Maryville University NURS 615:NURS 615 – EXAM 3 STUDY GUIDE (ANSWERS WITH RATIONALES) 2026

🧠(ANSWERS
NURS 615 – EXAM 3 STUDY GUIDE
WITH RATIONALES)

WEEK 8 – PAIN MANAGEMENT
1. First-Line Treatment for Acute Pain

✅
Q: What is first line for acute mild musculoskeletal pain?
Answer: NSAIDs (ibuprofen, naproxen) ± acetaminophen

💡Guidelines
Rationale:
recommend non-opioids FIRST. NSAIDs ↓ inflammation (main cause of
musculoskeletal pain).




2. NSAIDs BLACK BOX WARNING

✅
Q: Why do NSAIDs have a black box warning?
Answer:

 ↑ Risk of CV events (MI, stroke)
 ↑ Risk of GI bleeding, ulcer, perforation

💡COX-1
Rationale:
inhibition ↓ gastric protection; COX-2 imbalance → ↑ clot risk.




3. Salicylate Toxicity

✅
Q: First sign of aspirin toxicity?
Answer: Tinnitus

💡EarlyRationale:
CNS effect → ringing ears before metabolic changes.

, 4. Acetaminophen Toxicity

✅
Q: Signs of liver failure?
Answer:

 RUQ pain
 Jaundice
 Dark urine
 N/V

💡ToxicRationale:
metabolite (NAPQI) damages liver.




5. Opioid Receptors
Q: Difference between agonist vs partial vs antagonist?

Type Example Key Concept
Full agonist Morphine Full effect (high efficacy)
Partial agonist Buprenorphine Ceiling effect
Antagonist Naloxone Reversal

💡 Rationale:
 Affinity = binding
 Efficacy = activation




6. GOUT

✅
Q: First-line urate-lowering therapy?
Answer: Allopurinol


✅ Answer: Can trigger acute gout flare
Q: What happens when starting allopurinol?


💡RapidRationale:
uric acid shifts mobilize crystals.