NR 293 Exam 2 Practice Questions and Answers. NR 293 Exam
2 Practice Questions Chapter 10: Analgesic Drugs Test Bank
MULTIPLE CHOICE
NR 293 Exam 2 Practice Questions
Chapters 10, 11, 12, 13, 14, 15, 18, 19, 20, 21, 22, 23, 24, 25,
26
Chapter 10: Analgesic Drugs (Questions 1–20)
1. A patient is prescribed morphine sulfate for postoperative pain. The nurse
understands that morphine acts on which receptors to produce analgesia?
a. Alpha-adrenergic receptors
b. Dopamine receptors
c. Mu (μ) receptors
d. Serotonin receptors
Correct Solution: c. Mu (μ) receptors
Rationale: Morphine is an opioid agonist that primarily binds to mu receptors in the
CNS, inhibiting pain signal transmission.
2. A patient is receiving a continuous infusion of morphine via PCA pump. The
nurse notes the patient's respiratory rate is 8 breaths per minute. Which
medication should the nurse anticipate administering?
a. Nalbuphine (Nubain)
b. Naltrexone (ReVia)
c. Naloxone (Narcan)
d. Acetylcysteine (Mucomyst)
,Correct Solution: c. Naloxone (Narcan)
Rationale: Naloxone is a pure opioid antagonist used to reverse life-threatening
respiratory depression.
3. A patient with chronic cancer pain has been taking oxycodone (OxyContin) for
several weeks. The patient reports the medication is not working as well as it did
initially. The nurse recognizes this as:
a. Physical dependence
b. Tolerance
c. Addiction
d. Drug toxicity
Correct Solution: b. Tolerance
Rationale: Tolerance is the need for a higher dose to achieve the same analgesic effect, a
common physiologic response to chronic opioid use.
4. A nurse is providing education to a patient prescribed codeine for a persistent
cough. Which statement by the patient indicates a need for further teaching?
a. "I should increase my fluid intake to prevent constipation."
b. "I can drive my car as soon as I feel the effects of the medication wear off."
c. "I will avoid drinking alcohol while taking this medication."
d. "I should get up slowly from a sitting position to avoid dizziness."
Correct Solution: b. "I can drive my car as soon as I feel the effects of the
medication wear off."
Rationale: Opioids cause CNS depression; patients should not drive until they know how
the drug affects them, and often not at all during therapy.
5. A patient is brought to the ED after a motor vehicle accident and is in severe
pain. Which order for morphine sulfate 4 mg IV push should the nurse question?
a. Administer over 1 to 2 minutes.
,b. Monitor for respiratory depression.
c. Administer intramuscularly for faster absorption.
d. Reassess pain level 15 to 30 minutes after administration.
Correct Solution: c. Administer intramuscularly for faster absorption.
Rationale: IV route provides fastest onset; IM absorption is erratic and slower. IV is
preferred for acute severe pain.
6. A patient is taking acetaminophen (Tylenol) 650 mg every 6 hours for
osteoarthritis pain. The nurse reviews the patient's history and notes which finding
as a priority concern?
a. History of peptic ulcer disease
b. History of chronic alcoholism
c. History of hypertension
d. History of asthma
Correct Solution: b. History of chronic alcoholism
Rationale: Chronic alcohol use increases risk of hepatotoxicity from acetaminophen due
to depleted glutathione stores.
7. The nurse is administering an NSAID to a patient. The patient asks, "How does
this medication help my pain?" What is the nurse's best response?
a. "It blocks pain receptors in your brain similar to how morphine works."
b. "It inhibits the production of prostaglandins that cause pain and inflammation."
c. "It increases serotonin levels to help you ignore the pain."
d. "It relaxes the smooth muscles in your blood vessels."
Correct Solution: b. "It inhibits the production of prostaglandins that cause pain
and inflammation."
Rationale: NSAIDs inhibit COX enzymes, reducing prostaglandin synthesis.
, 8. A patient with a history of MI two years ago reports joint pain and requests
ibuprofen. What is the nurse's priority action?
a. Administer the ibuprofen as ordered.
b. Contact the healthcare provider to suggest naproxen instead.
c. Instruct the patient to take the ibuprofen with food.
d. Contact the healthcare provider to discuss a possible alternative to NSAIDs.
Correct Solution: d. Contact the healthcare provider to discuss a possible
alternative to NSAIDs.
Rationale: NSAIDs increase cardiovascular risk in patients with history of MI;
acetaminophen or other alternatives should be considered.
9. A patient is receiving pentazocine (Talwin), a mixed opioid agonist-antagonist.
The nurse understands a major disadvantage of this type of medication is:
a. It has a higher risk of respiratory depression than pure agonists.
b. It has a ceiling effect for analgesia.
c. It cannot be given orally.
d. It has no risk of physical dependence.
Correct Solution: b. It has a ceiling effect for analgesia.
Rationale: Mixed agonist-antagonists have a ceiling effect—after a certain dose,
increasing the dose does not increase analgesia.
10. The nurse is caring for a patient receiving naloxone (Narcan) to reverse
respiratory depression. After administration, the nurse should prioritize
monitoring for:
a. Hypertension and tachycardia
b. Severe constipation
c. Recurrence of respiratory depression
d. Hyperthermia
Correct Solution: c. Recurrence of respiratory depression
Rationale: Naloxone has a shorter duration of action than most opioids; respiratory
depression may recur as naloxone wears off.
