NRSG 3320 FINAL EXAM NEWEST 2026
ACTUAL EXAM| NRSG 3320 NURSING
CARE OF ADULTS 1 FINAL EXAM REVIEW
WITH COMPLETE 200 REAL EXAM
QUESTIONS AND CORRECT VERIFIED
ANSWERS WITH RATIONALS ALREADY
GRADED A+
EXAM FORMAT & TIPS
• Structure: Approximately 80–100 questions, including multiple-choice, select-all-
that-apply, medication calculations, and an unfolding case study.
• Time: You will have approximately 2 hours to complete the exam.
• Content Distribution: Roughly 20 questions cover the final modules
(immune/oncology/end-of-life), with the rest evenly distributed across all
previous modules.
• Focus: Know the disease process, risk factors, signs/symptoms,
complications, medical management, and nursing interventions for each
condition.
SECTION 1: PAIN MANAGEMENT (Questions 1–25)
1. How does pain affect elderly patients differently than younger adults?
, • Correct Answer: Elderly patients often experience depression and health issues
from immobility; they have slower drug metabolism and are at higher risk for
medication toxicity.
• Rationale: Age-related changes in renal and hepatic function slow drug
metabolism and excretion. Elderly patients may also underreport pain and
present with atypical symptoms.
2. What are the physiologic effects of unrelieved pain?
• Correct Answer: Increased heart rate, increased blood pressure, increased
cardiac output, increased vascular resistance, increased cortisol, immune
suppression, and hypercoagulation.
• Rationale: Unrelieved pain triggers the sympathetic nervous system, leading to
these changes. Chronic pain can also cause depression, isolation, and immobility-
related complications like DVT and constipation.
3. A patient with diabetes reports burning and tingling in their feet. What type of
pain is this?
• Correct Answer: Neuropathic pain (peripheral neuropathic pain).
• Rationale: Neuropathic pain results from damage to the peripheral or central
nervous system. Diabetic neuropathy is a classic example.
4. A patient with a surgical incision reports sharp, localized pain. What type of
pain is this?
• Correct Answer: Somatic nociceptive pain.
• Rationale: Somatic pain originates from skin, muscles, bones, and joints and is
typically described as sharp or aching.
5. A patient with appendicitis reports diffuse, cramping abdominal pain. What
type of pain is this?
• Correct Answer: Visceral nociceptive pain.
, • Rationale: Visceral pain originates from internal organs and is often described as
dull, cramping, or pressure-like.
6. What is the difference between acute and chronic pain?
• Correct Answer: Acute pain lasts less than 6 months; chronic pain lasts 6 months
or longer.
• Rationale: Acute pain serves as a warning signal; chronic pain persists beyond
normal healing time and can have a significant psychological impact.
7. A patient with cancer has both bone pain (somatic) and nerve compression pain
(neuropathic). What type of pain is this?
• Correct Answer: Mixed pain.
• Rationale: Mixed pain is a combination of nociceptive and neuropathic pain,
commonly seen in cancer patients.
8. What is the most reliable indicator of a patient's pain level?
• Correct Answer: The patient's self-report.
• Rationale: Pain is subjective; the patient's description is the gold standard for
assessment.
9. The nurse is assessing a patient's pain. What does the mnemonic "OLD CART"
stand for?
• Correct Answer: Onset, Location, Duration, Characteristics, Aggravating factors,
Relieving factors, Treatment.
• Rationale: This mnemonic ensures a comprehensive pain history.
10. When using a numeric pain scale, what is the correct range?
• Correct Answer: 0 to 10.
• Rationale: The scale should always start at 0 (no pain) and end at 10 (worst pain
imaginable).
, 11. The nurse is caring for a patient receiving morphine for severe postoperative
pain. What is the priority assessment?
• Correct Answer: Respiratory rate.
• Rationale: Opioids can cause respiratory depression. Monitoring respiratory rate
is the priority (ABCs).
12. A patient is prescribed patient-controlled analgesia (PCA). What is the nurse's
primary responsibility?
• Correct Answer: Monitor the patient's pain level, respiratory status, and sedation
level; ensure only the patient presses the button.
• Rationale: PCA allows patient control but requires vigilant monitoring for
complications like respiratory depression and oversedation.
13. What is the maximum daily dose of acetaminophen (Tylenol) to prevent
hepatotoxicity?
• Correct Answer: 4,000 mg per day.
• Rationale: Exceeding this dose can cause severe liver damage. Always assess for
other sources of acetaminophen.
14. What is the mechanism of action (MOA) of acetaminophen?
• Correct Answer: It prevents the formation of prostaglandins in the central
nervous system (CNS).
• Rationale: Acetaminophen is a COX inhibitor with minimal peripheral effect. It
relieves pain and reduces fever but is NOT anti-inflammatory.
15. What is the most common side effect of opioid therapy?
• Correct Answer: Constipation.
• Rationale: Opioids decrease gastrointestinal motility. Patients should be started
on a bowel regimen (stool softeners, increased fluids, fiber) proactively.
