NCLEX-RN Pharmacology Practice
Questions
Pain & Inflammation
20 Original NCLEX Next Gen (NGN)
MCQs with Detailed Rationales
Nursing Exam Study Guide |
ATI Pharmacology Made Easy Review
Question 1 (Easy)
Clinical Scenario
A 54-year-old woman with osteoarthritis reports bilateral knee
pain rated 6/10. Her health history includes hypertension
controlled with lisinopril. The provider prescribes ibuprofen 400
mg orally every 6 hours as needed for pain. Vital signs are
stable. Baseline serum creatinine is 0.9 mg/dL. The client asks
how to take the medication safely.
Question Stem
,Which statement by the nurse is the best patient teaching
regarding ibuprofen therapy?
A. "Take the medication on an empty stomach for faster
absorption."
B. "Stop taking the medication if your pain improves after one
dose."
C. "Take the medication with food or milk to help reduce
stomach irritation."
D. "Double the next dose if one dose does not relieve your
pain."
Correct Answer
C. Take the medication with food or milk to help reduce
stomach irritation.
Detailed Rationale
Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) that
inhibits cyclooxygenase (COX) enzymes, decreasing
prostaglandin synthesis responsible for pain, inflammation, and
fever. Although ibuprofen may be taken without food,
administering it with food or milk decreases gastrointestinal
irritation and may reduce the risk of dyspepsia, gastritis, and
peptic ulcer formation. Patients should also be instructed to use
the lowest effective dose for the shortest duration necessary
because prolonged NSAID use increases the risks of
,gastrointestinal bleeding, cardiovascular events, and kidney
injury. Adequate hydration should be encouraged, particularly
in older adults or those taking antihypertensive medications.
Option A is incorrect because taking ibuprofen on an empty
stomach increases gastrointestinal irritation. Option B is
incorrect because the medication should be used as prescribed
whenever pain recurs within dosing guidelines; discontinuation
after one dose is unnecessary unless directed by the provider.
Option D is unsafe because doubling doses significantly
increases the likelihood of adverse effects without improving
safety or effectiveness. Nurses should reinforce adherence to
prescribed dosing intervals and educate patients to report black
stools, persistent abdominal pain, or vomiting blood promptly.
Learning Objectives
After completing this question, the learner should be able to:
• Explain appropriate administration of NSAIDs to reduce
gastrointestinal adverse effects.
• Identify common patient education points for ibuprofen
therapy.
• Recognize medication practices that increase the risk of
toxicity.
Medication Safety Focus: Patient education
, Question 2 (Easy)
Clinical Scenario
A 32-year-old man is admitted after sustaining a fractured tibia.
The provider prescribes morphine sulfate 4 mg IV every 4
hours as needed for severe pain. Before administering the
medication, the nurse assesses the client. Vital signs are blood
pressure 128/78 mm Hg, heart rate 82/min, respiratory rate
8/min, oxygen saturation 93% on room air, and pain 9/10.
Question Stem
Which nursing action is the priority?
A. Administer the morphine as prescribed.
B. Notify the provider and withhold the morphine.
C. Encourage the client to ambulate before receiving the
medication.
D. Administer acetaminophen instead of morphine without
notifying the provider.
Correct Answer
B. Notify the provider and withhold the morphine.
Detailed Rationale
Morphine is an opioid analgesic that binds primarily to mu-
opioid receptors, producing analgesia but also depressing the
Questions
Pain & Inflammation
20 Original NCLEX Next Gen (NGN)
MCQs with Detailed Rationales
Nursing Exam Study Guide |
ATI Pharmacology Made Easy Review
Question 1 (Easy)
Clinical Scenario
A 54-year-old woman with osteoarthritis reports bilateral knee
pain rated 6/10. Her health history includes hypertension
controlled with lisinopril. The provider prescribes ibuprofen 400
mg orally every 6 hours as needed for pain. Vital signs are
stable. Baseline serum creatinine is 0.9 mg/dL. The client asks
how to take the medication safely.
Question Stem
,Which statement by the nurse is the best patient teaching
regarding ibuprofen therapy?
A. "Take the medication on an empty stomach for faster
absorption."
B. "Stop taking the medication if your pain improves after one
dose."
C. "Take the medication with food or milk to help reduce
stomach irritation."
D. "Double the next dose if one dose does not relieve your
pain."
Correct Answer
C. Take the medication with food or milk to help reduce
stomach irritation.
Detailed Rationale
Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) that
inhibits cyclooxygenase (COX) enzymes, decreasing
prostaglandin synthesis responsible for pain, inflammation, and
fever. Although ibuprofen may be taken without food,
administering it with food or milk decreases gastrointestinal
irritation and may reduce the risk of dyspepsia, gastritis, and
peptic ulcer formation. Patients should also be instructed to use
the lowest effective dose for the shortest duration necessary
because prolonged NSAID use increases the risks of
,gastrointestinal bleeding, cardiovascular events, and kidney
injury. Adequate hydration should be encouraged, particularly
in older adults or those taking antihypertensive medications.
Option A is incorrect because taking ibuprofen on an empty
stomach increases gastrointestinal irritation. Option B is
incorrect because the medication should be used as prescribed
whenever pain recurs within dosing guidelines; discontinuation
after one dose is unnecessary unless directed by the provider.
Option D is unsafe because doubling doses significantly
increases the likelihood of adverse effects without improving
safety or effectiveness. Nurses should reinforce adherence to
prescribed dosing intervals and educate patients to report black
stools, persistent abdominal pain, or vomiting blood promptly.
Learning Objectives
After completing this question, the learner should be able to:
• Explain appropriate administration of NSAIDs to reduce
gastrointestinal adverse effects.
• Identify common patient education points for ibuprofen
therapy.
• Recognize medication practices that increase the risk of
toxicity.
Medication Safety Focus: Patient education
, Question 2 (Easy)
Clinical Scenario
A 32-year-old man is admitted after sustaining a fractured tibia.
The provider prescribes morphine sulfate 4 mg IV every 4
hours as needed for severe pain. Before administering the
medication, the nurse assesses the client. Vital signs are blood
pressure 128/78 mm Hg, heart rate 82/min, respiratory rate
8/min, oxygen saturation 93% on room air, and pain 9/10.
Question Stem
Which nursing action is the priority?
A. Administer the morphine as prescribed.
B. Notify the provider and withhold the morphine.
C. Encourage the client to ambulate before receiving the
medication.
D. Administer acetaminophen instead of morphine without
notifying the provider.
Correct Answer
B. Notify the provider and withhold the morphine.
Detailed Rationale
Morphine is an opioid analgesic that binds primarily to mu-
opioid receptors, producing analgesia but also depressing the
