NUR 155 FUNDAMENTALS OF NURSING COMPREHENSIVE EXAM QUESTIONS COMPLETE WITH 100% CORRECT ANSWERS AND DETAILED RATIONALE

NUR 155 FUNDAMENTALS OF NURSING COMPREHENSIVE EXAM QUESTIONS COMPLETE WITH 100% CORRECT ANSWERS AND DETAILED RATIONALE 1. A patient who underwent a below-knee amputation 3 days ago reports severe pain in the missing foot. Which type of pain is this patient most likely experiencing? A) Visceral pain B) Referred pain C) Deep somatic pain D) Phantom pain Answer: D) Phantom pain Rationale: Phantom pain is pain that is perceived to originate from a body part that has been removed. This patient had a below-knee amputation and is experiencing pain in the missing foot, which is characteristic of phantom pain. Visceral pain originates from internal organs. Referred pain is felt at a site distant from the origin. Deep somatic pain arises from bones, ligaments, and tendons. ________________________________________ 2. The nurse is delegating tasks to nursing assistive personnel (NAP). Which task is appropriate for the nurse to delegate? A) Evaluating the effectiveness of a pain medication B) Administering oral over-the-counter pain medication C) Developing a plan of care for pain management D) Asking the patient about pain while obtaining vital signs Answer: D) Asking the patient about pain while obtaining vital signs Rationale: The nurse can delegate the task of asking about pain when NAP obtain vital signs, with instruction to report findings to the nurse promptly. Evaluation of medication effectiveness, developing care plans, and administering medications (including OTC) are responsibilities of the licensed nurse, not NAP. ________________________________________ 3. A patient with a history of which condition requires the nurse to exercise caution when administering acetaminophen (Tylenol)? A) Asthma B) Hepatitis C C) Gastric ulcer D) Renal insufficiency Answer: B) Hepatitis C Rationale: Acetaminophen can cause severe hepatotoxicity in patients with liver disease, including hepatitis C. Even in recommended doses, patients with liver impairment are at increased risk. While caution is needed with alcohol use, acetaminophen is generally safe for patients with gastric ulcers and does not significantly affect renal function. ________________________________________ 4. Before administering morphine 2 mg intravenously to a patient reporting postoperative pain, which action should the nurse take first? A) Assess the patient's pain level on a 0-10 scale B) Check the patient's blood pressure C) Assess the patient's respiratory rate and depth D) Review the patient's allergy history Answer: C) Assess the patient's respiratory rate and depth Rationale: Before administering an opioid analgesic like morphine, the nurse must assess respiratory status because opioids can cause respiratory depression. While pain assessment and allergy review are important, respiratory assessment is the priority safety measure before opioid administration. ________________________________________ 5. The nurse is preparing patient-controlled analgesia (PCA) for a postoperative patient. Which action is essential for patient safety? A) Instruct the patient to limit dosing to every 4 hours B) Ask another nurse to verify the PCA pump settings C) Teach the patient to press the button only when pain is severe D) Program the pump to allow unlimited dosing attempts Answer: B) Ask another nurse to verify the PCA pump settings Rationale: Having another nurse double-check the PCA setup is a critical safety measure to prevent dosing errors. The PCA pump has a lockout feature to prevent overdose. Patients should be instructed to dose before painful activities, not just when pain is severe. PCA is contraindicated for cognitively impaired patients. ________________________________________ 6. The nurse administers codeine 30 mg orally to a patient. When should the nurse reassess the patient's pain level? A) Immediately after administration B) 10 minutes after administration C) 30 minutes after administration D) 60 minutes after administration Answer: D) 60 minutes after administration Rationale: Oral codeine reaches peak concentration in approximately 60 minutes, so pain reassessment should occur at that time. IM or subcutaneous routes peak in 10 minutes. IV administration is almost immediate, but codeine is not recommended for IV use. ________________________________________ 7. Which medication is uniquely indicated to inhibit platelet aggregation in a patient at risk for thrombophlebitis? A) Ibuprofen (Motrin) B) Celecoxib (Celebrex) C) Aspirin (Ecotrin) D) Naproxen (Aleve) Answer: C) Aspirin (Ecotrin) Rationale: Aspirin uniquely inhibits platelet aggregation among NSAIDs. Low-dose aspirin therapy is used to decrease risk of thrombophlebitis, myocardial infarction, and stroke. Ibuprofen, celecoxib, and naproxen do not have this antiplatelet effect. ________________________________________ 8. A patient receiving epidural analgesia reports nausea, decreased blood pressure, and loss of motor function in the legs. What complication should the nurse suspect?