NCLEX-RN Pharmacology Practice
Questions |
Pain & Inflammation |
20 Original ATI & NGN-Style MCQs with
Detailed Rationales |
NSAIDs, Opioids, Corticosteroids,
Acetaminophen |
Nursing Exam Prep 2026–2027
Question 1
Easy
Clinical Scenario
A 52-year-old woman is prescribed ibuprofen 400 mg orally
every 6 hours as needed for osteoarthritis pain. She asks the
nurse how the medication works.
,Question Stem
Which explanation by the nurse is most accurate?
• A. “It blocks opioid receptors in the brain to reduce pain.”
• B. “It inhibits cyclooxygenase enzymes, reducing
prostaglandin production.”
• C. “It increases serotonin levels in the central nervous
system.”
• D. “It relaxes skeletal muscles around painful joints.”
Correct Answer
B
B. “It inhibits cyclooxygenase enzymes, reducing prostaglandin
production.”
Detailed Rationale
Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID). It
works by inhibiting cyclooxygenase (COX-1 and COX-2) enzymes,
which decreases prostaglandin synthesis. Prostaglandins
contribute to pain, inflammation, and fever, so reducing their
production provides analgesic and anti-inflammatory effects.
Option A is incorrect because opioid receptor blockade would
increase, not decrease, pain perception. NSAIDs do not act on
opioid receptors.
,Option C is incorrect because increasing serotonin levels is
associated with certain antidepressants, not ibuprofen.
Option D is incorrect because muscle relaxation is the action of
skeletal muscle relaxants such as cyclobenzaprine, not NSAIDs.
Nurses should teach patients that NSAIDs should be taken with
food or milk to reduce gastrointestinal irritation and that long-
term use may increase the risk of GI bleeding, renal
impairment, and cardiovascular events. Monitoring for black
stools, abdominal pain, decreased urine output, and elevated
blood pressure is important during therapy.
Learning Objective
• Describe the mechanism of action of ibuprofen.
• Differentiate NSAIDs from opioid analgesics.
• Identify key patient teaching points for NSAID therapy.
Medication Safety Focus
Patient education
# Question 2
Moderate
Clinical Scenario
, A 68-year-old man with chronic kidney disease is receiving
ketorolac for postoperative pain. His creatinine has increased
from 1.4 mg/dL to 2.2 mg/dL.
Question Stem
Which nursing action is the priority?
• A. Administer the next dose with food
• B. Encourage increased oral fluid intake
• C. Hold the medication and notify the provider
• D. Obtain a stool specimen for occult blood
Correct Answer
C
C. Hold the medication and notify the provider
Detailed Rationale
Ketorolac is a potent NSAID associated with significant
nephrotoxicity. An acute rise in creatinine indicates worsening
renal function. The priority nursing action is to hold the
medication and notify the provider to prevent further kidney
injury.
Option A is insufficient because administering the drug with
food may reduce GI irritation but does not address renal
impairment.
Questions |
Pain & Inflammation |
20 Original ATI & NGN-Style MCQs with
Detailed Rationales |
NSAIDs, Opioids, Corticosteroids,
Acetaminophen |
Nursing Exam Prep 2026–2027
Question 1
Easy
Clinical Scenario
A 52-year-old woman is prescribed ibuprofen 400 mg orally
every 6 hours as needed for osteoarthritis pain. She asks the
nurse how the medication works.
,Question Stem
Which explanation by the nurse is most accurate?
• A. “It blocks opioid receptors in the brain to reduce pain.”
• B. “It inhibits cyclooxygenase enzymes, reducing
prostaglandin production.”
• C. “It increases serotonin levels in the central nervous
system.”
• D. “It relaxes skeletal muscles around painful joints.”
Correct Answer
B
B. “It inhibits cyclooxygenase enzymes, reducing prostaglandin
production.”
Detailed Rationale
Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID). It
works by inhibiting cyclooxygenase (COX-1 and COX-2) enzymes,
which decreases prostaglandin synthesis. Prostaglandins
contribute to pain, inflammation, and fever, so reducing their
production provides analgesic and anti-inflammatory effects.
Option A is incorrect because opioid receptor blockade would
increase, not decrease, pain perception. NSAIDs do not act on
opioid receptors.
,Option C is incorrect because increasing serotonin levels is
associated with certain antidepressants, not ibuprofen.
Option D is incorrect because muscle relaxation is the action of
skeletal muscle relaxants such as cyclobenzaprine, not NSAIDs.
Nurses should teach patients that NSAIDs should be taken with
food or milk to reduce gastrointestinal irritation and that long-
term use may increase the risk of GI bleeding, renal
impairment, and cardiovascular events. Monitoring for black
stools, abdominal pain, decreased urine output, and elevated
blood pressure is important during therapy.
Learning Objective
• Describe the mechanism of action of ibuprofen.
• Differentiate NSAIDs from opioid analgesics.
• Identify key patient teaching points for NSAID therapy.
Medication Safety Focus
Patient education
# Question 2
Moderate
Clinical Scenario
, A 68-year-old man with chronic kidney disease is receiving
ketorolac for postoperative pain. His creatinine has increased
from 1.4 mg/dL to 2.2 mg/dL.
Question Stem
Which nursing action is the priority?
• A. Administer the next dose with food
• B. Encourage increased oral fluid intake
• C. Hold the medication and notify the provider
• D. Obtain a stool specimen for occult blood
Correct Answer
C
C. Hold the medication and notify the provider
Detailed Rationale
Ketorolac is a potent NSAID associated with significant
nephrotoxicity. An acute rise in creatinine indicates worsening
renal function. The priority nursing action is to hold the
medication and notify the provider to prevent further kidney
injury.
Option A is insufficient because administering the drug with
food may reduce GI irritation but does not address renal
impairment.
