Nclex 70 questions and answers for Fundamentals of Nursing
with Rationale (2025-2026)
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 - ANS>>:
3) Deep somatic
Rationale:
Deep somatic pain originates in ligaments, tendons, nerves, blood vessels, and bones. Therefore, a hi
fracture causes deep somatic pain. Phantom pain is pain that is perceived to originate from a part tha
was removed during surgery. Visceral pain is caused by deep internal pain receptors and commonl
occurs in the abdominal cavity, cranium, and thorax. Referred pain occurs in an area that is distant to th
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 - ANS>>:
1) Asking about pain during vital signs
Rationale:
The nurse can delegate the task of asking about pain when nursing assistive personnel (NAP) obtain vita
signs. The NAP must be instructed to report findings to the nurse without delay. The nurse shoul
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 practica
nurse.
,Which factor in the patient's past medical history dictates that the nurse exercise caution whe
administering acetaminophen (Tylenol)?
1) Hepatitis B
2) Occasional alcohol use
3) Allergy to aspirin
4) Gastric irritation with bleeding - ANS>>:
1) Hepatitis B
Rationale:
Even in recommended doses, acetaminophen can cause severe hepatotoxicity in patients with live
disease, such as hepatitis B. Patients who consume alcohol regularly should also use acetaminophe
cautiously. Those allergic to aspirin or other nonsteroidal anti-inflammatory drugs (NSAIDs) can us
acetaminophen safely. Acetaminophen rarely causes gastrointestinal (GI) problems; therefore, it can b
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 patien
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. - ANS>>:
3) Assess the patient's respiratory status.
Rationale:
Before administering an opioid analgesic, such as morphine, the nurse should assess the patient'
respiratory status because opioid analgesics can cause respiratory depression. It is not necessary t
clarify the order with the physician because morphine 4 mg IV is an appropriate dose. It is not necessar
to monitor the patient's heart rate.
Which action should the nurse take when preparing patient-controlled analgesia for a postoperativ
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. - ANS>>:
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 lockou
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, suc
as walking. Patient-controlled analgesia is contraindicated for those who are cognitively impaired.
The nurse administers codeine sulfate 30 mg orally to a patient who underwent craniotomy 3 days ago fo
a brain tumor. How soon after administration should the nurse reassess the patient's pain?
1) Immediately
2) In 10 minutes
3) In 15 minutes
4) In 60 minutes - ANS>>:
4) In 60 minutes
Rationale:
Codeine administered by the oral route reaches peak concentration in 60 minutes; therefore, the nurs
should reassess the patient's pain 60 minutes after administration. The nurse should reassess pain afte
10 minutes when administering codeine by the intramuscular or subcutaneous routes. Drug
administered by the intravenous (IV) route are effective almost immediately; however, codeine is no
recommended for IV administration.
Which nonsteroidal anti-inflammatory drug might be administered to inhibit platelet aggregation in
patient at risk for thrombophlebitis?
1) Ibuprofen (Motrin)
2) Celecoxib (Celebrex)
3) Aspirin (Ecotrin)
4) Indomethacin (Indocin) - ANS>>:
3) Aspirin (Ecotrin)
Rationale:
Aspirin is a unique NSAID that inhibits platelet aggregation. Low-dose aspirin therapy is commonl
administered to decrease the risk of thrombophlebitis, myocardial infarction, and stroke. Ibuprofen
celecoxib, and indomethacin are NSAIDs, but they do not inhibit platelet aggregation.
with Rationale (2025-2026)
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 - ANS>>:
3) Deep somatic
Rationale:
Deep somatic pain originates in ligaments, tendons, nerves, blood vessels, and bones. Therefore, a hi
fracture causes deep somatic pain. Phantom pain is pain that is perceived to originate from a part tha
was removed during surgery. Visceral pain is caused by deep internal pain receptors and commonl
occurs in the abdominal cavity, cranium, and thorax. Referred pain occurs in an area that is distant to th
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 - ANS>>:
1) Asking about pain during vital signs
Rationale:
The nurse can delegate the task of asking about pain when nursing assistive personnel (NAP) obtain vita
signs. The NAP must be instructed to report findings to the nurse without delay. The nurse shoul
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 practica
nurse.
,Which factor in the patient's past medical history dictates that the nurse exercise caution whe
administering acetaminophen (Tylenol)?
1) Hepatitis B
2) Occasional alcohol use
3) Allergy to aspirin
4) Gastric irritation with bleeding - ANS>>:
1) Hepatitis B
Rationale:
Even in recommended doses, acetaminophen can cause severe hepatotoxicity in patients with live
disease, such as hepatitis B. Patients who consume alcohol regularly should also use acetaminophe
cautiously. Those allergic to aspirin or other nonsteroidal anti-inflammatory drugs (NSAIDs) can us
acetaminophen safely. Acetaminophen rarely causes gastrointestinal (GI) problems; therefore, it can b
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 patien
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. - ANS>>:
3) Assess the patient's respiratory status.
Rationale:
Before administering an opioid analgesic, such as morphine, the nurse should assess the patient'
respiratory status because opioid analgesics can cause respiratory depression. It is not necessary t
clarify the order with the physician because morphine 4 mg IV is an appropriate dose. It is not necessar
to monitor the patient's heart rate.
Which action should the nurse take when preparing patient-controlled analgesia for a postoperativ
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. - ANS>>:
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 lockou
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, suc
as walking. Patient-controlled analgesia is contraindicated for those who are cognitively impaired.
The nurse administers codeine sulfate 30 mg orally to a patient who underwent craniotomy 3 days ago fo
a brain tumor. How soon after administration should the nurse reassess the patient's pain?
1) Immediately
2) In 10 minutes
3) In 15 minutes
4) In 60 minutes - ANS>>:
4) In 60 minutes
Rationale:
Codeine administered by the oral route reaches peak concentration in 60 minutes; therefore, the nurs
should reassess the patient's pain 60 minutes after administration. The nurse should reassess pain afte
10 minutes when administering codeine by the intramuscular or subcutaneous routes. Drug
administered by the intravenous (IV) route are effective almost immediately; however, codeine is no
recommended for IV administration.
Which nonsteroidal anti-inflammatory drug might be administered to inhibit platelet aggregation in
patient at risk for thrombophlebitis?
1) Ibuprofen (Motrin)
2) Celecoxib (Celebrex)
3) Aspirin (Ecotrin)
4) Indomethacin (Indocin) - ANS>>:
3) Aspirin (Ecotrin)
Rationale:
Aspirin is a unique NSAID that inhibits platelet aggregation. Low-dose aspirin therapy is commonl
administered to decrease the risk of thrombophlebitis, myocardial infarction, and stroke. Ibuprofen
celecoxib, and indomethacin are NSAIDs, but they do not inhibit platelet aggregation.
