NURS 120 | Medical-Surgical Nursing | Pain Management &
Pharmacologic Interventions 2026 |WCU
1. A patient with chronic back pain describes the sensation as ‘burning’ and
‘shooting’ down the leg. The nurse recognizes this as which type of pain?
A. Neuropathic pain
B. Visceral pain
C. Somatic pain
D. Psychogenic pain
Answer: A
Rationale: Neuropathic pain is caused by damage to peripheral nerves or structures in the
central nervous system and is typically described as burning, shooting, stabbing, or
electrical in nature.
2. A postoperative patient is receiving morphine sulfate via a Patient-Controlled
Analgesia (PCA) pump. The nurse notes the respiratory rate is 8 breaths per
minute. Which action should the nurse take first?
A. Administer naloxone (Narcan) immediately
B. Attempt to arouse the patient and encourage deep breathing
C. Notify the healthcare provider
D. Increase the IV fluid rate
Answer: B
Rationale: The first nursing action for opioid-induced respiratory depression is to
stimulate the patient to breathe. If the patient is not responsive or the rate does not
improve, naloxone is then indicated.
,3. When assessing pain in a cognitively impaired older adult, which tool is most
appropriate for the nurse to utilize?
A. Numerical Rating Scale (0-10)
B. Visual Analog Scale
C. PAINAD Scale
D. Wong-Baker FACES Scale
Answer: C
Rationale: The Pain Assessment in Advanced Dementia (PAINAD) scale is designed
specifically for patients with cognitive impairment who cannot communicate pain verbally.
4. A patient is prescribed a 24-hour maximum dose of acetaminophen. What is
the standard maximum recommended dose for a healthy adult to prevent
hepatotoxicity?
A. 2,000 mg
B. 4,000 mg
C. 3,000 mg
D. 5,000 mg
Answer: B
Rationale: The FDA and most hospital protocols recommend a maximum of 4,000 mg (4
grams) of acetaminophen in 24 hours for healthy adults to avoid liver damage.
5. Which side effect of opioid therapy is the patient most likely to develop
tolerance to over time?
A. Constipation
B. Miosis (pinpoint pupils)
C. Nausea and vomiting
D. Analgesic effect
Answer: C
, Rationale: Patients typically develop tolerance to nausea, vomiting, and sedation within a
few days. They do NOT develop tolerance to constipation or miosis.
6. A nurse is teaching a patient about a new prescription for Celecoxib. Which
patient statement indicates a need for further teaching?
A. I should report any black, tarry stools to my doctor.
B. I can take this even though I have a sulfa allergy.
C. This medication helps reduce inflammation without as much stomach upset.
D. I will monitor for swelling in my ankles.
Answer: B
Rationale: Celecoxib (Celebrex) is contraindicated in patients with a known sulfa allergy as
it contains a sulfonamide chain.
7. Which medication is considered a ‘pure’ opioid antagonist and is used to
reverse respiratory depression?
A. Methadone
B. Buprenorphine
C. Fentanyl
D. Naloxone
Answer: D
Rationale: Naloxone is an opioid antagonist that competes with opioids for receptor sites,
effectively reversing their effects.
Pharmacologic Interventions 2026 |WCU
1. A patient with chronic back pain describes the sensation as ‘burning’ and
‘shooting’ down the leg. The nurse recognizes this as which type of pain?
A. Neuropathic pain
B. Visceral pain
C. Somatic pain
D. Psychogenic pain
Answer: A
Rationale: Neuropathic pain is caused by damage to peripheral nerves or structures in the
central nervous system and is typically described as burning, shooting, stabbing, or
electrical in nature.
2. A postoperative patient is receiving morphine sulfate via a Patient-Controlled
Analgesia (PCA) pump. The nurse notes the respiratory rate is 8 breaths per
minute. Which action should the nurse take first?
A. Administer naloxone (Narcan) immediately
B. Attempt to arouse the patient and encourage deep breathing
C. Notify the healthcare provider
D. Increase the IV fluid rate
Answer: B
Rationale: The first nursing action for opioid-induced respiratory depression is to
stimulate the patient to breathe. If the patient is not responsive or the rate does not
improve, naloxone is then indicated.
,3. When assessing pain in a cognitively impaired older adult, which tool is most
appropriate for the nurse to utilize?
A. Numerical Rating Scale (0-10)
B. Visual Analog Scale
C. PAINAD Scale
D. Wong-Baker FACES Scale
Answer: C
Rationale: The Pain Assessment in Advanced Dementia (PAINAD) scale is designed
specifically for patients with cognitive impairment who cannot communicate pain verbally.
4. A patient is prescribed a 24-hour maximum dose of acetaminophen. What is
the standard maximum recommended dose for a healthy adult to prevent
hepatotoxicity?
A. 2,000 mg
B. 4,000 mg
C. 3,000 mg
D. 5,000 mg
Answer: B
Rationale: The FDA and most hospital protocols recommend a maximum of 4,000 mg (4
grams) of acetaminophen in 24 hours for healthy adults to avoid liver damage.
5. Which side effect of opioid therapy is the patient most likely to develop
tolerance to over time?
A. Constipation
B. Miosis (pinpoint pupils)
C. Nausea and vomiting
D. Analgesic effect
Answer: C
, Rationale: Patients typically develop tolerance to nausea, vomiting, and sedation within a
few days. They do NOT develop tolerance to constipation or miosis.
6. A nurse is teaching a patient about a new prescription for Celecoxib. Which
patient statement indicates a need for further teaching?
A. I should report any black, tarry stools to my doctor.
B. I can take this even though I have a sulfa allergy.
C. This medication helps reduce inflammation without as much stomach upset.
D. I will monitor for swelling in my ankles.
Answer: B
Rationale: Celecoxib (Celebrex) is contraindicated in patients with a known sulfa allergy as
it contains a sulfonamide chain.
7. Which medication is considered a ‘pure’ opioid antagonist and is used to
reverse respiratory depression?
A. Methadone
B. Buprenorphine
C. Fentanyl
D. Naloxone
Answer: D
Rationale: Naloxone is an opioid antagonist that competes with opioids for receptor sites,
effectively reversing their effects.
