Pharmacology
Nursing Pain Management (NR 293)
Comprehensive Study Guide
UPDATE
Actual Questions & Verified Answers
with Detailed Clinical Rationales
Practice Questions with Rationales
Nursing Program
Pharmacology
✓ 100% Verified Answers
✓ Complete Rationales Included
Exam (elaborations)
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,Pharmacology Nursing: Pain Management (NR 293) 2026/2027 UPDATE
1. A patient who has been taking morphine for chronic cancer pain reports that the usual
dose is no longer providing the same level of relief. How should the nurse best interpret this
finding?
A. The patient has developed drug tolerance and may require a dosage adjustment.
B. The patient is demonstrating physical dependence on the medication.
C. The patient has developed a psychological addiction to the opioid.
D. The patient is ‘drug seeking’ and should be monitored for diversion.
Answer: A
Rationale: Tolerance occurs when a larger dose of a drug is required to maintain the same
level of analgesia. It is a common physiological result of long-term opioid use and does not
necessarily indicate addiction.
2. A nurse is preparing to administer acetylcysteine to a patient. Which of the following
clinical scenarios most likely warrants this intervention?
A. A patient experiencing respiratory depression from a morphine overdose.
B. A patient who has ingested an excessive amount of aspirin and has tinnitus.
C. A patient with a serum acetaminophen level indicating hepatotoxicity.
D. A patient experiencing benzodiazepine-induced sedation.
, Answer: C
Rationale: Acetylcysteine is the specific antidote for acetaminophen (Tylenol) overdose. It
works by preventing the hepatotoxic metabolites of acetaminophen from damaging the
liver.
3. Which pharmacological mechanism is specific to Celecoxib (Celebrex) compared to
traditional NSAIDs like Ibuprofen?
A. Irreversible inhibition of platelet aggregation.
B. Non-selective inhibition of both COX-1 and COX-2 enzymes.
C. Selective inhibition of the COX-2 enzyme only.
D. Direct stimulation of the opioid mu-receptors.
Answer: C
Rationale: Celecoxib is a selective COX-2 inhibitor. Traditional NSAIDs inhibit both COX-1
(which protects the GI lining) and COX-2 (which mediates inflammation).
4. A nurse is caring for a patient receiving a continuous morphine infusion via a PCA pump.
Which assessment finding requires immediate notification of the provider?
A. Respiratory rate of 9 breaths per minute.
B. Reports of mild itching on the arms and chest.
C. Patient sleeping but easily aroused by verbal stimuli.
D. Last bowel movement was two days ago.
Nursing Pain Management (NR 293)
Comprehensive Study Guide
UPDATE
Actual Questions & Verified Answers
with Detailed Clinical Rationales
Practice Questions with Rationales
Nursing Program
Pharmacology
✓ 100% Verified Answers
✓ Complete Rationales Included
Exam (elaborations)
Instant PDF Download • Ready for Study
,Pharmacology Nursing: Pain Management (NR 293) 2026/2027 UPDATE
1. A patient who has been taking morphine for chronic cancer pain reports that the usual
dose is no longer providing the same level of relief. How should the nurse best interpret this
finding?
A. The patient has developed drug tolerance and may require a dosage adjustment.
B. The patient is demonstrating physical dependence on the medication.
C. The patient has developed a psychological addiction to the opioid.
D. The patient is ‘drug seeking’ and should be monitored for diversion.
Answer: A
Rationale: Tolerance occurs when a larger dose of a drug is required to maintain the same
level of analgesia. It is a common physiological result of long-term opioid use and does not
necessarily indicate addiction.
2. A nurse is preparing to administer acetylcysteine to a patient. Which of the following
clinical scenarios most likely warrants this intervention?
A. A patient experiencing respiratory depression from a morphine overdose.
B. A patient who has ingested an excessive amount of aspirin and has tinnitus.
C. A patient with a serum acetaminophen level indicating hepatotoxicity.
D. A patient experiencing benzodiazepine-induced sedation.
, Answer: C
Rationale: Acetylcysteine is the specific antidote for acetaminophen (Tylenol) overdose. It
works by preventing the hepatotoxic metabolites of acetaminophen from damaging the
liver.
3. Which pharmacological mechanism is specific to Celecoxib (Celebrex) compared to
traditional NSAIDs like Ibuprofen?
A. Irreversible inhibition of platelet aggregation.
B. Non-selective inhibition of both COX-1 and COX-2 enzymes.
C. Selective inhibition of the COX-2 enzyme only.
D. Direct stimulation of the opioid mu-receptors.
Answer: C
Rationale: Celecoxib is a selective COX-2 inhibitor. Traditional NSAIDs inhibit both COX-1
(which protects the GI lining) and COX-2 (which mediates inflammation).
4. A nurse is caring for a patient receiving a continuous morphine infusion via a PCA pump.
Which assessment finding requires immediate notification of the provider?
A. Respiratory rate of 9 breaths per minute.
B. Reports of mild itching on the arms and chest.
C. Patient sleeping but easily aroused by verbal stimuli.
D. Last bowel movement was two days ago.
