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
Chapter 10: Analgesic Drugs
MULTIPLE CHOICE
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
Answer: c. Mu (μ) receptors
Rationale: Morphine is an opioid agonist that primarily binds to mu (μ) receptors in the
central nervous system. This binding inhibits the transmission of pain signals, producing
analgesia, sedation, and euphoria. Alpha-adrenergic, dopamine, and serotonin receptors
are involved in other physiological processes but are not the primary targets for opioid
analgesia.
,2. A patient is receiving a continuous infusion of morphine via a patient-controlled
analgesia (PCA) pump. The nurse notes the patient’s respiratory rate has decreased
to 8 breaths per minute. Which medication should the nurse anticipate
administering?
a. Nalbuphine (Nubain)
b. Naltrexone (ReVia)
c. Naloxone (Narcan)
d. Acetylcysteine (Mucomyst)
Answer: c. Naloxone (Narcan)
Rationale: Naloxone is a pure opioid antagonist used to reverse life-threatening opioid-
induced respiratory depression. It competitively blocks opioid receptors. Nalbuphine is a
mixed agonist-antagonist that could precipitate withdrawal but is not the first-line
reversal agent for respiratory arrest. Naltrexone is an oral antagonist used for addiction
treatment. Acetylcysteine is used for acetaminophen overdose.
3. A patient with chronic cancer pain has been taking oxycodone (OxyContin) for
several weeks. The patient reports that 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
Answer: b. Tolerance
Rationale: Tolerance is a common physiologic response to opioids where a patient
requires a higher dose to achieve the same level of pain relief. It is not the same as
physical dependence (which involves withdrawal symptoms upon cessation) or addiction
(a psychological disorder characterized by compulsive drug use).
,4. A nurse is providing education to a patient who has been 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."
Answer: b. "I can drive my car as soon as I feel the effects of the medication wear
off."
Rationale: Opioids like codeine cause central nervous system (CNS) depression,
including drowsiness and altered cognitive function. Patients should not drive or
operate heavy machinery until they know how the drug affects them, and often not at all
while taking the medication, regardless of whether the "feeling" is gone. The other
statements are correct: fluids help with constipation, alcohol should be avoided due to
additive CNS depression, and slow position changes help prevent orthostatic
hypotension.
5. A patient is brought to the emergency department after a motor vehicle
accident. The patient 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.
, Answer: c. Administer intramuscularly for faster absorption.
Rationale: In an emergency setting or for acute severe pain, the IV route is preferred
over IM because it provides the fastest onset and predictable absorption. IM
administration has erratic absorption and is slower. The IV dose should be given slowly
(over 1-2 minutes) to prevent severe respiratory depression, and monitoring and
reassessment are standard of care.
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
Answer: b. History of chronic alcoholism
Rationale: Chronic alcohol use can deplete glutathione stores in the liver, increasing the
risk of hepatotoxicity from acetaminophen. The maximum daily dose should be reduced
(typically to 2,000-3,000 mg/day) for these patients. Peptic ulcer disease is a concern for
NSAIDs, not acetaminophen. Hypertension and asthma are not direct contraindications
for acetaminophen.
7. The nurse is administering a nonsteroidal anti-inflammatory drug (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."
Answers. NR 293 Exam 2 Practice Questions
Chapter 10: Analgesic Drugs Test Bank
MULTIPLE CHOICE
NR 293 Exam 2 Practice Questions
Chapter 10: Analgesic Drugs
MULTIPLE CHOICE
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
Answer: c. Mu (μ) receptors
Rationale: Morphine is an opioid agonist that primarily binds to mu (μ) receptors in the
central nervous system. This binding inhibits the transmission of pain signals, producing
analgesia, sedation, and euphoria. Alpha-adrenergic, dopamine, and serotonin receptors
are involved in other physiological processes but are not the primary targets for opioid
analgesia.
,2. A patient is receiving a continuous infusion of morphine via a patient-controlled
analgesia (PCA) pump. The nurse notes the patient’s respiratory rate has decreased
to 8 breaths per minute. Which medication should the nurse anticipate
administering?
a. Nalbuphine (Nubain)
b. Naltrexone (ReVia)
c. Naloxone (Narcan)
d. Acetylcysteine (Mucomyst)
Answer: c. Naloxone (Narcan)
Rationale: Naloxone is a pure opioid antagonist used to reverse life-threatening opioid-
induced respiratory depression. It competitively blocks opioid receptors. Nalbuphine is a
mixed agonist-antagonist that could precipitate withdrawal but is not the first-line
reversal agent for respiratory arrest. Naltrexone is an oral antagonist used for addiction
treatment. Acetylcysteine is used for acetaminophen overdose.
3. A patient with chronic cancer pain has been taking oxycodone (OxyContin) for
several weeks. The patient reports that 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
Answer: b. Tolerance
Rationale: Tolerance is a common physiologic response to opioids where a patient
requires a higher dose to achieve the same level of pain relief. It is not the same as
physical dependence (which involves withdrawal symptoms upon cessation) or addiction
(a psychological disorder characterized by compulsive drug use).
,4. A nurse is providing education to a patient who has been 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."
Answer: b. "I can drive my car as soon as I feel the effects of the medication wear
off."
Rationale: Opioids like codeine cause central nervous system (CNS) depression,
including drowsiness and altered cognitive function. Patients should not drive or
operate heavy machinery until they know how the drug affects them, and often not at all
while taking the medication, regardless of whether the "feeling" is gone. The other
statements are correct: fluids help with constipation, alcohol should be avoided due to
additive CNS depression, and slow position changes help prevent orthostatic
hypotension.
5. A patient is brought to the emergency department after a motor vehicle
accident. The patient 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.
, Answer: c. Administer intramuscularly for faster absorption.
Rationale: In an emergency setting or for acute severe pain, the IV route is preferred
over IM because it provides the fastest onset and predictable absorption. IM
administration has erratic absorption and is slower. The IV dose should be given slowly
(over 1-2 minutes) to prevent severe respiratory depression, and monitoring and
reassessment are standard of care.
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
Answer: b. History of chronic alcoholism
Rationale: Chronic alcohol use can deplete glutathione stores in the liver, increasing the
risk of hepatotoxicity from acetaminophen. The maximum daily dose should be reduced
(typically to 2,000-3,000 mg/day) for these patients. Peptic ulcer disease is a concern for
NSAIDs, not acetaminophen. Hypertension and asthma are not direct contraindications
for acetaminophen.
7. The nurse is administering a nonsteroidal anti-inflammatory drug (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."
