NSG 555 UPDATED EXAM SCRIPT QUESTIONS AND
SOLUTIONS GRADED A+
✔✔What is the impact of aging services on NP practice? - ✔✔Increased areas of NP
work in underserved areas, particularly in aging services.
✔✔What should NPs do to ensure compliance with standard care? - ✔✔Practice within
the requirements of their nurse practice act and organizational policies.
✔✔What should be addressed to ensure patient comfort in terminal care? - ✔✔Fatigue,
nausea, or vomiting.
✔✔What tools can be used to provide accurate prognosis in palliative care? -
✔✔Palliative care tools and predictors.
✔✔What signs indicate that a patient is nearing death? - ✔✔Skin changes, altered
breathing patterns, and changes in mental status.
✔✔How should a clinician determine the time of death? - ✔✔By noting the absence of
breathing and cardiac function for 1 minute.
✔✔What is somatic pain? - ✔✔Pain in tissue regions.
✔✔What is visceral pain? - ✔✔Pain in organs.
✔✔What is neuropathic pain? - ✔✔Pain in nerve roots.
✔✔What is considered acute pain? - ✔✔Pain lasting less than 1 month.
✔✔What should be the first step in pain management? - ✔✔Maximize nonopioid
choices before considering opioids.
✔✔What is the recommended approach when prescribing opioids? - ✔✔Order no more
than the expected duration and educate the patient on benefits and risks.
✔✔What should be established when starting opioid therapy? - ✔✔Treatment goals for
pain and function, and a plan for discontinuation.
✔✔What type of medication should be prescribed when starting opioid therapy? -
✔✔Immediate-release medication at the lowest effective dose.
✔✔What should be avoided when prescribing opioids? - ✔✔Dosing levels that yield
diminishing returns relative to risk.
,✔✔What are the first-line medications for neuropathic pain? - ✔✔Gabapentin and
pregabalin.
✔✔What is the recommended dosage for gabapentin? - ✔✔100-300 mg once daily,
with the ability to titrate up.
✔✔What should be avoided in cardiac patients when prescribing SNRIs? -
✔✔Venlafaxine due to potential EKG changes.
✔✔Which tricyclic antidepressants are recommended for neuropathic pain? -
✔✔Nortriptyline and desipramine.
✔✔What should not be coprescribed with SNRIs? - ✔✔Tricyclic Antidepressants
(TCAs).
✔✔What is the first recommendation of the CDC pain management guidelines for
opioids? - ✔✔Nonopioid therapies are at least as effective as opioids for many acute
pains.
✔✔What should clinicians do when selecting opioids for patients? - ✔✔Select
immediate-release opioids first, as they are least likely to lead to addiction.
✔✔What is the recommendation regarding opioid dosage for opioid-naïve patients? -
✔✔Prescribe the lowest effective dosage.
✔✔What should clinicians do if benefits of opioid therapy do not outweigh risks? -
✔✔They should not abruptly discontinue opioid therapy and should optimize nonopioid
therapies.
✔✔What should clinicians prescribe when opioids are needed for acute pain? - ✔✔No
greater quantity than needed for the expected duration of pain.
✔✔When should clinicians evaluate benefits and risks with patients starting opioid
therapy? - ✔✔Within 1-4 weeks of starting therapy or dosage escalation.
✔✔What should clinicians evaluate before and during opioid therapy? - ✔✔Risk for
opioid-related harms and discuss these risks with patients.
✔✔What strategy should clinicians incorporate into the management plan for opioid
therapy? - ✔✔Strategies to mitigate risk, including offering naloxone.
✔✔What data should clinicians review to assess a patient's risk for overdose? -
✔✔State prescription drug monitoring program (PDMP) data.
, ✔✔What caution should clinicians take when prescribing opioids and benzodiazepines?
- ✔✔Use particular caution and consider whether benefits outweigh risks of concurrent
use.
✔✔What treatment should clinicians offer to patients with opioid use disorder? -
✔✔Evidence-based medications to treat opioid use disorder, avoiding detoxing on their
own.
✔✔What is 'walking around knowledge' in the context of medical management? - ✔✔A
basic understanding of conditions expected of entry-level NPs, allowing discussion
without reading materials.
✔✔What are the main symptoms of cataracts? - ✔✔Gradually progressive blurred
vision, no pain or redness, and lens opacities.
✔✔What are common causes of cataracts? - ✔✔Aging process, diabetes, smoking, UV
exposure, and corticosteroid treatment.
✔✔What is the treatment indicated when cataracts affect daily activities? - ✔✔Surgery,
specifically extraction and lens implant.
✔✔What is the main surgical technique for cataract removal? - ✔✔Ultrasonic
fragmentation (phacoemulsification) of the lens nucleus.
✔✔What is the prognosis for patients undergoing cataract surgery? - ✔✔Patients
typically recover very well from cataract surgery.
✔✔What risk is associated with the use of alpha-blockers in cataract surgery? -
✔✔Greatest risk of floppy iris syndrome.
✔✔What are the clinical findings of Dry Eye Syndrome? - ✔✔Dryness, redness, foreign
body sensation, and variable vision.
✔✔What is the indication for laser treatments after cataract surgery? - ✔✔If the
posterior capsule opacifies months to years after the initial surgery.
✔✔What is the primary method of cataract surgery that reduces postoperative
complications? - ✔✔Performing surgery through a small incision without the need for
sutures.
✔✔What is the significance of topical eyedrops in cataract management? - ✔✔They
may dissolve or prevent cataracts.
