NUR 2356 MDC 1 Final Exam 2026 Update
|NUR2356 Multidimensional Care 1 Final Exam
Version A & B With Complete 300 Questions
And Correct Detailed Answers|Agrade
Glen is an 82 year old who needs to be prescribed a new drug. What changes in elimination
should be taken into consideration when prescribing for Glen? A. Increased GFR will require
higher doses of some renally excreted drugs
B. Decreased tubular secretion of medication will require dosage adjustments
C. Thin skin will cause increased elimination via sweat
D. Decreased lung capacity will lead to measurable decreases in lung excretion of drugs B.
Decreased tubular secretion of medication will require dosage adjustments
A medication review of an elderly person's medications involves:
A. Asking the patient to bring a list of current prescription medications to the visit
B. Having the patient bring all of their prescription, over-the-counter, and herbal medication to
the visit
C. Asking what other providers are writing prescriptions for them
D. All of the above D. All of the above
Steps to avoid polypharmacy include:
A. Prescribing two or fewer drugs from each drug class
B. Reviewing a complete drug history every 12 to 18 months
C. Encouraging the elderly patient to coordinate their care with all of their providers
D. Evaluating for duplications in drug therapy and discontinuing any duplications D. Evaluating
for duplications in drug therapy and discontinuing any duplications
Robert is a 72 year old who has hypertension and angina. He is at risk for common medication
practices seen in the elderly including:
A. Use of another person's medications
B. Hoarding medications
C. Changing his medication regimen without telling his provider
D. All of the above D. All of the above
To improve positive outcomes when prescribing for the elderly the nurse practitioner should:
1|Page
,A. Assess cognitive functioning in the elder
B. Encourage the patient to take a weekly "drug holiday" to keep drug costs down
C. Encourage the patient to cut drugs in half with a knife to lower costs
D. All of the above A. Assess cognitive functioning in the elder
When an elderly diabetic patient is constipated the best treatment options include:
A. Mineral oil
B. Bulk-forming laxatives such as psyllium
C. Stimulant laxatives such as senna
D. Stool softeners such as docusate D. Stool softeners such as docusate
Delta is an 88 year old who has mild low back pain. What guidelines should be followed when
prescribing pain management for Delta?
A. Keep the dose of oxycodone low to prevent development of tolerance
B. Acetaminophen is the first-line drug of choice
C. Avoid prescribing NSAIDs
D. Add in a short-acting benzodiazepine for a synergistic effect on pain B. Acetaminophen is
the first-line drug of choice
Robert is complaining of poor sleep. Medications that may contribute to sleep problems in the
elderly include:
A. Diuretics
B. Trazodone
C. Clonazepam
D. Levodopa A. Diuretics
Different areas of the brain are involved in specific aspects of pain. The reticular and limbic
systems in the brain influence:
A. The sensory aspects of pain
B. The discriminative aspects of pain
C. The motivational aspects of pain
D. The cognitive aspects of pain C. The motivational aspects of pain
Patients need to be questioned about all pain sites because:
A. Patients tend to report the most severe or important in their perception
B. Pain tolerance generally decreases with repeated exposure
2|Page
,C. The reported pain site is usually the most important to treat
D. Pain may be referred from a different site to the one reported A. Patients tend to report the
most severe or important in their perception
The chemicals that promote the spread of pain locally include:
A. Serotonin
B. Norepinephrine
C. Enkephalin
D. Neurokinin A D. Neurokinin A
Narcotics are exogenous opiates. They act by:
A. Inhibiting pain transmission in the spinal cord
B. Attaching to receptors in the afferent neuron to inhibit the release of substance P
C. Blocking neurotransmitters in the midbrain
D. Increasing beta-lipoprotein excretion from the pituitary B. Attaching to receptors in the
afferent neuron to inhibit the release of substance P
Age is a factor in different responses to pain. Which of the following age-related statements
about pain is NOT true?
A. Preterm and newborn infants do not yet have functional pain pathways.
B. Painful experiences and prolonged exposure to analgesic drugs during pregnancy may
permanently alter neuronal organization in the child.
C. Increases in pain threshold in older adults may be related to peripheral neuropathies and
changes in skin thickness
D. Decreases in pain tolerance are evident in older adults A. Preterm and newborn infants do
not yet have functional pain pathways.
Which of the following statements is true about acute pain?
A. Somatic pain comes from body surfaces and is only sharp and well localized.
B. Visceral pain comes from the internal organs and is most responsive to acetaminophen and
opiates.
