Practice Exercises for the NCLEX Examination 6th Edition
Edition By LaCharity, Kumagai, and Hosler
,Chapter 1. Pain MULTIPLE CHOICE
1. A client tells the nurse practitioner she rarely feels pain, but when she does, she seeks medical care right away. Th
nurse practitioner interprets this as an understanding that pain:
1. functions as a protective mechanism.
2. involves the automatic withdrawal reflex.
3. increases sensitivity to pain.
4. promotes healing.
CORRECT CHOICE: 1
RATIONALE: Pain acts as a defense system by using reflexes, memory, and avoidance behaviors to preven
harm. Although withdrawal reflexes are part of the response, they alone do not explain the purpose of pain. P
does not heighten sensitivity to itself nor directly cause healing. Its essential role is warning the body of dang
and prompting protective action.
PTS: 1 DIF: Analyze REF: Definitions and Implications of Pain
2. A client states that the touch of bed linens on their skin feels extremely painful. The nurse practitioner recognizes
this as:
1. allodynia.
2. modulation.
3. kinesthesia.
4. proprioception.
CORRECT CHOICE: 1
RATIONALE: Allodynia, also known as hyperalgesia, occurs when normally harmless stimuli are perceived
as painful. Kinesthesia refers to awareness of movement, and proprioception relates to body position.
Modulation describes the regulation of how pain is processed.
PTS: 1 DIF: Analyze REF: Peripheral Nervous System
3. A client complains of severe abdominal pain. The nurse practitioner identifies this as:
1. Neuralgia
2. Pathological
3. Somatic
, 4. Visceral
CORRECT CHOICE: 4
RATIONALE: Visceral pain originates from the internal organs or the gastrointestinal tract. Somatic pain
arises from structures like bones, joints, muscles, skin, or connective tissue. Neuralgia and pathological pain
result from nerve injury or abnormal neuronal transmission.
PTS: 1 DIF: Analyze REF: Types of Pain
4. A client with acute appendicitis reports abdominal pain. The nurse practitioner should describe this pain as:
1. chronic.
2. neuropathic.
3. referred.
4. acute.
CORRECT CHOICE: 4
RATIONALE: Acute pain has a rapid onset and is short in duration. Chronic pain lasts more than 6 months.
Referred pain is felt at a distant site from the source. Neuropathic pain occurs along nerve branches and is
sudden and sharp.
PTS: 1 DIF: Apply REF: Types of Pain
5. A client is holding a pillow over the abdomen, lying with knees flexed, and vital signs show high blood pressure a
pulse. What should the nurse practitioner say?
1. “Can I bring you anything?”
2. “Would you like something for pain?”
3. “You look comfortable.”
4. “Your blood pressure is elevated.”
CORRECT CHOICE: 2
RATIONALE: Increased blood pressure and heart rate are sympathetic signs of pain. The client’s posture an
use of a pillow also suggest discomfort. The most appropriate response is offering pain relief. Other response
fail to address the client’s pain directly.
PTS: 1 DIF: Apply REF: Assessing the Clinical Manifestations of Pain
, 6. A client with chronic pain asks why Demerol is not prescribed like it was after knee surgery. The nurse practitione
should respond:
1. “You don’t need medication that strong.”
2. “That drug no longer exists.”
3. “That drug doesn’t last very long.”
4. “It can raise your blood pressure.”
CORRECT CHOICE: 3
RATIONALE: Meperidine (Demerol) is no longer commonly used because it provides relief for only 2–3
hours and its metabolite can cause toxic effects. Telling the client the drug is short-acting is the most accurate
explanation. The other responses are misleading.
PTS: 1 DIF: Apply REF: Opioid Analgesics
7. A client is told a tricyclic antidepressant will help control chronic pain. The nurse practitioner expects the provider
order:
1. Amitriptyline.
2. Baclofen.
3. Gabapentin.
4. Diazepam.
CORRECT CHOICE: 1
RATIONALE: Amitriptyline is a tricyclic antidepressant. Gabapentin is an anticonvulsant, Baclofen is a
muscle relaxant, and Diazepam is a benzodiazepine.
PTS: 1 DIF: Analyze REF: Adjuvant Medications
8. A client receiving scheduled medication for terminal cancer reports extra pain during daily activities. The nurse
practitioner identifies this as:
1. breakthrough pain.
2. intractable pain.
3. psychosomatic pain.
4. acute pain.
CORRECT CHOICE: 1