Ultimate 2025 NUR 518 Clinical Essentials Final
Exam Preparation: With 100 Proven Questions,
Detailed Answers, and Expert Strategies for Top
Performance
1. A nurse is caring for a patient who has just had major abdominal surgery to
resect a portion of his colon. What is the most reliable sign that the patient has
significant postoperative pain?
A. The patient rates his pain a 7 on a scale of 0 to 10.
B. The patient winces and guards the area as the nurse gently palpates the abdomen.
C. The patient is having trouble sleeping and has become irritable.
D. The patient is moaning softly and frowning, with a pinched expression on his face.
Correct Answer: A. The patient rates his pain a 7 on a scale of 0 to 10.
Rationale: The most reliable indicator of significant postoperative pain is the patient's
self-report of pain intensity. A pain rating of 7 out of 10 is considered moderate to severe
pain, making this the most reliable sign.
2. What will the nurse instruct nursing assistive personnel (NAP) to do regarding the
management of a patient's pain?
A. "Let me know at least 30 minutes before you transport her so I can administer her
analgesics."
B. "Be sure to keep the room temperature high and the TV on at all times."
C. "Be sure to tell me if you notice grimacing, guarding, or any unusual behavior."
D. "I've given her some medication; please report to me whether it seems to have
relieved her pain within an hour or so."
Correct Answer: A. "Let me know at least 30 minutes before you transport her so I
can administer her analgesics."
Rationale: Proper timing of analgesic administration is essential to managing pain
effectively. By notifying the nurse 30 minutes in advance, the NAP ensures that pain
relief is given before any discomfort occurs due to transportation.
,3. Which observation indicates that a patient's analgesic has been effective in
managing pain that she rated a 6 out of 10 on a pain rating scale before the
intervention?
A. The patient is seen quietly reading a magazine.
B. The patient rates her current pain as 3 out of 10 on the pain rating scale.
C. The patient is overheard telling her family that she is "feeling better today."
D. The patient is observed sleeping, with a respiratory rate assessed at 18/minute,
compared with 22/minute before the intervention.
Correct Answer: B. The patient rates her current pain as 3 out of 10 on the pain
rating scale.
Rationale: A decrease in pain rating (from 6 to 3 out of 10) clearly indicates that the
analgesic has been effective in managing the patient's pain.
4. A patient with a herniated disk is scheduled for surgery to fuse two vertebrae in
her cervical spine. Which activity is most likely to be a palliative factor for this
patient?
A. Repainting her new apartment
B. Lifting moving boxes on and off of a truck
C. Performing neck, back, and shoulder exercises prescribed by a physical therapist
D. Performing yoga exercises from the patient's favorite set of videotapes
Correct Answer: C. Performing neck, back, and shoulder exercises prescribed by a
physical therapist
Rationale: Physical therapy exercises prescribed for the specific condition are likely to
help alleviate pain, improve mobility, and prevent further injury, making it the most
effective palliative intervention for this patient.
5. The nurse notices that his patient has none of the signs and symptoms normally
associated with pain, such as diaphoresis, tachycardia, and hypertension. The
patient does, however, seem moody and a bit uncooperative. What conclusion
does the nurse draw?
A. It is likely the patient is a drug seeker and has little or no pain.
B. The patient's problem is more mental than physical.
C. The absence of physiological signs and symptoms is associated with chronic pain.
D. The patient's pain cannot be accurately assessed until the patient has been treated
for anxiety.
, Correct Answer: C. The absence of physiological signs and symptoms is associated
with chronic pain.
Rationale: Chronic pain may not always present with typical signs like tachycardia or
diaphoresis. Emotional responses like irritability or mood changes can be
manifestations of chronic pain without accompanying physiological symptoms.
6. Which of the following is a risk factor for decreased oxygen saturation level in a
patient?
A. Chest wall injury
B. Restlessness
C. Hypotension
D. Prescribed bronchodilators
Correct Answer: A. Chest wall injury
Rationale: A chest wall injury can impair the patient’s ability to breathe deeply,
potentially leading to hypoventilation and reduced oxygen saturation levels.
7. What should the nurse teach nursing assistive personnel (NAP) about selecting
the appropriate site for measuring a patient's oxygen saturation level?
A. "Do not use the fingers if her nails are polished."
B. "I've checked her capillary refill, and it's acceptable in both her hands and feet."
C. "Please review the patient's previously documented pulse oximetry readings for the
site used."
D. "Ask the patient to keep her finger motionless while you are monitoring her oxygen
saturation."
Correct Answer: B. "I've checked her capillary refill, and it's acceptable in both her
hands and feet."
Rationale: Proper capillary refill ensures that the peripheral circulation is adequate for
accurate pulse oximetry readings. Ensuring good circulation at the site will help obtain
reliable oxygen saturation readings.
8. The nurse measures a patient's oxygen saturation level as being 83%. What
would the nurse do first?
