Mdc 1 Exam 2 Study Guide Rasmussen University
Complete Q&A With Verified Answers And Detailed
Rationales Pain Management 2026| Instant
Download - Complete 146 Verified Q&A with
Answers & Rationales for Exam Prep
Q1
Which assessment finding most strongly suggests neuropathic pain rather than nociceptive pain?
A. Pain described as aching and relieved by rest.
B. Pain accompanied by burning, tingling, and hyperalgesia.
C. Pain localized to a surgical incision site.
D. Pain that worsens with movement and improves with heat.
Answer: B
Rationale: Neuropathic pain arises from nerve injury and is characterized by burning, tingling, and
hyperalgesia, unlike nociceptive pain which is typically aching and responsive to rest or heat. Options A,
C, and D describe nociceptive or somatic pain patterns.
Q2
A patient with chronic cancer pain reports 8/10 despite scheduled long-acting morphine. What is the
priority nursing action?
A. Administer the prescribed PRN short-acting opioid and reassess.
B. Wait until the next scheduled long-acting dose.
C. Encourage distraction techniques only.
D. Contact the provider to increase the long-acting dose immediately.
Answer: A
Rationale: Breakthrough pain requires prompt administration of a short-acting opioid as prescribed,
followed by reassessment. Waiting or using only non-pharmacologic methods is inappropriate for severe
pain; contacting the provider for a dose change is not the immediate priority.
,Q3
Which patient is at highest risk for opioid-induced respiratory depression?
A. A patient with a history of substance use disorder.
B. A patient with obstructive sleep apnea receiving opioids.
C. A patient with hypertension on beta-blockers.
D. A patient with a fractured femur receiving NSAIDs.
Answer: B
Rationale: Obstructive sleep apnea increases sensitivity to opioids and risk of respiratory depression.
Substance use disorder increases risk of misuse but not necessarily respiratory depression; hypertension
and NSAID use are not direct risk factors.
Q4
Which non-pharmacological intervention is most appropriate for a patient with acute incisional pain?
A. Guided imagery and relaxation breathing.
B. Vigorous massage over the incision.
C. Application of ice directly to the wound.
D. Encouraging bed rest without movement.
Answer: A
Rationale: Guided imagery and relaxation are safe, effective adjuncts for acute pain. Massage over an
incision, direct ice application, and prolonged immobility may cause harm or complications.
Q5
A patient using PCA reports nausea and pruritus. Which action should the nurse take first?
A. Stop the PCA and administer naloxone.
B. Administer prescribed antiemetic and antipruritic, then reassess.
C. Increase the PCA demand dose.
D. Encourage the patient to use the PCA more frequently.
Answer: B
Rationale: Nausea and pruritus are common opioid side effects; treating them with prescribed
medications while continuing analgesia is appropriate. Naloxone is reserved for respiratory depression;
increasing PCA dose would worsen side effects.
,Q6
Which statement by a patient indicates correct understanding of epidural analgesia safety?
A. I will report any new back pain or leg weakness immediately.
B. I can ambulate without assistance after epidural placement.
C. I should not use the call button for minor discomfort.
D. I will apply heat to the epidural site for comfort.
Answer: A
Rationale: New back pain or leg weakness may indicate epidural hematoma or abscess and requires
immediate reporting. Ambulating unassisted is unsafe due to motor blockade; withholding calls or applying
heat is inappropriate.
Q7
Which pain assessment tool is most appropriate for a patient unable to self-report pain due to advanced
dementia?
A. Numeric Rating Scale
B. Wong-Baker FACES
C. PAINAD
D. Visual Analog Scale
Answer: C
Rationale: PAINAD is a behavioral tool validated for patients with dementia who cannot self-report.
Numeric, FACES, and visual analog scales require self-report and are unreliable in advanced dementia.
Q8
Which patient teaching is essential before discharge on around-the-clock oral opioids?
A. Increase the dose if pain is not relieved within 10 minutes.
B. Take a stool softener and increase fluid and fiber intake.
C. Stop the medication abruptly when pain subsides.
D. Avoid all other medications to prevent interactions.
Answer: B
Rationale: Opioids cause constipation; preventive bowel management with stool softeners, fluids, and
fiber is essential. Dose escalation without guidance, abrupt cessation, and avoiding all other medications
are unsafe or incorrect.