C. Referred pain is present in a distant site for the pain source and is based on activation of the
same spinal segment as the actual pain site.
D. Acute neuropathic pain is caused by lack of blood supply to the nerves in a given area. C.
Referred pain is present in a distant site for the pain source and is based on activation of the same
spinal segment as the actual pain site.
One of the main drug classes used to treat acute pain is NSAIDs. They are used because:
3|Page
, A. They have less risk for liver damage than acetaminophen
B. Inflammation is a common cause of acute pain
C. They have minimal GI irritation
D. Regulation of blood flow to the kidney is not affected by these drugs B. Inflammation is a
common cause of acute pain
Opiates are used mainly to treat moderate to severe pain. Which of the following is NOT true
about these drugs?
A. All opiates are scheduled drugs which require a DEA license to prescribe. B. Opiates
stimulate only mu receptors for the control of pain.
C. Most of the adverse effects of opiates are related to mu receptor stimulation.
D. Naloxone is an antagonist to opiates. B. Opiates stimulate only mu receptors for the
control of pain.
If interventions to resolve the cause of pain (RICE) are insufficient, pain medications are given
based on the severity of pain. Drugs are given in which order of use?
A. NSAIDs, opiates, corticosteroids
B. Low-dose opiates, salicylates, increased dose of opiates
C. Opiates, non-opiates, increased dose of non-opiate
D. Non-opiate, increased dose of non-opiate, opiate D. Non-opiate, increased dose of non-opiate,
opiate
The goal of treatment of acute pain is:
A. Pain at a tolerable level where patient may return to activities of daily living B. Reduction of
pain with a minimum of drug adverse effects
C. Reduction or elimination of pain with minimum adverse reactions
D. Adequate pain relief without constipation or nausea from the drugs C. Reduction or
elimination of pain with minimum adverse reactions
Which of the following statements is true about age and pain?
A. Use of drugs that depend heavily on the renal system for excretion may require dosage
adjustments in very young children.
B. Among the NSAIDs, indomethacin is the preferred drug because of lower adverse effects
profiles than other NSAIDs.
C. Older adults who have dementia probably do not experience much pain due to loss of pain
receptors in the brain.
D. Acetaminophen is especially useful in both children and adults because it has no effect on
platelets and has fewer adverse effects than NSAIDs. Acetaminophen is especially useful
4|Page
|NUR2356 Multidimensional Care 1 Final Exam
Version A & B With Complete 300 Questions
And Correct Detailed Answers|Agrade
Glen is an 82 year old who needs to be prescribed a new drug. What changes in elimination
should be taken into consideration when prescribing for Glen? A. Increased GFR will require
higher doses of some renally excreted drugs
B. Decreased tubular secretion of medication will require dosage adjustments
C. Thin skin will cause increased elimination via sweat
D. Decreased lung capacity will lead to measurable decreases in lung excretion of drugs B.
Decreased tubular secretion of medication will require dosage adjustments
A medication review of an elderly person's medications involves:
A. Asking the patient to bring a list of current prescription medications to the visit
B. Having the patient bring all of their prescription, over-the-counter, and herbal medication to
the visit
C. Asking what other providers are writing prescriptions for them
D. All of the above D. All of the above
Steps to avoid polypharmacy include:
A. Prescribing two or fewer drugs from each drug class
B. Reviewing a complete drug history every 12 to 18 months
C. Encouraging the elderly patient to coordinate their care with all of their providers
D. Evaluating for duplications in drug therapy and discontinuing any duplications D. Evaluating
for duplications in drug therapy and discontinuing any duplications
Robert is a 72 year old who has hypertension and angina. He is at risk for common medication
practices seen in the elderly including:
A. Use of another person's medications
B. Hoarding medications
C. Changing his medication regimen without telling his provider
D. All of the above D. All of the above
To improve positive outcomes when prescribing for the elderly the nurse practitioner should:
1|Page
,A. Assess cognitive functioning in the elder
B. Encourage the patient to take a weekly "drug holiday" to keep drug costs down
C. Encourage the patient to cut drugs in half with a knife to lower costs
D. All of the above A. Assess cognitive functioning in the elder
When an elderly diabetic patient is constipated the best treatment options include:
A. Mineral oil
B. Bulk-forming laxatives such as psyllium
C. Stimulant laxatives such as senna
D. Stool softeners such as docusate D. Stool softeners such as docusate
Delta is an 88 year old who has mild low back pain. What guidelines should be followed when
prescribing pain management for Delta?
