Wish you all the best in your exams, happy studying.
FSCJ NUR1023C
Volume II
Section 1: Concept of Comfort, Pain, & Sleep
1. A client with diabetic neuropathy describes their pain as a "constant, burning, electrical
shock" in their feet. The nurse recognizes this as neuropathic pain. Which class of
medication is considered a first-line adjuvant therapy for this specific type of pain?
A) Nonsteroidal anti-inflammatory drugs (NSAIDs).
B) Short-acting opioid agonists.
C) Anticonvulsants (e.g., Gabapentin).
D) Muscle relaxants.
Elaboration: Neuropathic pain arises from abnormal processing of sensory input by the
peripheral or central nervous system. Traditional analgesics are often ineffective;
anticonvulsants and antidepressants are the gold standard adjuvant therapies because they
stabilize hyperactive nerve membranes.
2. A client is receiving morphine via a Patient-Controlled Analgesia (PCA) pump. The nurse
understands that the "lockout interval" on the pump is designed to:
A) Prevent the client from receiving a continuous basal rate of medication.
B) Alert the nurse when the syringe is empty.
C) Prevent overdose by blocking the administration of additional bolus doses during a
specific timeframe.
D) Automatically titrate the dose based on the client's respiratory rate.
Elaboration: The lockout interval is a safety mechanism programmed into the PCA. Even if the
patient pushes the button repeatedly, the pump will only deliver a dose after the prescribed
time interval has passed.
3. According to the Gate Control Theory of Pain, which intervention relies on stimulating
large-diameter tactile nerve fibers to "close the gate" to pain signals?
A) Administering a local anesthetic block.
B) Applying a warm compress and massaging the affected area.
C) Teaching the client guided imagery and deep breathing.
, D) Administering an intravenous opioid.
Elaboration: Tactile and thermal stimulation activate large, fast A-beta fibers. These fibers
compete with and block the transmission of pain signals carried by the slower C and A-delta
fibers at the dorsal horn of the spinal cord.
4. The nurse is assessing a postoperative client who is opioid-naïve and receiving IV
hydromorphone. Which assessment finding is the earliest indicator of clinically
significant respiratory depression?
A) A respiratory rate of 10 breaths per minute.
B) An oxygen saturation ($SpO_2$) of 92%.
C) Increasing sedation and inability to stay awake during conversation.
D) Cyanosis of the nail beds.
Elaboration: Sedation always precedes respiratory depression. A client who frequently falls
asleep mid-conversation (a high sedation score) requires immediate intervention (decreasing
the dose) before the respiratory rate drops to a dangerous level.
5. A client with osteoarthritis is prescribed prolonged, high-dose ibuprofen. The nurse
should monitor the client closely for which severe adverse effect?
A) Respiratory depression.
B) Severe bradycardia.
C) Gastrointestinal bleeding and renal impairment.
D) Hepatic necrosis.
Elaboration: NSAIDs inhibit prostaglandin synthesis. Prostaglandins are necessary to protect
the gastric mucosal lining and maintain renal blood flow. Long-term use frequently causes
peptic ulcers and nephrotoxicity.
6. A client in the intensive care unit is exhibiting signs of sensory overload. Which nursing
intervention is most appropriate?
A) Leave the television on to provide comforting background noise.
B) Keep the room brightly lit to prevent disorientation.
C) Cluster nursing care to provide extended, uninterrupted periods of rest.
D) Speak loudly when entering the room to ensure the client hears.
, Elaboration: Sensory overload occurs when the reticular activating system is overwhelmed by
constant stimuli. Clustering care minimizes interactions, allowing the nervous system time to
recover.
7. A client with Obstructive Sleep Apnea (OSA) is prescribed a Continuous Positive Airway
Pressure (CPAP) machine. How does this device prevent apneic episodes?
A) It delivers a continuous flow of 100% oxygen to maintain $SpO_2$.
B) It mechanically forces the diaphragm to contract.
C) It uses room air under positive pressure to act as a pneumatic splint, keeping the
oropharynx open.
D) It detects apnea and administers a shock to wake the patient.
Elaboration: OSA is caused by the relaxation and collapse of the soft tissues in the throat
during sleep. CPAP forces a continuous stream of air that holds the airway open.
8. During which stage of sleep does the body perform maximum tissue repair, muscle
growth, and bone remodeling?
A) NREM Stage 1.
B) NREM Stage 2.
C) NREM Stage 3 (Slow-Wave Sleep).
D) REM Sleep.
Elaboration: Stage 3 (deep sleep) triggers the release of human growth hormone, making it
the most critical stage for physical restoration. REM sleep is primarily responsible for
cognitive and memory restoration.
9. The nurse is assessing pain in an advanced dementia patient who is nonverbal. Which
tool is most appropriate?
A) The Numeric Rating Scale (0-10).
B) The Wong-Baker FACES Scale.
C) The PAINAD (Pain Assessment in Advanced Dementia) Scale.
D) The FLACC scale.
Elaboration: The PAINAD scale evaluates specific behavioral indicators—such as breathing,
negative vocalization, facial expression, body language, and consolability—in cognitively
impaired adults.