, Q9
Which cultural consideration is most important when assessing pain in a patient from a culture that values
stoicism?
A. Assume the patient is not experiencing significant pain.
B. Use a formal pain scale and observe for nonverbal cues.
C. Avoid asking about pain to respect cultural norms.
D. Rely solely on family reports of pain.
Answer: B
Rationale: Cultural stoicism may lead to underreporting; using validated scales and observing nonverbal
cues improves assessment. Assuming no pain, avoiding inquiry, or relying solely on family is unsafe and
culturally insensitive.
Q10
Which assessment finding best distinguishes neuropathic from nociceptive pain?
A. Pain described as aching and well-localized to the injury site
B. Pain accompanied by burning, tingling, and hypersensitivity in a dermatomal pattern
C. Pain that resolves with rest and scheduled NSAIDs
D. Pain proportional to the extent of visible tissue damage
Answer: B
Rationale: Neuropathic pain arises from nerve injury and classically presents with burning, tingling,
electric-shock quality, and allodynia/hyperalgesia in a nerve distribution. Nociceptive pain is aching,
well-localized, and proportional to tissue injury, and typically responds to NSAIDs/rest. Thus A, C, and D
describe nociceptive, not neuropathic, pain.
Q11
A patient reports 8/10 pain but is laughing and joking with visitors. Best nursing interpretation?
A. The reported score is exaggerated; reassess later when calm
B. Behavioral cues override self-report; document 2/10
C. Self-report is the most reliable indicator; treat the reported pain
D. Distraction proves pain is tolerable; withhold analgesia
Answer: C
Rationale: Current standards (Joint Commission, QSEN patient-centered care) affirm that the patient's
self-report is the single most reliable pain indicator; behavior and vital signs are adjuncts, not substitutes.
Laughing or distraction does not invalidate pain. Options A, B, and D inappropriately dismiss self-report.
Complete Q&A With Verified Answers And Detailed
Rationales Pain Management 2026| Instant
Download - Complete 146 Verified Q&A with
Answers & Rationales for Exam Prep
Q1
Which assessment finding most strongly suggests neuropathic pain rather than nociceptive pain?
A. Pain described as aching and relieved by rest.
B. Pain accompanied by burning, tingling, and hyperalgesia.
C. Pain localized to a surgical incision site.
D. Pain that worsens with movement and improves with heat.
Answer: B
Rationale: Neuropathic pain arises from nerve injury and is characterized by burning, tingling, and
hyperalgesia, unlike nociceptive pain which is typically aching and responsive to rest or heat. Options A,
C, and D describe nociceptive or somatic pain patterns.
Q2
A patient with chronic cancer pain reports 8/10 despite scheduled long-acting morphine. What is the
priority nursing action?
A. Administer the prescribed PRN short-acting opioid and reassess.
B. Wait until the next scheduled long-acting dose.
C. Encourage distraction techniques only.
D. Contact the provider to increase the long-acting dose immediately.
Answer: A
Rationale: Breakthrough pain requires prompt administration of a short-acting opioid as prescribed,
followed by reassessment. Waiting or using only non-pharmacologic methods is inappropriate for severe
pain; contacting the provider for a dose change is not the immediate priority.
,Q3
Which patient is at highest risk for opioid-induced respiratory depression?
A. A patient with a history of substance use disorder.
B. A patient with obstructive sleep apnea receiving opioids.
C. A patient with hypertension on beta-blockers.
D. A patient with a fractured femur receiving NSAIDs.
Answer: B
Rationale: Obstructive sleep apnea increases sensitivity to opioids and risk of respiratory depression.
Substance use disorder increases risk of misuse but not necessarily respiratory depression; hypertension
and NSAID use are not direct risk factors.
Q4
Which non-pharmacological intervention is most appropriate for a patient with acute incisional pain?