A. Keep the dose of oxycodone low to prevent development of tolerance
B. Acetaminophen is the first-line drug of choice
C. Avoid prescribing NSAIDs
D. Add in a short-acting benzodiazepine for a synergistic effect on pain B. Acetaminophen is
the first-line drug of choice
Robert is complaining of poor sleep. Medications that may contribute to sleep problems in the
elderly include:
A. Diuretics
B. Trazodone
C. Clonazepam
D. Levodopa A. Diuretics
Different areas of the brain are involved in specific aspects of pain. The reticular and limbic
systems in the brain influence:
A. The sensory aspects of pain
B. The discriminative aspects of pain
C. The motivational aspects of pain
D. The cognitive aspects of pain C. The motivational aspects of pain
Patients need to be questioned about all pain sites because:
A. Patients tend to report the most severe or important in their perception
B. Pain tolerance generally decreases with repeated exposure
2|Page
,C. The reported pain site is usually the most important to treat
D. Pain may be referred from a different site to the one reported A. Patients tend to report the
most severe or important in their perception
The chemicals that promote the spread of pain locally include:
A. Serotonin
B. Norepinephrine
C. Enkephalin
D. Neurokinin A D. Neurokinin A
Narcotics are exogenous opiates. They act by:
A. Inhibiting pain transmission in the spinal cord
B. Attaching to receptors in the afferent neuron to inhibit the release of substance P
C. Blocking neurotransmitters in the midbrain
D. Increasing beta-lipoprotein excretion from the pituitary B. Attaching to receptors in the
afferent neuron to inhibit the release of substance P
Age is a factor in different responses to pain. Which of the following age-related statements
about pain is NOT true?
A. Preterm and newborn infants do not yet have functional pain pathways.
B. Painful experiences and prolonged exposure to analgesic drugs during pregnancy may
permanently alter neuronal organization in the child.
C. Increases in pain threshold in older adults may be related to peripheral neuropathies and
changes in skin thickness
D. Decreases in pain tolerance are evident in older adults A. Preterm and newborn infants do
not yet have functional pain pathways.
Which of the following statements is true about acute pain?
A. Somatic pain comes from body surfaces and is only sharp and well localized.
B. Visceral pain comes from the internal organs and is most responsive to acetaminophen and
opiates.
C. Referred pain is present in a distant site for the pain source and is based on activation of the
same spinal segment as the actual pain site.
D. Acute neuropathic pain is caused by lack of blood supply to the nerves in a given area. C.
Referred pain is present in a distant site for the pain source and is based on activation of the same
spinal segment as the actual pain site.
One of the main drug classes used to treat acute pain is NSAIDs. They are used because:
3|Page
, A. They have less risk for liver damage than acetaminophen
B. Inflammation is a common cause of acute pain
C. They have minimal GI irritation
D. Regulation of blood flow to the kidney is not affected by these drugs B. Inflammation is a
common cause of acute pain
Opiates are used mainly to treat moderate to severe pain. Which of the following is NOT true
about these drugs?
A. All opiates are scheduled drugs which require a DEA license to prescribe. B. Opiates
stimulate only mu receptors for the control of pain.
C. Most of the adverse effects of opiates are related to mu receptor stimulation.
D. Naloxone is an antagonist to opiates. B. Opiates stimulate only mu receptors for the
control of pain.
If interventions to resolve the cause of pain (RICE) are insufficient, pain medications are given
based on the severity of pain. Drugs are given in which order of use?
A. NSAIDs, opiates, corticosteroids
B. Low-dose opiates, salicylates, increased dose of opiates
C. Opiates, non-opiates, increased dose of non-opiate
D. Non-opiate, increased dose of non-opiate, opiate D. Non-opiate, increased dose of non-opiate,
opiate
The goal of treatment of acute pain is:
A. Pain at a tolerable level where patient may return to activities of daily living B. Reduction of
pain with a minimum of drug adverse effects
C. Reduction or elimination of pain with minimum adverse reactions
D. Adequate pain relief without constipation or nausea from the drugs C. Reduction or
elimination of pain with minimum adverse reactions
Which of the following statements is true about age and pain?
A. Use of drugs that depend heavily on the renal system for excretion may require dosage
adjustments in very young children.
B. Among the NSAIDs, indomethacin is the preferred drug because of lower adverse effects
profiles than other NSAIDs.
C. Older adults who have dementia probably do not experience much pain due to loss of pain
receptors in the brain.
D. Acetaminophen is especially useful in both children and adults because it has no effect on
platelets and has fewer adverse effects than NSAIDs. Acetaminophen is especially useful
4|Page
