Correct answer ✔✔ Corticosteroids, Local anesthetics, Antiseizure meds,
NSAIDs
A pt is receiving a continuous infusion of morphine via an epidural catheter following major ab
surgery. Which actions should the nurse include in the plan of care? (SATA) - Correct answer ✔✔
Label the catheter as an epidural access, Assess the pt's pain relief frequently, Use sterile
,technique when caring for the catheter, Monitor the pt's LOC, Monitor pt's VS, Assess the motor
and sensory function of the pt's lower extremities
A patient with multiple injuries resulting from an automobile accident tells the nurse that he
has "bad" pain but that he can "tough it out" and does not require pain med. To gain the pt's
participation in pain management, what is the most important for the nurse to explain to the
pt? - Correct answer ✔✔ unrelieved pain has many harmful effects on the body that can impair
recovery
The pt has chronic pain that is no long relieved with oral morphine. Which med would the nurse
expect to be ordered to provide better pain relief for this pt? - Correct answer ✔✔ Fentanyl
After the family members of a post-op pt leave, the pt tells the nurse that his family gave him a
headache by fussing over him so much. What is an appropriate intervention by the nurse? -
Correct answer ✔✔ Ask the pt's permission to use acupressure to ease his headache
Which question asked by the nurse will give the most information about the patient's metastatic
bone cancer pain? - Correct answer ✔✔ "How would you describe your pain?"
A patient who has had good control for chronic pain using a fentanyl (Duragesic) patch reports
rapid onset pain at a level 9 (0 to 10 scale) and requests "something for pain that will work
quickly." How will the nurse document the type of pain reported by this patient? - Correct
answer ✔✔ Breakthrough pain
The nurse teaches a student nurse about the action of ibuprofen. Which statement, if made by
the student, indicates that teaching was effective? - Correct answer ✔✔ "The drug decreases
production of pain-sensitizing chemicals."
A nurse assesses a patient with chronic cancer pain who is receiving imipramine (Tofranil) in
addition to long-acting morphine (MS Contin). Which statement, if made by the patient,
indicates to the nurse that the patient is receiving adequate pain control? - Correct answer ✔✔
"I can accomplish activities without much discomfort."
, A patient with chronic back pain has learned to control the pain with the use of imagery and
hypnosis. The patient's spouse asks the nurse how these techniques work. Which response by
the nurse is accurate? - Correct answer ✔✔ "The strategies work by affecting the perception of
pain."
A patient who is receiving sustained-release morphine sulfate (MS Contin) every 12 hours for
chronic pain experiences level 9 (0 to 10 scale) breakthrough pain and anxiety. Which action by
the nurse is appropriate for treating this change in assessment? - Correct answer ✔✔ Offer
immediate-release morphine 30 mg orally.
A patient with chronic neck pain is seen in the clinic for follow-up. To evaluate whether the pain
management is effective, which question is best for the nurse to ask? - Correct answer ✔✔
"Does pain keep you from activities that you enjoy?"
A patient with a deep partial thickness burn has been receiving hydromorphone through
patient-controlled analgesia (PCA) for 1 week. The nurse caring for the patient during the
previous shift reports that the patient wakes up frequently during the night reporting pain.
What action by the nurse is appropriate? - Correct answer ✔✔ Consult with the health care
provider about using a different treatment protocol to control the patient's pain.
A patient receiving epidural morphine has not voided for over 10 hours. What action should the
nurse take first? - Correct answer ✔✔ Ask if the patient feels the need to void.
The nurse assesses that a home hospice patient with terminal cancer who reports severe pain
has a respiratory rate of 11 breaths/min. Which action should the nurse take? - Correct answer
✔✔ Titrate the prescribed morphine dose up until the patient indicates adequate pain relief.
The nurse is completing the medication reconciliation form for a patient admitted with chronic
cancer pain. Which medication is of most concern to the nurse? - Correct answer ✔✔
Meperidine (Demerol) 25 mg every 4 hours
PRACTICE REVIEW
Pain has been defined as "whatever the person experiencing the pain says it is, existing
whenever the patient says it does." This definition is problematic for the nurse when caring
which type of patient? - Correct answer ✔✔ A patient with decreased cognitive function
One the first postoperative day following a bowel resection, the pt complains of abdominal and
incision pain rated at 9 on a scale of 0 to 10. Postoperative orders include morphine 4 mg IV q4h
for pain and may repeat morphine 4 mg IV for breakthrough pain. The nurse determines that it
has been only 1 3/4 hours since the last dose of morphine and wants to wait a little longer.
What effect does the nurse's actions have on the patient? - Correct answer ✔✔ indicates that
the nurse understands the adage of "start low and go slow" in administering analgesics
Once generated, what may block the transmission of an action potential along a peripheral
nerve fiber to the dorsal root of the spinal cord? - Correct answer ✔✔ The action potential must
cross several synapses, points at which the impulse may be blocked by drugs.
A pt comes to the clinic with a complaint of a dull pain in the anterior and posterior neck. On
exam, the nurse notes that the pt has full ROM of the neck and no throat redness or enlarged
head or neck lymph nodes. What will be the nurse's next appropriate assessment indicated by
these findings? - Correct answer ✔✔ palpation of the liver
While caring or an unconscious pt, the nurse discovers a stage 2 pressure ulcer on the pt's heel.
During care of the ulcer, what is the nurse's understanding of the pt's perception of pain? -
Correct answer ✔✔ the area should be treated as a painful lesion, using gentle cleansing and
dressing
Amitriptyline is prescribed for a pt with chronic pain from fibromyalgia. When the nurse
explains that this drug is an antidepressant, the pt states that she is in pain, not depressed.
