NCLEX-RN Pharmacology Pain &
Inflammation Exam |
Original NGN Practice Questions with
Detailed Rationales |
ATI-Style Nursing Test Bank Study Guide
Question 1
Clinical Scenario
A 45-year-old client with osteoarthritis reports bilateral knee
pain rated 7/10. The provider prescribes ibuprofen 600 mg
orally every 6 hours as needed. The client has a history of peptic
ulcer disease and hypertension.
Question Stem
Which assessment finding should cause the nurse to question
the prescription?
A. Blood pressure of 146/88 mm Hg
B. History of gastric ulcer disease
C. Pain score of 7/10
D. Age older than 40 years
,Correct Answer
B. History of gastric ulcer disease
Detailed Rationale
Nonsteroidal anti-inflammatory drugs (NSAIDs), including
ibuprofen, inhibit cyclooxygenase (COX) enzymes and reduce
prostaglandin production. Although this mechanism decreases
inflammation and pain, prostaglandins also protect the gastric
mucosa by promoting mucus production and maintaining
gastric blood flow. A history of peptic ulcer disease significantly
increases the risk of gastrointestinal bleeding and ulcer
recurrence when NSAIDs are used.
Option A is incorrect because mild hypertension requires
monitoring but is not an absolute contraindication. Option C
supports the need for analgesia and does not require
questioning the order. Option D is incorrect because age greater
than 40 alone does not contraindicate ibuprofen.
The nurse should notify the provider and consider alternatives
such as acetaminophen or adding gastroprotective therapy if
NSAID treatment is necessary. Teaching should include
monitoring for black stools, hematemesis, and abdominal pain.
Learning Objectives
After completing this question, the learner should be able to:
• Identify contraindications to NSAID therapy.
, • Recognize risk factors for gastrointestinal bleeding.
• Apply medication safety principles when administering
analgesics.
Medication Safety Focus
Contraindication
Question 2
Clinical Scenario
A 70-year-old client with rheumatoid arthritis is prescribed
long-term prednisone therapy. The client asks why periodic
bone density testing is necessary.
Question Stem
Which response by the nurse is most appropriate?
A. "Prednisone may cause severe liver damage."
B. "Prednisone can increase your risk for osteoporosis."
C. "Prednisone commonly causes kidney stones."
D. "Prednisone directly destroys cartilage."
Correct Answer
B. "Prednisone can increase your risk for osteoporosis."
Detailed Rationale
Inflammation Exam |
Original NGN Practice Questions with
Detailed Rationales |
ATI-Style Nursing Test Bank Study Guide
Question 1
Clinical Scenario
A 45-year-old client with osteoarthritis reports bilateral knee
pain rated 7/10. The provider prescribes ibuprofen 600 mg
orally every 6 hours as needed. The client has a history of peptic
ulcer disease and hypertension.
Question Stem
Which assessment finding should cause the nurse to question
the prescription?
A. Blood pressure of 146/88 mm Hg
B. History of gastric ulcer disease
C. Pain score of 7/10
D. Age older than 40 years
,Correct Answer
B. History of gastric ulcer disease
Detailed Rationale
Nonsteroidal anti-inflammatory drugs (NSAIDs), including
ibuprofen, inhibit cyclooxygenase (COX) enzymes and reduce
prostaglandin production. Although this mechanism decreases
inflammation and pain, prostaglandins also protect the gastric
mucosa by promoting mucus production and maintaining
gastric blood flow. A history of peptic ulcer disease significantly
increases the risk of gastrointestinal bleeding and ulcer
recurrence when NSAIDs are used.
Option A is incorrect because mild hypertension requires
monitoring but is not an absolute contraindication. Option C
supports the need for analgesia and does not require
questioning the order. Option D is incorrect because age greater
than 40 alone does not contraindicate ibuprofen.
The nurse should notify the provider and consider alternatives
such as acetaminophen or adding gastroprotective therapy if
NSAID treatment is necessary. Teaching should include
monitoring for black stools, hematemesis, and abdominal pain.
Learning Objectives
After completing this question, the learner should be able to:
• Identify contraindications to NSAID therapy.
, • Recognize risk factors for gastrointestinal bleeding.
• Apply medication safety principles when administering
analgesics.
Medication Safety Focus
Contraindication
Question 2
Clinical Scenario
A 70-year-old client with rheumatoid arthritis is prescribed
long-term prednisone therapy. The client asks why periodic
bone density testing is necessary.
Question Stem
Which response by the nurse is most appropriate?
A. "Prednisone may cause severe liver damage."
B. "Prednisone can increase your risk for osteoporosis."
C. "Prednisone commonly causes kidney stones."
D. "Prednisone directly destroys cartilage."
Correct Answer
B. "Prednisone can increase your risk for osteoporosis."
Detailed Rationale
