NCLEX-RN Pharmacology Made Easy
Pain & Inflammation Exam |
20 NGN-Style Practice Questions with
Detailed Rationales |
ATI-Inspired Nursing Study Guide
Question 1
Clinical Scenario
A 68-year-old woman with osteoarthritis reports worsening
bilateral knee pain that interferes with walking. Her medical
history includes hypertension, chronic kidney disease (stage 3),
and gastroesophageal reflux disease. Current medications
include lisinopril, hydrochlorothiazide, and omeprazole. The
provider prescribes ibuprofen 600 mg orally every 8 hours as
needed for pain.
Question Stem
Which nursing action is the highest priority before
administering the first dose of ibuprofen?
A. Assess the patient's most recent serum creatinine level.
,B. Administer the medication with milk.
C. Encourage increased dietary calcium intake.
D. Instruct the patient to avoid grapefruit juice.
Correct Answer
Correct Answer: A. Assess the patient's most recent serum
creatinine level.
Detailed Rationale
Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) that
inhibits cyclooxygenase (COX) enzymes, reducing prostaglandin
synthesis responsible for pain and inflammation. However,
prostaglandins also help maintain renal blood flow, especially in
patients with compromised kidney function. This patient has
stage 3 chronic kidney disease and is taking lisinopril and a
diuretic, a combination that increases the risk of NSAID-induced
acute kidney injury. Assessing renal function before initiating
therapy is the priority because impaired renal perfusion may
worsen existing kidney disease. Monitoring serum creatinine
and estimated glomerular filtration rate (eGFR) guides safe
medication use and helps determine whether an alternative
analgesic should be considered.
Option B is appropriate patient teaching because taking NSAIDs
with food or milk may decrease gastrointestinal irritation, but
this does not address the most immediate safety concern.
,Option C has no direct relationship to ibuprofen therapy. Option
D is incorrect because grapefruit juice is not a clinically
significant interaction with ibuprofen.
Nurses should also monitor blood pressure, gastrointestinal
bleeding, edema, and decreased urine output during therapy.
Older adults are particularly susceptible to NSAID-related renal
and gastrointestinal complications.
Learning Objectives
After completing this question, the learner should be able to:
• Identify patients at increased risk for NSAID-induced
kidney injury.
• Prioritize assessment before NSAID administration.
• Recognize the effects of prostaglandin inhibition on renal
perfusion.
Medication Safety Focus
Monitoring
Question 2
Clinical Scenario
A 45-year-old man is recovering after abdominal surgery. He
rates his incisional pain as 8/10. The provider prescribes
, morphine sulfate 2 mg IV every 2 hours as needed. Before
administration, the nurse notes the following assessment
findings:
• Respiratory rate: 8 breaths/min
• Oxygen saturation: 92% on room air
• Blood pressure: 110/68 mm Hg
• Heart rate: 76 beats/min
• Patient is difficult to arouse.
Question Stem
Which nursing action should the nurse take first?
A. Administer the prescribed morphine.
B. Notify the provider after administering oxygen.
C. Withhold morphine and assess the patient's airway and
respiratory status.
D. Reassess the patient's pain in one hour.
Correct Answer
Correct Answer: C. Withhold morphine and assess the
patient's airway and respiratory status.
Detailed Rationale
Pain & Inflammation Exam |
20 NGN-Style Practice Questions with
Detailed Rationales |
ATI-Inspired Nursing Study Guide
Question 1
Clinical Scenario
A 68-year-old woman with osteoarthritis reports worsening
bilateral knee pain that interferes with walking. Her medical
history includes hypertension, chronic kidney disease (stage 3),
and gastroesophageal reflux disease. Current medications
include lisinopril, hydrochlorothiazide, and omeprazole. The
provider prescribes ibuprofen 600 mg orally every 8 hours as
needed for pain.
Question Stem
Which nursing action is the highest priority before
administering the first dose of ibuprofen?
A. Assess the patient's most recent serum creatinine level.
,B. Administer the medication with milk.
C. Encourage increased dietary calcium intake.
D. Instruct the patient to avoid grapefruit juice.
Correct Answer
Correct Answer: A. Assess the patient's most recent serum
creatinine level.
Detailed Rationale
Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) that
inhibits cyclooxygenase (COX) enzymes, reducing prostaglandin
synthesis responsible for pain and inflammation. However,
prostaglandins also help maintain renal blood flow, especially in
patients with compromised kidney function. This patient has
stage 3 chronic kidney disease and is taking lisinopril and a
diuretic, a combination that increases the risk of NSAID-induced
acute kidney injury. Assessing renal function before initiating
therapy is the priority because impaired renal perfusion may
worsen existing kidney disease. Monitoring serum creatinine
and estimated glomerular filtration rate (eGFR) guides safe
medication use and helps determine whether an alternative
analgesic should be considered.
Option B is appropriate patient teaching because taking NSAIDs
with food or milk may decrease gastrointestinal irritation, but
this does not address the most immediate safety concern.
,Option C has no direct relationship to ibuprofen therapy. Option
D is incorrect because grapefruit juice is not a clinically
significant interaction with ibuprofen.
Nurses should also monitor blood pressure, gastrointestinal
bleeding, edema, and decreased urine output during therapy.
Older adults are particularly susceptible to NSAID-related renal
and gastrointestinal complications.
Learning Objectives
After completing this question, the learner should be able to:
• Identify patients at increased risk for NSAID-induced
kidney injury.
• Prioritize assessment before NSAID administration.
• Recognize the effects of prostaglandin inhibition on renal
perfusion.
Medication Safety Focus
Monitoring
Question 2
Clinical Scenario
A 45-year-old man is recovering after abdominal surgery. He
rates his incisional pain as 8/10. The provider prescribes
, morphine sulfate 2 mg IV every 2 hours as needed. Before
administration, the nurse notes the following assessment
findings:
• Respiratory rate: 8 breaths/min
• Oxygen saturation: 92% on room air
• Blood pressure: 110/68 mm Hg
• Heart rate: 76 beats/min
• Patient is difficult to arouse.
Question Stem
Which nursing action should the nurse take first?
A. Administer the prescribed morphine.
B. Notify the provider after administering oxygen.
C. Withhold morphine and assess the patient's airway and
respiratory status.
D. Reassess the patient's pain in one hour.
Correct Answer
Correct Answer: C. Withhold morphine and assess the
patient's airway and respiratory status.
Detailed Rationale