A. Guided imagery and relaxation breathing.
B. Vigorous massage over the incision.
C. Application of ice directly to the wound.
D. Encouraging bed rest without movement.
Answer: A
Rationale: Guided imagery and relaxation are safe, effective adjuncts for acute pain. Massage over an
incision, direct ice application, and prolonged immobility may cause harm or complications.
Q5
A patient using PCA reports nausea and pruritus. Which action should the nurse take first?
A. Stop the PCA and administer naloxone.
B. Administer prescribed antiemetic and antipruritic, then reassess.
C. Increase the PCA demand dose.
D. Encourage the patient to use the PCA more frequently.
Answer: B
Rationale: Nausea and pruritus are common opioid side effects; treating them with prescribed
medications while continuing analgesia is appropriate. Naloxone is reserved for respiratory depression;
increasing PCA dose would worsen side effects.
,Q6
Which statement by a patient indicates correct understanding of epidural analgesia safety?
A. I will report any new back pain or leg weakness immediately.
B. I can ambulate without assistance after epidural placement.
C. I should not use the call button for minor discomfort.
D. I will apply heat to the epidural site for comfort.
Answer: A
Rationale: New back pain or leg weakness may indicate epidural hematoma or abscess and requires
immediate reporting. Ambulating unassisted is unsafe due to motor blockade; withholding calls or applying
heat is inappropriate.
Q7
Which pain assessment tool is most appropriate for a patient unable to self-report pain due to advanced
dementia?
A. Numeric Rating Scale
B. Wong-Baker FACES
C. PAINAD
D. Visual Analog Scale
Answer: C
Rationale: PAINAD is a behavioral tool validated for patients with dementia who cannot self-report.
Numeric, FACES, and visual analog scales require self-report and are unreliable in advanced dementia.
Q8
Which patient teaching is essential before discharge on around-the-clock oral opioids?
A. Increase the dose if pain is not relieved within 10 minutes.
B. Take a stool softener and increase fluid and fiber intake.
C. Stop the medication abruptly when pain subsides.
D. Avoid all other medications to prevent interactions.
Answer: B
Rationale: Opioids cause constipation; preventive bowel management with stool softeners, fluids, and
fiber is essential. Dose escalation without guidance, abrupt cessation, and avoiding all other medications
are unsafe or incorrect.
, Q9
Which cultural consideration is most important when assessing pain in a patient from a culture that values
stoicism?
A. Assume the patient is not experiencing significant pain.
B. Use a formal pain scale and observe for nonverbal cues.
C. Avoid asking about pain to respect cultural norms.
D. Rely solely on family reports of pain.
Answer: B
Rationale: Cultural stoicism may lead to underreporting; using validated scales and observing nonverbal
cues improves assessment. Assuming no pain, avoiding inquiry, or relying solely on family is unsafe and
culturally insensitive.
Q10
Which assessment finding best distinguishes neuropathic from nociceptive pain?
A. Pain described as aching and well-localized to the injury site
B. Pain accompanied by burning, tingling, and hypersensitivity in a dermatomal pattern
C. Pain that resolves with rest and scheduled NSAIDs
D. Pain proportional to the extent of visible tissue damage
Answer: B
Rationale: Neuropathic pain arises from nerve injury and classically presents with burning, tingling,
electric-shock quality, and allodynia/hyperalgesia in a nerve distribution. Nociceptive pain is aching,
well-localized, and proportional to tissue injury, and typically responds to NSAIDs/rest. Thus A, C, and D
describe nociceptive, not neuropathic, pain.
Q11
A patient reports 8/10 pain but is laughing and joking with visitors. Best nursing interpretation?
A. The reported score is exaggerated; reassess later when calm
B. Behavioral cues override self-report; document 2/10
C. Self-report is the most reliable indicator; treat the reported pain
D. Distraction proves pain is tolerable; withhold analgesia
Answer: C
Rationale: Current standards (Joint Commission, QSEN patient-centered care) affirm that the patient's
self-report is the single most reliable pain indicator; behavior and vital signs are adjuncts, not substitutes.
Laughing or distraction does not invalidate pain. Options A, B, and D inappropriately dismiss self-report.
