PHARM HESI: PAIN MANAGEMENT &
MEDICATION PROTOCOLS QUESTIONS
AND ANSWERS WITH VERIFIED
SOLUTIONS 2026/2027 UPDATE. JUST
RELEASED
1. A patient receiving a continuous intravenous infusion of morphine sulfate exhibits a
respiratory rate of 8 breaths per minute and is lethargic. Which action should the nurse take
first?
A. Decrease the infusion rate by half.
B. Prepare to administer intravenous naloxone.
C. Administer a bolus of normal saline.
D. Assess the patient’s blood pressure and heart rate.
Answer: B
Conceptual Explanation: Respiratory depression (RR < 10) and altered level of
consciousness are signs of opioid toxicity. Naloxone is the opioid antagonist indicated to
reverse life-threatening respiratory depression.
,2. When teaching a patient about the maximum daily dose of acetaminophen for a healthy
adult, which value is correct according to the latest FDA guidelines to prevent hepatotoxicity?
A. 2,000 mg
B. 4,000 mg
C. 3,000 mg
D. 5,000 mg
Answer: B
Conceptual Explanation: The standard maximum daily dose for a healthy adult is 4,000
mg (4g). Exceeding this increases the risk of severe liver damage.
3. A patient is prescribed celecoxib for osteoarthritis. The nurse should notify the provider if
the patient has a known allergy to which of the following?
A. Penicillin
B. Shellfish
C. Sulfonamides
D. Latex
Answer: C
Conceptual Explanation: Celecoxib, a COX-2 inhibitor, contains a sulfonamide moiety and
is contraindicated in patients with a sulfa allergy.
, 4. Which assessment finding is the most sensitive early indicator of opioid-induced
respiratory depression?
A. Decrease in oxygen saturation (SpO2)
B. Pinpoint pupils
C. Change in the level of consciousness (sedation)
D. Increased carbon dioxide levels (EtCO2)
Answer: C
Conceptual Explanation: Sedation precedes respiratory depression. A patient who is
increasingly difficult to arouse is at high risk for impending respiratory failure.
5. A patient with chronic pain is being switched from oral morphine to a transdermal fentanyl
patch. Which instruction is vital for the nurse to include?
A. Apply a heating pad over the patch to increase absorption.
B. The patch will provide immediate pain relief within 30 minutes.
C. Fold the used patch with the adhesive sides together before disposal.
D. Avoid drinking grapefruit juice while using the patch.
Answer: C
Conceptual Explanation: Used patches contain significant residual medication and must
be disposed of safely (usually by folding and flushing or putting in a sharps container) to
MEDICATION PROTOCOLS QUESTIONS
AND ANSWERS WITH VERIFIED
SOLUTIONS 2026/2027 UPDATE. JUST
RELEASED
1. A patient receiving a continuous intravenous infusion of morphine sulfate exhibits a
respiratory rate of 8 breaths per minute and is lethargic. Which action should the nurse take
first?
A. Decrease the infusion rate by half.
B. Prepare to administer intravenous naloxone.
C. Administer a bolus of normal saline.
D. Assess the patient’s blood pressure and heart rate.
Answer: B
Conceptual Explanation: Respiratory depression (RR < 10) and altered level of
consciousness are signs of opioid toxicity. Naloxone is the opioid antagonist indicated to
reverse life-threatening respiratory depression.
,2. When teaching a patient about the maximum daily dose of acetaminophen for a healthy
adult, which value is correct according to the latest FDA guidelines to prevent hepatotoxicity?
A. 2,000 mg
B. 4,000 mg
C. 3,000 mg
D. 5,000 mg
Answer: B
Conceptual Explanation: The standard maximum daily dose for a healthy adult is 4,000
mg (4g). Exceeding this increases the risk of severe liver damage.
3. A patient is prescribed celecoxib for osteoarthritis. The nurse should notify the provider if
the patient has a known allergy to which of the following?
A. Penicillin
B. Shellfish
C. Sulfonamides
D. Latex
Answer: C
Conceptual Explanation: Celecoxib, a COX-2 inhibitor, contains a sulfonamide moiety and
is contraindicated in patients with a sulfa allergy.
, 4. Which assessment finding is the most sensitive early indicator of opioid-induced
respiratory depression?
A. Decrease in oxygen saturation (SpO2)
B. Pinpoint pupils
C. Change in the level of consciousness (sedation)
D. Increased carbon dioxide levels (EtCO2)
Answer: C
Conceptual Explanation: Sedation precedes respiratory depression. A patient who is
increasingly difficult to arouse is at high risk for impending respiratory failure.
5. A patient with chronic pain is being switched from oral morphine to a transdermal fentanyl
patch. Which instruction is vital for the nurse to include?
A. Apply a heating pad over the patch to increase absorption.
B. The patch will provide immediate pain relief within 30 minutes.
C. Fold the used patch with the adhesive sides together before disposal.
D. Avoid drinking grapefruit juice while using the patch.
Answer: C
Conceptual Explanation: Used patches contain significant residual medication and must
be disposed of safely (usually by folding and flushing or putting in a sharps container) to