FSCJ NUR1023C
Volume II
Section 1: Concept of Comfort, Pain, & Sleep
1. A client with diabetic neuropathy describes their pain as a "constant, burning, electrical
shock" in their feet. The nurse recognizes this as neuropathic pain. Which class of
medication is considered a first-line adjuvant therapy for this specific type of pain?
A) Nonsteroidal anti-inflammatory drugs (NSAIDs).
B) Short-acting opioid agonists.
C) Anticonvulsants (e.g., Gabapentin).
D) Muscle relaxants.
Elaboration: Neuropathic pain arises from abnormal processing of sensory input by the
peripheral or central nervous system. Traditional analgesics are often ineffective;
anticonvulsants and antidepressants are the gold standard adjuvant therapies because they
stabilize hyperactive nerve membranes.
2. A client is receiving morphine via a Patient-Controlled Analgesia (PCA) pump. The nurse
understands that the "lockout interval" on the pump is designed to:
A) Prevent the client from receiving a continuous basal rate of medication.
B) Alert the nurse when the syringe is empty.
C) Prevent overdose by blocking the administration of additional bolus doses during a
specific timeframe.
D) Automatically titrate the dose based on the client's respiratory rate.
Elaboration: The lockout interval is a safety mechanism programmed into the PCA. Even if the
patient pushes the button repeatedly, the pump will only deliver a dose after the prescribed
time interval has passed.
3. According to the Gate Control Theory of Pain, which intervention relies on stimulating
large-diameter tactile nerve fibers to "close the gate" to pain signals?
A) Administering a local anesthetic block.
B) Applying a warm compress and massaging the affected area.
C) Teaching the client guided imagery and deep breathing.
, D) Administering an intravenous opioid.
Elaboration: Tactile and thermal stimulation activate large, fast A-beta fibers. These fibers
compete with and block the transmission of pain signals carried by the slower C and A-delta
fibers at the dorsal horn of the spinal cord.
4. The nurse is assessing a postoperative client who is opioid-naïve and receiving IV
hydromorphone. Which assessment finding is the earliest indicator of clinically
significant respiratory depression?
A) A respiratory rate of 10 breaths per minute.
B) An oxygen saturation ($SpO_2$) of 92%.
C) Increasing sedation and inability to stay awake during conversation.
D) Cyanosis of the nail beds.
Elaboration: Sedation always precedes respiratory depression. A client who frequently falls
asleep mid-conversation (a high sedation score) requires immediate intervention (decreasing
the dose) before the respiratory rate drops to a dangerous level.
5. A client with osteoarthritis is prescribed prolonged, high-dose ibuprofen. The nurse
should monitor the client closely for which severe adverse effect?
A) Respiratory depression.
B) Severe bradycardia.
C) Gastrointestinal bleeding and renal impairment.
D) Hepatic necrosis.
Elaboration: NSAIDs inhibit prostaglandin synthesis. Prostaglandins are necessary to protect
the gastric mucosal lining and maintain renal blood flow. Long-term use frequently causes
peptic ulcers and nephrotoxicity.
6. A client in the intensive care unit is exhibiting signs of sensory overload. Which nursing
intervention is most appropriate?
A) Leave the television on to provide comforting background noise.
B) Keep the room brightly lit to prevent disorientation.
C) Cluster nursing care to provide extended, uninterrupted periods of rest.
D) Speak loudly when entering the room to ensure the client hears.
, Elaboration: Sensory overload occurs when the reticular activating system is overwhelmed by
constant stimuli. Clustering care minimizes interactions, allowing the nervous system time to
recover.
7. A client with Obstructive Sleep Apnea (OSA) is prescribed a Continuous Positive Airway
Pressure (CPAP) machine. How does this device prevent apneic episodes?
A) It delivers a continuous flow of 100% oxygen to maintain $SpO_2$.
B) It mechanically forces the diaphragm to contract.
C) It uses room air under positive pressure to act as a pneumatic splint, keeping the
oropharynx open.
D) It detects apnea and administers a shock to wake the patient.
Elaboration: OSA is caused by the relaxation and collapse of the soft tissues in the throat
during sleep. CPAP forces a continuous stream of air that holds the airway open.
8. During which stage of sleep does the body perform maximum tissue repair, muscle
growth, and bone remodeling?
A) NREM Stage 1.
B) NREM Stage 2.
C) NREM Stage 3 (Slow-Wave Sleep).
D) REM Sleep.
Elaboration: Stage 3 (deep sleep) triggers the release of human growth hormone, making it
the most critical stage for physical restoration. REM sleep is primarily responsible for
cognitive and memory restoration.
9. The nurse is assessing pain in an advanced dementia patient who is nonverbal. Which
tool is most appropriate?
A) The Numeric Rating Scale (0-10).
B) The Wong-Baker FACES Scale.
C) The PAINAD (Pain Assessment in Advanced Dementia) Scale.
D) The FLACC scale.
Elaboration: The PAINAD scale evaluates specific behavioral indicators—such as breathing,
negative vocalization, facial expression, body language, and consolability—in cognitively
impaired adults.