SOLUTIONS GRADED A+
✔✔What is the impact of aging services on NP practice? - ✔✔Increased areas of NP
work in underserved areas, particularly in aging services.
✔✔What should NPs do to ensure compliance with standard care? - ✔✔Practice within
the requirements of their nurse practice act and organizational policies.
✔✔What should be addressed to ensure patient comfort in terminal care? - ✔✔Fatigue,
nausea, or vomiting.
✔✔What tools can be used to provide accurate prognosis in palliative care? -
✔✔Palliative care tools and predictors.
✔✔What signs indicate that a patient is nearing death? - ✔✔Skin changes, altered
breathing patterns, and changes in mental status.
✔✔How should a clinician determine the time of death? - ✔✔By noting the absence of
breathing and cardiac function for 1 minute.
✔✔What is somatic pain? - ✔✔Pain in tissue regions.
✔✔What is visceral pain? - ✔✔Pain in organs.
✔✔What is neuropathic pain? - ✔✔Pain in nerve roots.
✔✔What is considered acute pain? - ✔✔Pain lasting less than 1 month.
✔✔What should be the first step in pain management? - ✔✔Maximize nonopioid
choices before considering opioids.
✔✔What is the recommended approach when prescribing opioids? - ✔✔Order no more
than the expected duration and educate the patient on benefits and risks.
✔✔What should be established when starting opioid therapy? - ✔✔Treatment goals for
pain and function, and a plan for discontinuation.
✔✔What type of medication should be prescribed when starting opioid therapy? -
✔✔Immediate-release medication at the lowest effective dose.
✔✔What should be avoided when prescribing opioids? - ✔✔Dosing levels that yield
diminishing returns relative to risk.
,✔✔What are the first-line medications for neuropathic pain? - ✔✔Gabapentin and
pregabalin.
✔✔What is the recommended dosage for gabapentin? - ✔✔100-300 mg once daily,
with the ability to titrate up.
✔✔What should be avoided in cardiac patients when prescribing SNRIs? -
✔✔Venlafaxine due to potential EKG changes.
✔✔Which tricyclic antidepressants are recommended for neuropathic pain? -
✔✔Nortriptyline and desipramine.
✔✔What should not be coprescribed with SNRIs? - ✔✔Tricyclic Antidepressants
(TCAs).
✔✔What is the first recommendation of the CDC pain management guidelines for
opioids? - ✔✔Nonopioid therapies are at least as effective as opioids for many acute
pains.
✔✔What should clinicians do when selecting opioids for patients? - ✔✔Select
immediate-release opioids first, as they are least likely to lead to addiction.
✔✔What is the recommendation regarding opioid dosage for opioid-naïve patients? -
✔✔Prescribe the lowest effective dosage.
✔✔What should clinicians do if benefits of opioid therapy do not outweigh risks? -
✔✔They should not abruptly discontinue opioid therapy and should optimize nonopioid
therapies.
✔✔What should clinicians prescribe when opioids are needed for acute pain? - ✔✔No
greater quantity than needed for the expected duration of pain.
✔✔When should clinicians evaluate benefits and risks with patients starting opioid
therapy? - ✔✔Within 1-4 weeks of starting therapy or dosage escalation.
✔✔What should clinicians evaluate before and during opioid therapy? - ✔✔Risk for
opioid-related harms and discuss these risks with patients.
✔✔What strategy should clinicians incorporate into the management plan for opioid
therapy? - ✔✔Strategies to mitigate risk, including offering naloxone.
✔✔What data should clinicians review to assess a patient's risk for overdose? -
✔✔State prescription drug monitoring program (PDMP) data.
, ✔✔What caution should clinicians take when prescribing opioids and benzodiazepines?
- ✔✔Use particular caution and consider whether benefits outweigh risks of concurrent
use.
✔✔What treatment should clinicians offer to patients with opioid use disorder? -
✔✔Evidence-based medications to treat opioid use disorder, avoiding detoxing on their
own.
✔✔What is 'walking around knowledge' in the context of medical management? - ✔✔A
basic understanding of conditions expected of entry-level NPs, allowing discussion
without reading materials.
✔✔What are the main symptoms of cataracts? - ✔✔Gradually progressive blurred
vision, no pain or redness, and lens opacities.
✔✔What are common causes of cataracts? - ✔✔Aging process, diabetes, smoking, UV
exposure, and corticosteroid treatment.
✔✔What is the treatment indicated when cataracts affect daily activities? - ✔✔Surgery,
specifically extraction and lens implant.
✔✔What is the main surgical technique for cataract removal? - ✔✔Ultrasonic
fragmentation (phacoemulsification) of the lens nucleus.
✔✔What is the prognosis for patients undergoing cataract surgery? - ✔✔Patients
typically recover very well from cataract surgery.
✔✔What risk is associated with the use of alpha-blockers in cataract surgery? -
✔✔Greatest risk of floppy iris syndrome.
✔✔What are the clinical findings of Dry Eye Syndrome? - ✔✔Dryness, redness, foreign
body sensation, and variable vision.
✔✔What is the indication for laser treatments after cataract surgery? - ✔✔If the
posterior capsule opacifies months to years after the initial surgery.
✔✔What is the primary method of cataract surgery that reduces postoperative
complications? - ✔✔Performing surgery through a small incision without the need for
sutures.
✔✔What is the significance of topical eyedrops in cataract management? - ✔✔They
may dissolve or prevent cataracts.