,What is the nurse's best response to the pt? - Correct answer ✔✔ some antidepressant drugs
relieve pain by releasing neurotransmitters that prevent pain impulses from reaching the brain
A pt with trigeminal neuralgia has moderate to severe burning and shooting pain. In helping the
pt to manage the pain, the nurse recognizes what about this type of pain? - Correct answer ✔✔
includes tx with adjuvant analgesics
A patient with advanced colorectal cancer has continuous, poorly localized ab pain at an
intensity of 5 on a scale of 0 to 10. How does the nurse teach the pt to use pain meds? - Correct
answer ✔✔ on an around the clock schedule
A patient who has been taking ibuprofen and imipramine (Tofranil) for control of cancer pain is
having increased pain. What would the nurse recommend to the HCP as an appropriate change
in the med plan? - Correct answer ✔✔ add PO oxycodone to the other meds
A pt with chronic cancer related pain has started using MS Contin for pain control and has
developed common side effects of the drug. The nurse reassures the pt that tolerance will
develop to most of the side effects but that continued tx will most likely be required for what? -
Correct answer ✔✔ Constipation
A post-op 68 y/o opioid naive pt is receiving morphine by PCA for post-op pain. What is the
rationale for not initiating the PCA analgesic with a basal dose of analgesic as well? - Correct
answer ✔✔ Adverse resp outcomes
Which measures or drugs may be effective in controlling pain in the physiologic pain process of
transduction? (SATA) - Correct answer ✔✔ Corticosteroids, Local anesthetics, Antiseizure meds,
NSAIDs
A pt is receiving a continuous infusion of morphine via an epidural catheter following major ab
surgery. Which actions should the nurse include in the plan of care? (SATA) - Correct answer ✔✔
Label the catheter as an epidural access, Assess the pt's pain relief frequently, Use sterile
,technique when caring for the catheter, Monitor the pt's LOC, Monitor pt's VS, Assess the motor
and sensory function of the pt's lower extremities
A patient with multiple injuries resulting from an automobile accident tells the nurse that he
has "bad" pain but that he can "tough it out" and does not require pain med. To gain the pt's
participation in pain management, what is the most important for the nurse to explain to the
pt? - Correct answer ✔✔ unrelieved pain has many harmful effects on the body that can impair
recovery
The pt has chronic pain that is no long relieved with oral morphine. Which med would the nurse
expect to be ordered to provide better pain relief for this pt? - Correct answer ✔✔ Fentanyl
After the family members of a post-op pt leave, the pt tells the nurse that his family gave him a
headache by fussing over him so much. What is an appropriate intervention by the nurse? -
Correct answer ✔✔ Ask the pt's permission to use acupressure to ease his headache
Which question asked by the nurse will give the most information about the patient's metastatic
bone cancer pain? - Correct answer ✔✔ "How would you describe your pain?"
A patient who has had good control for chronic pain using a fentanyl (Duragesic) patch reports
rapid onset pain at a level 9 (0 to 10 scale) and requests "something for pain that will work
quickly." How will the nurse document the type of pain reported by this patient? - Correct
answer ✔✔ Breakthrough pain
The nurse teaches a student nurse about the action of ibuprofen. Which statement, if made by
the student, indicates that teaching was effective? - Correct answer ✔✔ "The drug decreases
production of pain-sensitizing chemicals."
A nurse assesses a patient with chronic cancer pain who is receiving imipramine (Tofranil) in
addition to long-acting morphine (MS Contin). Which statement, if made by the patient,
indicates to the nurse that the patient is receiving adequate pain control? - Correct answer ✔✔
"I can accomplish activities without much discomfort."
, A patient with chronic back pain has learned to control the pain with the use of imagery and
hypnosis. The patient's spouse asks the nurse how these techniques work. Which response by
the nurse is accurate? - Correct answer ✔✔ "The strategies work by affecting the perception of
pain."
A patient who is receiving sustained-release morphine sulfate (MS Contin) every 12 hours for
chronic pain experiences level 9 (0 to 10 scale) breakthrough pain and anxiety. Which action by
the nurse is appropriate for treating this change in assessment? - Correct answer ✔✔ Offer
immediate-release morphine 30 mg orally.
A patient with chronic neck pain is seen in the clinic for follow-up. To evaluate whether the pain
management is effective, which question is best for the nurse to ask? - Correct answer ✔✔
"Does pain keep you from activities that you enjoy?"
A patient with a deep partial thickness burn has been receiving hydromorphone through
patient-controlled analgesia (PCA) for 1 week. The nurse caring for the patient during the
previous shift reports that the patient wakes up frequently during the night reporting pain.
What action by the nurse is appropriate? - Correct answer ✔✔ Consult with the health care
provider about using a different treatment protocol to control the patient's pain.
A patient receiving epidural morphine has not voided for over 10 hours. What action should the
nurse take first? - Correct answer ✔✔ Ask if the patient feels the need to void.
The nurse assesses that a home hospice patient with terminal cancer who reports severe pain
has a respiratory rate of 11 breaths/min. Which action should the nurse take? - Correct answer
✔✔ Titrate the prescribed morphine dose up until the patient indicates adequate pain relief.
The nurse is completing the medication reconciliation form for a patient admitted with chronic
cancer pain. Which medication is of most concern to the nurse? - Correct answer ✔✔
Meperidine (Demerol) 25 mg every 4 hours
