ATI Pharmacology Made Easy
Pain & Inflammation Exam Questions |
20 Original NCLEX-RN Next Gen (NGN)
Practice Questions with Detailed
Rationales
| NSAIDs, Opioids, Corticosteroids,
DMARDs, Gout & Migraine
Pharmacology |
Nursing Exam Study Guide
Question 1
Clinical Scenario
A 28-year-old woman is admitted with severe postoperative
pain following an appendectomy. The provider prescribes
morphine 4 mg IV every 3 hours as needed. Before
administration, the nurse assesses the client and notes a
,respiratory rate of 10/min, oxygen saturation of 92% on room
air, and sedation score indicating the client is difficult to arouse.
Question Stem
Which action should the nurse take first?
A. Administer the prescribed morphine dose
B. Encourage the client to take deep breaths
C. Withhold morphine and notify the provider
D. Reassess pain in 1 hour
Correct Answer
C. Withhold morphine and notify the provider
Detailed Rationale
Opioids such as morphine can cause dose-dependent
respiratory depression and excessive sedation. A respiratory
rate of 10/min combined with difficulty arousing the client
suggests opioid-induced respiratory compromise. The nurse
should withhold the medication and notify the provider
immediately. Additional interventions may include
administering supplemental oxygen, increasing monitoring, and
preparing naloxone if necessary.
Option A is unsafe because administering morphine could
worsen respiratory depression. Option B may be appropriate
,later but does not address the immediate safety concern.
Option D delays intervention and places the client at risk.
Assessment of sedation level is often a more sensitive indicator
of opioid toxicity than pain rating alone. Nurses should always
evaluate respiratory status before administering opioids,
particularly IV formulations.
Learning Objective
After completing this question, the learner should be able to:
• Identify signs of opioid-induced respiratory depression.
• Prioritize nursing interventions for opioid safety.
• Assess respiratory status before opioid administration.
• Recognize when to notify the provider.
Medication Safety Focus
Monitoring
Question 2
Clinical Scenario
A 72-year-old client with osteoarthritis takes ibuprofen daily for
knee pain. The client reports black, tarry stools and increasing
fatigue over the past week.
Question Stem
, Which adverse effect of ibuprofen should the nurse suspect?
A. Gastrointestinal bleeding
B. Hyperthyroidism
C. Urinary retention
D. Hypoglycemia
Correct Answer
A. Gastrointestinal bleeding
Detailed Rationale
NSAIDs such as ibuprofen inhibit cyclooxygenase (COX)
enzymes, decreasing prostaglandin synthesis. While this
reduces pain and inflammation, it also decreases protective
gastric mucus production, increasing the risk of gastric
ulceration and gastrointestinal bleeding.
Black, tarry stools (melena) suggest upper GI bleeding. Fatigue
may indicate blood loss anemia. Older adults are particularly
vulnerable to NSAID-related GI complications.
Option B is unrelated to NSAID therapy. Option C is more
commonly associated with anticholinergic medications. Option
D is not a typical effect of ibuprofen.
The nurse should hold further NSAID administration, assess vital
signs, monitor hemoglobin and hematocrit levels, and notify
the provider.
Pain & Inflammation Exam Questions |
20 Original NCLEX-RN Next Gen (NGN)
Practice Questions with Detailed
Rationales
| NSAIDs, Opioids, Corticosteroids,
DMARDs, Gout & Migraine
Pharmacology |
Nursing Exam Study Guide
Question 1
Clinical Scenario
A 28-year-old woman is admitted with severe postoperative
pain following an appendectomy. The provider prescribes
morphine 4 mg IV every 3 hours as needed. Before
administration, the nurse assesses the client and notes a
,respiratory rate of 10/min, oxygen saturation of 92% on room
air, and sedation score indicating the client is difficult to arouse.
Question Stem
Which action should the nurse take first?
A. Administer the prescribed morphine dose
B. Encourage the client to take deep breaths
C. Withhold morphine and notify the provider
D. Reassess pain in 1 hour
Correct Answer
C. Withhold morphine and notify the provider
Detailed Rationale
Opioids such as morphine can cause dose-dependent
respiratory depression and excessive sedation. A respiratory
rate of 10/min combined with difficulty arousing the client
suggests opioid-induced respiratory compromise. The nurse
should withhold the medication and notify the provider
immediately. Additional interventions may include
administering supplemental oxygen, increasing monitoring, and
preparing naloxone if necessary.
Option A is unsafe because administering morphine could
worsen respiratory depression. Option B may be appropriate
,later but does not address the immediate safety concern.
Option D delays intervention and places the client at risk.
Assessment of sedation level is often a more sensitive indicator
of opioid toxicity than pain rating alone. Nurses should always
evaluate respiratory status before administering opioids,
particularly IV formulations.
Learning Objective
After completing this question, the learner should be able to:
• Identify signs of opioid-induced respiratory depression.
• Prioritize nursing interventions for opioid safety.
• Assess respiratory status before opioid administration.
• Recognize when to notify the provider.
Medication Safety Focus
Monitoring
Question 2
Clinical Scenario
A 72-year-old client with osteoarthritis takes ibuprofen daily for
knee pain. The client reports black, tarry stools and increasing
fatigue over the past week.
Question Stem
, Which adverse effect of ibuprofen should the nurse suspect?
A. Gastrointestinal bleeding
B. Hyperthyroidism
C. Urinary retention
D. Hypoglycemia
Correct Answer
A. Gastrointestinal bleeding
Detailed Rationale
NSAIDs such as ibuprofen inhibit cyclooxygenase (COX)
enzymes, decreasing prostaglandin synthesis. While this
reduces pain and inflammation, it also decreases protective
gastric mucus production, increasing the risk of gastric
ulceration and gastrointestinal bleeding.
Black, tarry stools (melena) suggest upper GI bleeding. Fatigue
may indicate blood loss anemia. Older adults are particularly
vulnerable to NSAID-related GI complications.
Option B is unrelated to NSAID therapy. Option C is more
commonly associated with anticholinergic medications. Option
D is not a typical effect of ibuprofen.
The nurse should hold further NSAID administration, assess vital
signs, monitor hemoglobin and hematocrit levels, and notify
the provider.