ACTUAL EXAM| NRSG 3320 NURSING
CARE OF ADULTS 1 FINAL EXAM REVIEW
WITH COMPLETE 200 REAL EXAM
QUESTIONS AND CORRECT VERIFIED
ANSWERS WITH RATIONALS ALREADY
GRADED A+
EXAM FORMAT & TIPS
• Structure: Approximately 80–100 questions, including multiple-choice, select-all-
that-apply, medication calculations, and an unfolding case study.
• Time: You will have approximately 2 hours to complete the exam.
• Content Distribution: Roughly 20 questions cover the final modules
(immune/oncology/end-of-life), with the rest evenly distributed across all
previous modules.
• Focus: Know the disease process, risk factors, signs/symptoms,
complications, medical management, and nursing interventions for each
condition.
SECTION 1: PAIN MANAGEMENT (Questions 1–25)
1. How does pain affect elderly patients differently than younger adults?
, • Correct Answer: Elderly patients often experience depression and health issues
from immobility; they have slower drug metabolism and are at higher risk for
medication toxicity.
• Rationale: Age-related changes in renal and hepatic function slow drug
metabolism and excretion. Elderly patients may also underreport pain and
present with atypical symptoms.
2. What are the physiologic effects of unrelieved pain?
• Correct Answer: Increased heart rate, increased blood pressure, increased
cardiac output, increased vascular resistance, increased cortisol, immune
suppression, and hypercoagulation.
• Rationale: Unrelieved pain triggers the sympathetic nervous system, leading to
these changes. Chronic pain can also cause depression, isolation, and immobility-
related complications like DVT and constipation.
3. A patient with diabetes reports burning and tingling in their feet. What type of
pain is this?
• Correct Answer: Neuropathic pain (peripheral neuropathic pain).
• Rationale: Neuropathic pain results from damage to the peripheral or central
nervous system. Diabetic neuropathy is a classic example.
4. A patient with a surgical incision reports sharp, localized pain. What type of
pain is this?
• Correct Answer: Somatic nociceptive pain.
• Rationale: Somatic pain originates from skin, muscles, bones, and joints and is
typically described as sharp or aching.
5. A patient with appendicitis reports diffuse, cramping abdominal pain. What
type of pain is this?
• Correct Answer: Visceral nociceptive pain.
, • Rationale: Visceral pain originates from internal organs and is often described as
dull, cramping, or pressure-like.
6. What is the difference between acute and chronic pain?
• Correct Answer: Acute pain lasts less than 6 months; chronic pain lasts 6 months
or longer.
• Rationale: Acute pain serves as a warning signal; chronic pain persists beyond
normal healing time and can have a significant psychological impact.
7. A patient with cancer has both bone pain (somatic) and nerve compression pain
(neuropathic). What type of pain is this?
• Correct Answer: Mixed pain.
• Rationale: Mixed pain is a combination of nociceptive and neuropathic pain,
commonly seen in cancer patients.
8. What is the most reliable indicator of a patient's pain level?
• Correct Answer: The patient's self-report.
• Rationale: Pain is subjective; the patient's description is the gold standard for
assessment.
9. The nurse is assessing a patient's pain. What does the mnemonic "OLD CART"
stand for?
• Correct Answer: Onset, Location, Duration, Characteristics, Aggravating factors,
Relieving factors, Treatment.
• Rationale: This mnemonic ensures a comprehensive pain history.
10. When using a numeric pain scale, what is the correct range?
• Correct Answer: 0 to 10.
• Rationale: The scale should always start at 0 (no pain) and end at 10 (worst pain
imaginable).
, 11. The nurse is caring for a patient receiving morphine for severe postoperative
pain. What is the priority assessment?
• Correct Answer: Respiratory rate.
• Rationale: Opioids can cause respiratory depression. Monitoring respiratory rate
is the priority (ABCs).
12. A patient is prescribed patient-controlled analgesia (PCA). What is the nurse's
primary responsibility?
• Correct Answer: Monitor the patient's pain level, respiratory status, and sedation
level; ensure only the patient presses the button.
• Rationale: PCA allows patient control but requires vigilant monitoring for
complications like respiratory depression and oversedation.
13. What is the maximum daily dose of acetaminophen (Tylenol) to prevent
hepatotoxicity?
• Correct Answer: 4,000 mg per day.
• Rationale: Exceeding this dose can cause severe liver damage. Always assess for
other sources of acetaminophen.
14. What is the mechanism of action (MOA) of acetaminophen?
• Correct Answer: It prevents the formation of prostaglandins in the central
nervous system (CNS).
• Rationale: Acetaminophen is a COX inhibitor with minimal peripheral effect. It
relieves pain and reduces fever but is NOT anti-inflammatory.
15. What is the most common side effect of opioid therapy?
• Correct Answer: Constipation.
• Rationale: Opioids decrease gastrointestinal motility. Patients should be started
on a bowel regimen (stool softeners, increased fluids, fiber) proactively.
