Penn State University
3 MAXE 152 SRUN
PSU
Ross and Carol Nese College of Nursing · BSN Program
NURSING
MAKING LIFE BETTER
EST. 1855
NURS 251 — Exam 3: Pain, Sleep, Communication &
Cognition
PA I N M A N A G E M E N T · S L E E P D I S O R D E R S · T H E R A P E U T I C CO M M U N I C AT I O N · G E R I AT R I C SY N D R O M E S
· SENSORY FUNCTION
INSTITUTION Penn State University COURSE CODE NURS 251
PROGRAM Bachelor of Science in Nursing (BSN) ACADEMIC YEAR
EXAM TITLE NURS 251 — Exam 3: Pain, Sleep, TOTAL QUESTIONS 40 Questions
Communication & Cognition
COURSE TITLE Foundations of Professional Nursing · FORMAT Multiple Choice — Select the Single Best
Psychosocial & Sensory Health Answer
EXAMINATION INSTRUCTIONS
▸ Questions cover pain assessment/management, sleep physiology/disorders, therapeutic communication, cognition, sensory
function, and geriatric syndromes.
▸ Select the single best answer based on nursing fundamentals and NCLEX prioritization frameworks.
▸ Pay careful attention to pain types, sleep stages, phases of the nurse-patient relationship, and cognitive assessment.
▸ Correct answers and detailed rationales appear below each question for comprehensive exam preparation.
PAIN MANAGEMENT · SLEEP · COMMUNICATION · COGNITION · SENSORY · Questions 1
GERIATRIC SYNDROMES – 40
1. What is the definition of pain according to nursing fundamentals?
A. An objective measurement based on vital sign changes
B. Whatever the patient says it is, whenever the patient says it does—SUBJECTIVE
C. Only nociceptive stimulation of nerve fibers
D. A condition that always correlates with tissue damage
CORRECT ANSWER B. Whatever the patient says it is, whenever the patient says it does—SUBJECTIVE
RATIONALE Pain is a subjective experience—the gold standard for pain assessment is the patient's self-report. Margo
McCaffery's classic definition: "Pain is whatever the experiencing person says it is, existing whenever the
experiencing person says it does." The nurse must BELIEVE the patient's report. Vital signs may be normal in
chronic pain. Lack of objective findings does not mean pain is absent.
, 2. What is the difference between acute and chronic (persistent) pain?
A. Acute: results from abnormal pain signaling; Chronic: results from tissue injury
B. Acute: result of potential/actual tissue injury with nociceptive activation; Chronic: results from abnormal pain-
signaling process persisting beyond normal healing
C. There is no difference—both are identical
D. Acute pain is always less severe than chronic pain
CORRECT ANSWER B. Acute: result of potential/actual tissue injury with nociceptive activation; Chronic: results from
abnormal pain-signaling process persisting beyond normal healing
RATIONALE Acute pain has a clear cause—tissue injury activating nociceptors. It is self-limited and resolves with healing.
Physiologic signs include: tachycardia, hypertension, increased RR, diaphoresis. Chronic (persistent) pain
continues beyond the expected healing time (>3–6 months) and results from abnormal pain processing. Vital
sign changes may be absent in chronic pain due to physiologic adaptation.
3. What is neuropathic pain?
A. Pain arising from tissue damage outside the nervous system
B. Pain arising from damage to peripheral nerves or the CNS—result of abnormal sensory input
C. Pain from visceral organ inflammation
D. Pain that is entirely psychological in origin
CORRECT ANSWER B. Pain arising from damage to peripheral nerves or the CNS—result of abnormal sensory input
RATIONALE Neuropathic pain results from nerve damage or dysfunction—described as burning, shooting, tingling, or
"pins and needles." Examples: diabetic neuropathy, post-herpetic neuralgia, phantom limb pain, spinal cord
injury pain. It responds poorly to traditional analgesics but better to adjuvant medications (anticonvulsants—
gabapentin, pregabalin; antidepressants—duloxetine, amitriptyline). Nociceptive pain (Option A) arises from
tissue injury outside the nervous system.
4. What is a key nursing implication regarding acetaminophen (APAP)?
A. It has no maximum daily dose
B. Do not exceed 4 grams in 24 hours—can cause liver toxicity
C. It is an opioid analgesic
D. It inhibits platelet aggregation like NSAIDs
CORRECT ANSWER B. Do not exceed 4 grams in 24 hours—can cause liver toxicity
RATIONALE Acetaminophen (Tylenol) is a non-opioid analgesic with a CEILING effect—doses beyond the maximum
provide no additional pain relief but cause hepatotoxicity. The maximum is 4 g/24 hours for adults (lower in
liver disease or heavy alcohol use—often 2–3 g). It does NOT have anti-inflammatory or anti-platelet effects
(unlike NSAIDs). It is often combined with opioids (Norco, Percocet)—always calculate total APAP from all
sources.