2 Practice Questions Chapter 10: Analgesic Drugs Test Bank
MULTIPLE CHOICE
NR 293 Exam 2 Practice Questions
Chapters 10, 11, 12, 13, 14, 15, 18, 19, 20, 21, 22, 23, 24, 25,
26
Chapter 10: Analgesic Drugs (Questions 1–20)
1. A patient is prescribed morphine sulfate for postoperative pain. The nurse
understands that morphine acts on which receptors to produce analgesia?
a. Alpha-adrenergic receptors
b. Dopamine receptors
c. Mu (μ) receptors
d. Serotonin receptors
Correct Solution: c. Mu (μ) receptors
Rationale: Morphine is an opioid agonist that primarily binds to mu receptors in the
CNS, inhibiting pain signal transmission.
2. A patient is receiving a continuous infusion of morphine via PCA pump. The
nurse notes the patient's respiratory rate is 8 breaths per minute. Which
medication should the nurse anticipate administering?
a. Nalbuphine (Nubain)
b. Naltrexone (ReVia)
c. Naloxone (Narcan)
d. Acetylcysteine (Mucomyst)
,Correct Solution: c. Naloxone (Narcan)
Rationale: Naloxone is a pure opioid antagonist used to reverse life-threatening
respiratory depression.
3. A patient with chronic cancer pain has been taking oxycodone (OxyContin) for
several weeks. The patient reports the medication is not working as well as it did
initially. The nurse recognizes this as:
a. Physical dependence
b. Tolerance
c. Addiction
d. Drug toxicity
Correct Solution: b. Tolerance
Rationale: Tolerance is the need for a higher dose to achieve the same analgesic effect, a
common physiologic response to chronic opioid use.
4. A nurse is providing education to a patient prescribed codeine for a persistent
cough. Which statement by the patient indicates a need for further teaching?
a. "I should increase my fluid intake to prevent constipation."
b. "I can drive my car as soon as I feel the effects of the medication wear off."
c. "I will avoid drinking alcohol while taking this medication."
d. "I should get up slowly from a sitting position to avoid dizziness."
Correct Solution: b. "I can drive my car as soon as I feel the effects of the
medication wear off."
Rationale: Opioids cause CNS depression; patients should not drive until they know how
the drug affects them, and often not at all during therapy.
5. A patient is brought to the ED after a motor vehicle accident and is in severe
pain. Which order for morphine sulfate 4 mg IV push should the nurse question?
a. Administer over 1 to 2 minutes.
,b. Monitor for respiratory depression.
c. Administer intramuscularly for faster absorption.
d. Reassess pain level 15 to 30 minutes after administration.
Correct Solution: c. Administer intramuscularly for faster absorption.
Rationale: IV route provides fastest onset; IM absorption is erratic and slower. IV is
preferred for acute severe pain.
6. A patient is taking acetaminophen (Tylenol) 650 mg every 6 hours for
osteoarthritis pain. The nurse reviews the patient's history and notes which finding
as a priority concern?
a. History of peptic ulcer disease
b. History of chronic alcoholism
c. History of hypertension
d. History of asthma
Correct Solution: b. History of chronic alcoholism
Rationale: Chronic alcohol use increases risk of hepatotoxicity from acetaminophen due
to depleted glutathione stores.
7. The nurse is administering an NSAID to a patient. The patient asks, "How does
this medication help my pain?" What is the nurse's best response?
a. "It blocks pain receptors in your brain similar to how morphine works."
b. "It inhibits the production of prostaglandins that cause pain and inflammation."
c. "It increases serotonin levels to help you ignore the pain."
d. "It relaxes the smooth muscles in your blood vessels."
Correct Solution: b. "It inhibits the production of prostaglandins that cause pain
and inflammation."
Rationale: NSAIDs inhibit COX enzymes, reducing prostaglandin synthesis.
, 8. A patient with a history of MI two years ago reports joint pain and requests
ibuprofen. What is the nurse's priority action?
a. Administer the ibuprofen as ordered.
b. Contact the healthcare provider to suggest naproxen instead.
c. Instruct the patient to take the ibuprofen with food.
d. Contact the healthcare provider to discuss a possible alternative to NSAIDs.
Correct Solution: d. Contact the healthcare provider to discuss a possible
alternative to NSAIDs.
Rationale: NSAIDs increase cardiovascular risk in patients with history of MI;
acetaminophen or other alternatives should be considered.
9. A patient is receiving pentazocine (Talwin), a mixed opioid agonist-antagonist.
The nurse understands a major disadvantage of this type of medication is:
a. It has a higher risk of respiratory depression than pure agonists.
b. It has a ceiling effect for analgesia.
c. It cannot be given orally.
d. It has no risk of physical dependence.
Correct Solution: b. It has a ceiling effect for analgesia.
Rationale: Mixed agonist-antagonists have a ceiling effect—after a certain dose,
increasing the dose does not increase analgesia.
10. The nurse is caring for a patient receiving naloxone (Narcan) to reverse
respiratory depression. After administration, the nurse should prioritize
monitoring for:
a. Hypertension and tachycardia
b. Severe constipation
c. Recurrence of respiratory depression
d. Hyperthermia
Correct Solution: c. Recurrence of respiratory depression
Rationale: Naloxone has a shorter duration of action than most opioids; respiratory
depression may recur as naloxone wears off.
