NCLEX-RN Pharmacology Practice
Questions
Pain and Inflammation
20 Original NCLEX Next Generation
(NGN) MCQs with Detailed Rationales
ATI Pharmacology Made Easy Review |
Nursing Exam Prep PDF
Question 1
Clinical Scenario
A 68-year-old woman with osteoarthritis reports persistent
bilateral knee pain rated 7/10 despite nonpharmacologic
measures. Her medical history includes hypertension, stage 3
chronic kidney disease (eGFR 48 mL/min/1.73 m²), and
gastroesophageal reflux disease. Current medications include
lisinopril, hydrochlorothiazide, and omeprazole. The provider
prescribes acetaminophen 650 mg orally every 6 hours as
,needed for pain. The client asks why acetaminophen was
selected instead of ibuprofen.
Question Stem
Which response by the nurse is most appropriate?
A. "Ibuprofen is avoided because it may worsen kidney function
and increase your risk for gastrointestinal bleeding."
B. "Acetaminophen completely eliminates inflammation,
making it the preferred treatment for osteoarthritis."
C. "Ibuprofen is contraindicated in all adults over 65 years of
age."
D. "Acetaminophen is more effective than NSAIDs for reducing
joint inflammation."
Correct Answer
Correct Answer: A. "Ibuprofen is avoided because it may
worsen kidney function and increase your risk for
gastrointestinal bleeding."
Detailed Rationale
Acetaminophen is commonly recommended as an initial
analgesic for mild to moderate osteoarthritis pain, particularly
in patients with chronic kidney disease or increased
gastrointestinal risk. NSAIDs such as ibuprofen inhibit
cyclooxygenase (COX) enzymes, decreasing prostaglandin
,synthesis. While this reduces inflammation and pain,
prostaglandins also help maintain renal blood flow and protect
the gastric mucosa. In older adults with chronic kidney disease,
NSAIDs may precipitate acute kidney injury, worsen
hypertension, promote fluid retention, and increase the risk of
gastrointestinal ulceration and bleeding. The nurse should
explain that acetaminophen provides analgesic and antipyretic
effects without these renal and gastrointestinal risks when used
within recommended doses.
Option B is incorrect because acetaminophen has minimal anti-
inflammatory activity and should not be described as
eliminating inflammation.
Option C is incorrect because NSAIDs are not absolutely
contraindicated solely due to age; instead, clinicians carefully
weigh risks and benefits.
Option D is incorrect because NSAIDs are generally more
effective than acetaminophen for inflammatory pain.
Acetaminophen was selected primarily because of the client's
comorbidities and overall safety profile.
Patient teaching should include avoiding duplicate
acetaminophen-containing products and limiting total daily
intake to reduce hepatotoxicity risk.
Learning Objectives
, After completing this question, the learner should be able to:
• Explain why acetaminophen may be preferred over NSAIDs
in chronic kidney disease.
• Identify renal and gastrointestinal risks associated with
NSAID therapy.
• Educate patients regarding safe acetaminophen dosing.
Medication Safety Focus
Contraindication and patient education
Question 2
Clinical Scenario
A 54-year-old man is admitted with severe acute gout affecting
his right great toe. He rates the pain as 9/10. His medical
history includes hypertension and peptic ulcer disease. The
provider prescribes colchicine. Before administering the
medication, the nurse reviews the patient's assessment
findings.
Question Stem
Which finding requires the nurse to notify the provider before
administering colchicine?
A. Temperature of 37.2°C (99°F)
Questions
Pain and Inflammation
20 Original NCLEX Next Generation
(NGN) MCQs with Detailed Rationales
ATI Pharmacology Made Easy Review |
Nursing Exam Prep PDF
Question 1
Clinical Scenario
A 68-year-old woman with osteoarthritis reports persistent
bilateral knee pain rated 7/10 despite nonpharmacologic
measures. Her medical history includes hypertension, stage 3
chronic kidney disease (eGFR 48 mL/min/1.73 m²), and
gastroesophageal reflux disease. Current medications include
lisinopril, hydrochlorothiazide, and omeprazole. The provider
prescribes acetaminophen 650 mg orally every 6 hours as
,needed for pain. The client asks why acetaminophen was
selected instead of ibuprofen.
Question Stem
Which response by the nurse is most appropriate?
A. "Ibuprofen is avoided because it may worsen kidney function
and increase your risk for gastrointestinal bleeding."
B. "Acetaminophen completely eliminates inflammation,
making it the preferred treatment for osteoarthritis."
C. "Ibuprofen is contraindicated in all adults over 65 years of
age."
D. "Acetaminophen is more effective than NSAIDs for reducing
joint inflammation."
Correct Answer
Correct Answer: A. "Ibuprofen is avoided because it may
worsen kidney function and increase your risk for
gastrointestinal bleeding."
Detailed Rationale
Acetaminophen is commonly recommended as an initial
analgesic for mild to moderate osteoarthritis pain, particularly
in patients with chronic kidney disease or increased
gastrointestinal risk. NSAIDs such as ibuprofen inhibit
cyclooxygenase (COX) enzymes, decreasing prostaglandin
,synthesis. While this reduces inflammation and pain,
prostaglandins also help maintain renal blood flow and protect
the gastric mucosa. In older adults with chronic kidney disease,
NSAIDs may precipitate acute kidney injury, worsen
hypertension, promote fluid retention, and increase the risk of
gastrointestinal ulceration and bleeding. The nurse should
explain that acetaminophen provides analgesic and antipyretic
effects without these renal and gastrointestinal risks when used
within recommended doses.
Option B is incorrect because acetaminophen has minimal anti-
inflammatory activity and should not be described as
eliminating inflammation.
Option C is incorrect because NSAIDs are not absolutely
contraindicated solely due to age; instead, clinicians carefully
weigh risks and benefits.
Option D is incorrect because NSAIDs are generally more
effective than acetaminophen for inflammatory pain.
Acetaminophen was selected primarily because of the client's
comorbidities and overall safety profile.
Patient teaching should include avoiding duplicate
acetaminophen-containing products and limiting total daily
intake to reduce hepatotoxicity risk.
Learning Objectives
, After completing this question, the learner should be able to:
• Explain why acetaminophen may be preferred over NSAIDs
in chronic kidney disease.
• Identify renal and gastrointestinal risks associated with
NSAID therapy.
• Educate patients regarding safe acetaminophen dosing.
Medication Safety Focus
Contraindication and patient education
Question 2
Clinical Scenario
A 54-year-old man is admitted with severe acute gout affecting
his right great toe. He rates the pain as 9/10. His medical
history includes hypertension and peptic ulcer disease. The
provider prescribes colchicine. Before administering the
medication, the nurse reviews the patient's assessment
findings.
Question Stem
Which finding requires the nurse to notify the provider before
administering colchicine?
A. Temperature of 37.2°C (99°F)