A. Reassess the oxygen saturation in a different location.
B. Promptly report the assessment data to the charge nurse.
Exam Preparation: With 100 Proven Questions,
Detailed Answers, and Expert Strategies for Top
Performance
1. A nurse is caring for a patient who has just had major abdominal surgery to
resect a portion of his colon. What is the most reliable sign that the patient has
significant postoperative pain?
A. The patient rates his pain a 7 on a scale of 0 to 10.
B. The patient winces and guards the area as the nurse gently palpates the abdomen.
C. The patient is having trouble sleeping and has become irritable.
D. The patient is moaning softly and frowning, with a pinched expression on his face.
Correct Answer: A. The patient rates his pain a 7 on a scale of 0 to 10.
Rationale: The most reliable indicator of significant postoperative pain is the patient's
self-report of pain intensity. A pain rating of 7 out of 10 is considered moderate to severe
pain, making this the most reliable sign.
2. What will the nurse instruct nursing assistive personnel (NAP) to do regarding the
management of a patient's pain?
A. "Let me know at least 30 minutes before you transport her so I can administer her
analgesics."
B. "Be sure to keep the room temperature high and the TV on at all times."
C. "Be sure to tell me if you notice grimacing, guarding, or any unusual behavior."
D. "I've given her some medication; please report to me whether it seems to have
relieved her pain within an hour or so."
Correct Answer: A. "Let me know at least 30 minutes before you transport her so I
can administer her analgesics."
Rationale: Proper timing of analgesic administration is essential to managing pain
effectively. By notifying the nurse 30 minutes in advance, the NAP ensures that pain
relief is given before any discomfort occurs due to transportation.
,3. Which observation indicates that a patient's analgesic has been effective in
managing pain that she rated a 6 out of 10 on a pain rating scale before the
intervention?
A. The patient is seen quietly reading a magazine.
B. The patient rates her current pain as 3 out of 10 on the pain rating scale.
C. The patient is overheard telling her family that she is "feeling better today."
D. The patient is observed sleeping, with a respiratory rate assessed at 18/minute,
compared with 22/minute before the intervention.
Correct Answer: B. The patient rates her current pain as 3 out of 10 on the pain
rating scale.
Rationale: A decrease in pain rating (from 6 to 3 out of 10) clearly indicates that the
analgesic has been effective in managing the patient's pain.
4. A patient with a herniated disk is scheduled for surgery to fuse two vertebrae in
her cervical spine. Which activity is most likely to be a palliative factor for this
patient?
A. Repainting her new apartment
B. Lifting moving boxes on and off of a truck
C. Performing neck, back, and shoulder exercises prescribed by a physical therapist
D. Performing yoga exercises from the patient's favorite set of videotapes
Correct Answer: C. Performing neck, back, and shoulder exercises prescribed by a
physical therapist
Rationale: Physical therapy exercises prescribed for the specific condition are likely to
help alleviate pain, improve mobility, and prevent further injury, making it the most
effective palliative intervention for this patient.
5. The nurse notices that his patient has none of the signs and symptoms normally
associated with pain, such as diaphoresis, tachycardia, and hypertension. The
patient does, however, seem moody and a bit uncooperative. What conclusion
does the nurse draw?
A. It is likely the patient is a drug seeker and has little or no pain.
B. The patient's problem is more mental than physical.
C. The absence of physiological signs and symptoms is associated with chronic pain.
D. The patient's pain cannot be accurately assessed until the patient has been treated
for anxiety.
, Correct Answer: C. The absence of physiological signs and symptoms is associated
with chronic pain.
Rationale: Chronic pain may not always present with typical signs like tachycardia or
diaphoresis. Emotional responses like irritability or mood changes can be
manifestations of chronic pain without accompanying physiological symptoms.
6. Which of the following is a risk factor for decreased oxygen saturation level in a
patient?
A. Chest wall injury
B. Restlessness
C. Hypotension
D. Prescribed bronchodilators
Correct Answer: A. Chest wall injury
Rationale: A chest wall injury can impair the patient’s ability to breathe deeply,
potentially leading to hypoventilation and reduced oxygen saturation levels.
7. What should the nurse teach nursing assistive personnel (NAP) about selecting
the appropriate site for measuring a patient's oxygen saturation level?
A. "Do not use the fingers if her nails are polished."
B. "I've checked her capillary refill, and it's acceptable in both her hands and feet."
C. "Please review the patient's previously documented pulse oximetry readings for the
site used."
D. "Ask the patient to keep her finger motionless while you are monitoring her oxygen
saturation."
Correct Answer: B. "I've checked her capillary refill, and it's acceptable in both her
hands and feet."
Rationale: Proper capillary refill ensures that the peripheral circulation is adequate for
accurate pulse oximetry readings. Ensuring good circulation at the site will help obtain
reliable oxygen saturation readings.
8. The nurse measures a patient's oxygen saturation level as being 83%. What
would the nurse do first?
A. Reassess the oxygen saturation in a different location.
B. Promptly report the assessment data to the charge nurse.
