Medical-Surgical Nursing I Final
Exam Review | Exam 1, Midterm &
Final Questions and Answers | 2026
Update | 100% Correct – Jersey
College.
SECTION 1: PAIN MANAGEMENT
Question 1
The single most reliable indicator of pain is:
A. Changes in vital signs
B. The patient's self-report
C. Facial expression
D. Guarding behavior
Correct Answer: B
Rationale: The patient's self-report is the single most reliable indicator of pain. Pain is
whatever the patient says it is. While vital signs, facial expressions, and guarding may
indicate pain, they are not reliable indicators as patients may learn to mask these signs
or they may be absent in chronic pain.
,Question 2
Pain stimulates the sympathetic nervous system and could result in an increase in which
of the following? (Select all that apply)
A. Blood pressure
B. Heart rate
C. Respirations
D. Gastrointestinal motility
Correct Answers: A, B, C
Rationale: Pain stimulates the sympathetic nervous system, resulting in increased blood
pressure, heart rate, and respirations. Gastrointestinal motility decreases (not increases)
as part of the stress response.
Question 3
Which of the following is a physiologic effect of unrelieved pain? (Select all that apply)
A. Increases glucagon production
B. Decreases insulin secretion
C. Depresses immune function
D. Decreases metabolic rate
Correct Answers: A, B, C
,Rationale: Unrelieved pain increases glucagon production, decreases insulin secretion,
and depresses immune function. It can also lead to addictive behaviors. Pain increases
metabolic rate, not decreases it.
Question 4
Which analgesic primarily produces pain relief by preventing prostaglandin formation?
A. Acetaminophen
B. Opioids
C. NSAIDs
D. Local anesthetics
Correct Answer: C
Rationale: NSAIDs primarily produce pain relief by preventing prostaglandin formation.
Prostaglandins initiate inflammation and contribute to tissue swelling and pain.
Question 5
Which route of medication administration should be avoided in patients who are
thrombocytopenic?
A. Oral
B. Intravenous
C. Rectal
D. Topical
Correct Answer: C
, Rationale: The rectal route should be avoided in patients who are thrombocytopenic
(low platelets) due to the risk of bleeding and tissue trauma.
Question 6
The maximum daily dose of acetaminophen is:
A. 2000 mg
B. 3000 mg
C. 4000 mg
D. 5000 mg
Correct Answer: C
Rationale: Acetaminophen should not exceed 4,000 mg/day to avoid hepatotoxicity. For
patients with liver disease or chronic alcohol use, the maximum dose should be lower
(2,000–3,000 mg/day).
Question 7
Aspirin or acetaminophen is given for:
A. Severe pain
B. Moderate pain
C. Mild to moderate pain
D. Neuropathic pain
Correct Answer: C
Exam Review | Exam 1, Midterm &
Final Questions and Answers | 2026
Update | 100% Correct – Jersey
College.
SECTION 1: PAIN MANAGEMENT
Question 1
The single most reliable indicator of pain is:
A. Changes in vital signs
B. The patient's self-report
C. Facial expression
D. Guarding behavior
Correct Answer: B
Rationale: The patient's self-report is the single most reliable indicator of pain. Pain is
whatever the patient says it is. While vital signs, facial expressions, and guarding may
indicate pain, they are not reliable indicators as patients may learn to mask these signs
or they may be absent in chronic pain.
,Question 2
Pain stimulates the sympathetic nervous system and could result in an increase in which
of the following? (Select all that apply)
A. Blood pressure
B. Heart rate
C. Respirations
D. Gastrointestinal motility
Correct Answers: A, B, C
Rationale: Pain stimulates the sympathetic nervous system, resulting in increased blood
pressure, heart rate, and respirations. Gastrointestinal motility decreases (not increases)
as part of the stress response.
Question 3
Which of the following is a physiologic effect of unrelieved pain? (Select all that apply)
A. Increases glucagon production
B. Decreases insulin secretion
C. Depresses immune function
D. Decreases metabolic rate
Correct Answers: A, B, C
,Rationale: Unrelieved pain increases glucagon production, decreases insulin secretion,
and depresses immune function. It can also lead to addictive behaviors. Pain increases
metabolic rate, not decreases it.
Question 4
Which analgesic primarily produces pain relief by preventing prostaglandin formation?
A. Acetaminophen
B. Opioids
C. NSAIDs
D. Local anesthetics
Correct Answer: C
Rationale: NSAIDs primarily produce pain relief by preventing prostaglandin formation.
Prostaglandins initiate inflammation and contribute to tissue swelling and pain.
Question 5
Which route of medication administration should be avoided in patients who are
thrombocytopenic?
A. Oral
B. Intravenous
C. Rectal
D. Topical
Correct Answer: C
, Rationale: The rectal route should be avoided in patients who are thrombocytopenic
(low platelets) due to the risk of bleeding and tissue trauma.
Question 6
The maximum daily dose of acetaminophen is:
A. 2000 mg
B. 3000 mg
C. 4000 mg
D. 5000 mg
Correct Answer: C
Rationale: Acetaminophen should not exceed 4,000 mg/day to avoid hepatotoxicity. For
patients with liver disease or chronic alcohol use, the maximum dose should be lower
(2,000–3,000 mg/day).
Question 7
Aspirin or acetaminophen is given for:
A. Severe pain
B. Moderate pain
C. Mild to moderate pain
D. Neuropathic pain
Correct Answer: C