3 MAXE 152 SRUN
PSU
Ross and Carol Nese College of Nursing · BSN Program
NURSING
MAKING LIFE BETTER
EST. 1855
NURS 251 — Exam 3: Pain, Sleep, Communication &
Cognition
PA I N M A N A G E M E N T · S L E E P D I S O R D E R S · T H E R A P E U T I C CO M M U N I C AT I O N · G E R I AT R I C SY N D R O M E S
· SENSORY FUNCTION
INSTITUTION Penn State University COURSE CODE NURS 251
PROGRAM Bachelor of Science in Nursing (BSN) ACADEMIC YEAR
EXAM TITLE NURS 251 — Exam 3: Pain, Sleep, TOTAL QUESTIONS 40 Questions
Communication & Cognition
COURSE TITLE Foundations of Professional Nursing · FORMAT Multiple Choice — Select the Single Best
Psychosocial & Sensory Health Answer
EXAMINATION INSTRUCTIONS
▸ Questions cover pain assessment/management, sleep physiology/disorders, therapeutic communication, cognition, sensory
function, and geriatric syndromes.
▸ Select the single best answer based on nursing fundamentals and NCLEX prioritization frameworks.
▸ Pay careful attention to pain types, sleep stages, phases of the nurse-patient relationship, and cognitive assessment.
▸ Correct answers and detailed rationales appear below each question for comprehensive exam preparation.
PAIN MANAGEMENT · SLEEP · COMMUNICATION · COGNITION · SENSORY · Questions 1
GERIATRIC SYNDROMES – 40
1. What is the definition of pain according to nursing fundamentals?
A. An objective measurement based on vital sign changes
B. Whatever the patient says it is, whenever the patient says it does—SUBJECTIVE
C. Only nociceptive stimulation of nerve fibers
D. A condition that always correlates with tissue damage
CORRECT ANSWER B. Whatever the patient says it is, whenever the patient says it does—SUBJECTIVE
RATIONALE Pain is a subjective experience—the gold standard for pain assessment is the patient's self-report. Margo
McCaffery's classic definition: "Pain is whatever the experiencing person says it is, existing whenever the
experiencing person says it does." The nurse must BELIEVE the patient's report. Vital signs may be normal in
chronic pain. Lack of objective findings does not mean pain is absent.
, 2. What is the difference between acute and chronic (persistent) pain?
A. Acute: results from abnormal pain signaling; Chronic: results from tissue injury
B. Acute: result of potential/actual tissue injury with nociceptive activation; Chronic: results from abnormal pain-
signaling process persisting beyond normal healing
C. There is no difference—both are identical
D. Acute pain is always less severe than chronic pain
CORRECT ANSWER B. Acute: result of potential/actual tissue injury with nociceptive activation; Chronic: results from
abnormal pain-signaling process persisting beyond normal healing
RATIONALE Acute pain has a clear cause—tissue injury activating nociceptors. It is self-limited and resolves with healing.
Physiologic signs include: tachycardia, hypertension, increased RR, diaphoresis. Chronic (persistent) pain
continues beyond the expected healing time (>3–6 months) and results from abnormal pain processing. Vital
sign changes may be absent in chronic pain due to physiologic adaptation.
3. What is neuropathic pain?
A. Pain arising from tissue damage outside the nervous system
B. Pain arising from damage to peripheral nerves or the CNS—result of abnormal sensory input
C. Pain from visceral organ inflammation
D. Pain that is entirely psychological in origin
CORRECT ANSWER B. Pain arising from damage to peripheral nerves or the CNS—result of abnormal sensory input
RATIONALE Neuropathic pain results from nerve damage or dysfunction—described as burning, shooting, tingling, or
"pins and needles." Examples: diabetic neuropathy, post-herpetic neuralgia, phantom limb pain, spinal cord
injury pain. It responds poorly to traditional analgesics but better to adjuvant medications (anticonvulsants—
gabapentin, pregabalin; antidepressants—duloxetine, amitriptyline). Nociceptive pain (Option A) arises from
tissue injury outside the nervous system.
4. What is a key nursing implication regarding acetaminophen (APAP)?
A. It has no maximum daily dose
B. Do not exceed 4 grams in 24 hours—can cause liver toxicity
C. It is an opioid analgesic
D. It inhibits platelet aggregation like NSAIDs
CORRECT ANSWER B. Do not exceed 4 grams in 24 hours—can cause liver toxicity
RATIONALE Acetaminophen (Tylenol) is a non-opioid analgesic with a CEILING effect—doses beyond the maximum
provide no additional pain relief but cause hepatotoxicity. The maximum is 4 g/24 hours for adults (lower in
liver disease or heavy alcohol use—often 2–3 g). It does NOT have anti-inflammatory or anti-platelet effects
(unlike NSAIDs). It is often combined with opioids (Norco, Percocet)—always calculate total APAP from all
sources.
