NURS 103: Fundamentals of Nursing - Pain Assessment &
Management (2026/2027) WCU
1. A nurse is caring for a patient experiencing phantom limb pain following a
lower extremity amputation. How should the nurse categorize this type of pain?
A. Neuropathic pain
B. Somatic pain
C. Visceral pain
D. Psychogenic pain
Answer: A
Rationale: Neuropathic pain results from injury to or abnormal processing of peripheral
nerves or the central nervous system. Phantom limb pain is a classic example of
neuropathic pain.
2. According to the Gate Control Theory of Pain, which mechanism explains why
a back massage might alleviate pain?
A. Massage stimulates large-diameter sensory fibers to close the gate to pain impulses.
B. Massage increases the production of substance P in the dorsal horn.
C. Massage blocks the release of endorphins in the synapses.
D. Massage stimulates small-diameter C-fibers to inhibit the thalamus.
Answer: A
Rationale: The Gate Control Theory suggests that stimulating large-diameter A-beta fibers
(via touch or massage) can close the ‘gate’ in the spinal cord, preventing pain signals from
small-diameter fibers from reaching the brain.
,3. Which assessment finding is a physiologic response specifically associated
with acute pain rather than chronic pain?
A. Normal heart rate and blood pressure
B. Sleep disturbances and fatigue
C. Depression and withdrawal
D. Pupillary dilation and increased respiratory rate
Answer: D
Rationale: Acute pain triggers the sympathetic nervous system (fight or flight), leading to
tachycardia, hypertension, and pupillary dilation. In chronic pain, the body often adapts,
and vital signs may remain normal.
4. A client reports severe pain but is observed laughing and talking with visitors.
Which nursing action is most appropriate?
A. Document that the client is likely exaggerating the pain level.
B. Wait until the visitors leave to reassess the pain.
C. Administer the prescribed analgesic based on the client’s report.
D. Suggest that the client does not need medication because of the distraction.
Answer: C
Rationale: Pain is a subjective experience; the ‘gold standard’ is the patient’s self-report.
Distraction is a valid coping mechanism and does not mean the pain is absent.
5. Which pain assessment tool is most appropriate for a 4-year-old child?
A. Wong-Baker FACES Scale
B. PAINAD Scale
C. Numeric Rating Scale (0-10)
D. CRIES Scale
Answer: A
Rationale: The Wong-Baker FACES Scale is designed for children as young as 3 years old
who can point to a face that represents their level of hurt.
, 6. When assessing pain in an elderly patient with advanced dementia, which
tool should the nurse utilize?
A. Visual Analog Scale
B. PAINAD Scale
C. FLACC Scale
D. Simple Descriptive Pain Intensity Scale
Answer: B
Rationale: The Pain Assessment in Advanced Dementia (PAINAD) scale is specifically
designed to assess pain in non-verbal patients with cognitive impairment through
observation of breathing, vocalization, and body language.
7. A patient with a history of chronic pain requires increasing doses of an opioid
to achieve the same level of pain relief. The nurse recognizes this phenomenon
as:
A. Physical dependence
B. Tolerance
C. Addiction
D. Pseudoaddiction
Answer: B
Rationale: Tolerance is a normal physiological state where the body becomes accustomed
to the drug, requiring higher doses to achieve the same effect.
8. What is the primary benefit of using a Patient-Controlled Analgesia (PCA)
pump?
A. It eliminates the risk of respiratory depression.
B. It maintains a more constant level of serum drug concentration.
C. It allows the nurse to spend less time monitoring the patient.
D. It allows family members to control pain for the patient.
Answer: B
Management (2026/2027) WCU
1. A nurse is caring for a patient experiencing phantom limb pain following a
lower extremity amputation. How should the nurse categorize this type of pain?
A. Neuropathic pain
B. Somatic pain
C. Visceral pain
D. Psychogenic pain
Answer: A
Rationale: Neuropathic pain results from injury to or abnormal processing of peripheral
nerves or the central nervous system. Phantom limb pain is a classic example of
neuropathic pain.
2. According to the Gate Control Theory of Pain, which mechanism explains why
a back massage might alleviate pain?
A. Massage stimulates large-diameter sensory fibers to close the gate to pain impulses.
B. Massage increases the production of substance P in the dorsal horn.
C. Massage blocks the release of endorphins in the synapses.
D. Massage stimulates small-diameter C-fibers to inhibit the thalamus.
Answer: A
Rationale: The Gate Control Theory suggests that stimulating large-diameter A-beta fibers
(via touch or massage) can close the ‘gate’ in the spinal cord, preventing pain signals from
small-diameter fibers from reaching the brain.
,3. Which assessment finding is a physiologic response specifically associated
with acute pain rather than chronic pain?
A. Normal heart rate and blood pressure
B. Sleep disturbances and fatigue
C. Depression and withdrawal
D. Pupillary dilation and increased respiratory rate
Answer: D
Rationale: Acute pain triggers the sympathetic nervous system (fight or flight), leading to
tachycardia, hypertension, and pupillary dilation. In chronic pain, the body often adapts,
and vital signs may remain normal.
4. A client reports severe pain but is observed laughing and talking with visitors.
Which nursing action is most appropriate?
A. Document that the client is likely exaggerating the pain level.
B. Wait until the visitors leave to reassess the pain.
C. Administer the prescribed analgesic based on the client’s report.
D. Suggest that the client does not need medication because of the distraction.
Answer: C
Rationale: Pain is a subjective experience; the ‘gold standard’ is the patient’s self-report.
Distraction is a valid coping mechanism and does not mean the pain is absent.
5. Which pain assessment tool is most appropriate for a 4-year-old child?
A. Wong-Baker FACES Scale
B. PAINAD Scale
C. Numeric Rating Scale (0-10)
D. CRIES Scale
Answer: A
Rationale: The Wong-Baker FACES Scale is designed for children as young as 3 years old
who can point to a face that represents their level of hurt.
, 6. When assessing pain in an elderly patient with advanced dementia, which
tool should the nurse utilize?
A. Visual Analog Scale
B. PAINAD Scale
C. FLACC Scale
D. Simple Descriptive Pain Intensity Scale
Answer: B
Rationale: The Pain Assessment in Advanced Dementia (PAINAD) scale is specifically
designed to assess pain in non-verbal patients with cognitive impairment through
observation of breathing, vocalization, and body language.
7. A patient with a history of chronic pain requires increasing doses of an opioid
to achieve the same level of pain relief. The nurse recognizes this phenomenon
as:
A. Physical dependence
B. Tolerance
C. Addiction
D. Pseudoaddiction
Answer: B
Rationale: Tolerance is a normal physiological state where the body becomes accustomed
to the drug, requiring higher doses to achieve the same effect.
8. What is the primary benefit of using a Patient-Controlled Analgesia (PCA)
pump?
A. It eliminates the risk of respiratory depression.
B. It maintains a more constant level of serum drug concentration.
C. It allows the nurse to spend less time monitoring the patient.
D. It allows family members to control pain for the patient.
Answer: B
