Nclex Practice Questions NURS MISC Laney
College 2022/2023 updated with rationale
CHAPTER 1
PAIN
1. A chronic pain client reports to you, the charge nurse, that the nurse
have not been responding to requests for pain medication. What is
your initial action?
a. Check the MARs and nurses’ notes for the past several days.
b. Ask the nurse educator to give an in-service about pain management.
c. Perform a complete pain assessment and history on the client.
d. Have a conference with the nurses responsible for the care of this client
2. Family members are encouraging your client to “tough it out” rather
than run the risk of becoming addicted to narcotics. The client is
stoically abiding by the family’s wishes. Priority nursing interventions
for this client should target which dimension of pain?
a. Sensory
b. Affective
c. Sociocultural
d. Behavioral
e. Cognitive
3. A client with diabetic neuropathy reports a burning, electrical-type in
the lower extremities that is not responding to NSAIDs. You
anticipate that the physician will order which adjuvant medication for
this type of pain?
a. Amitriptyline (Elavil)
b. Corticosteroids
c. Methylphenidate (Ritalin)
d. Lorazepam (Ativan)
4. Which client is most likely to receive opioids for extended periods of
time?
a. A client with fibrolyalgia
b. A client with phantom limb pain
c. A client with progressive pancreatic cancer
d. A client with trigeminal neuralgia
5. As the charge nurse, you are reviewing the charts of clients who were
assigned to a newly graduated RN. The RN has correctly charted dose
and time of medication, but there is no documentation regarding non-
pharmaceutical measures. What action should you take first?
a. Make a note in the nurse’s file and continue to observe clinical
performance
b. Refer the new nurse to the in-service education department.
c. Quiz the nurse about knowledge of pain management
d. Give praise for the correct dose and time and discuss the deficits in
charting.
6. In caring for a young child with pain, which assessment tool is the
most useful?
,a. Simple description pain intensity scale
b. 0-10 numeric pain scale
, c. Faces pain-rating scale
d. McGill-Melzack pain questionnaire
7. In applying the principles of pain treatment, what is the first
consideration?
a. Treatment is based on client goals.
b. A multidisciplinary approach is needed.
c. The client must be believed about perceptions of own pain.
d. Drug side effects must be prevented and managed.
8. Which route of administration is preferred if immediate analgesia and
rapid titration are necessary?
a. Intraspinal
b. Patient-controlled analgesia (PCA)
c. Intravenous (IV)
d. Sublingual
9. When titrating an analgesic to manage pain, what is the priority goal?
a. Administer smallest dose that provides relief with the fewest side
effects.
b. Titrate upward until the client is pain free.
c. Titrate downwards to prevent toxicity.
d. Ensure that the drug is adequate to meet the client’s subjective needs.
10.In educating clients about non-pharmaceutical alternatives, which
topic could you delegate to an experienced LPN/LVN, who will
function under your continued support and supervision?
a. Therapeutic touch
b. Use of heat and cold applications
c. Meditation
d. Transcutaneous electrical nerve stimulation (TENS)
11.Place the examples of drugs in the order of usage according to the
World Health Organization (WHO) analgesic ladder.
a. Morphine, hydromorphone, acetaminophen and lorazepam
b. NSAIDs and corticosteroids
c. Codeine, oxycodone and diphenhydramine
, ,
12.Which client is at greater risk for respiratory depression while
receiving opioids for analgesia?
a. An elderly chronic pain client with a hip fracture
b. A client with a heroin addiction and back pain
c. A young female client with advanced multiple myeloma
d. A child with an arm fracture and cystic fibrosis
13.A client appears upset and tearful, but denies pain and refuses pain
medication, because “my sibling is a drug addict and has ruined out
lives.” What is the priority intervention for this client?
a. Encourage expression of fears on past experiences
b. Provide accurate information about use of pain medication
c. Explain that addiction is unlikely among acute care clients.
d. Seek family assistance in resolving this problem.
, 14.A client is being tapered off opioids and the nurse is watchful for
signs of withdrawal. What is one of the first signs of withdrawal?
a. Fever
b. Nausea
c. Diaphoresis
d. Abdominal cramps
15.In caring for clients with pain and discomfort, which task is most
appropriate to delegate to the nursing assistant?
a. Assist the client with preparation of a sitz bath.
b. Monitor the client for signs of discomfort while ambulating
c. Coach the client to deep breathe during painful procedures
d. Evaluate relief after applying a cold application.
16.The physician has ordered a placebo for a chronic pain client. You are
newly hired nurse and you feel very uncomfortable administering the
medication. What is the first action that you should take?
a. Prepare the medication and hand it to the physician
b. Check the hospital policy regarding use of the placebo.
c. Follow a personal code of ethics and refuse to give it.
d. Contact the charge nurse for advice.
17.For a cognitively impaired client who cannot accurately report pain,
what is the first action that you should take?
a. Closely assess for nonverbal signs such as grimacing or rocking.
b. Obtain baseline behavioral indicators from family members.
c. Look at the MAR and chart, to note the time of the last dose and
response.
d. Give the maximum PRS dose within the minimum time frame for relief.
18.Which route of administration is preferable for administration of daily
analgesics (if all body systems are functional)?
a. IV
b. IM or subcutaneous
c. Oral
d. Transdermal
e. PCA
19.A first day post-operative client on a PCA pump reports that the pain
control is inadequate. What is the first action you should take?
a. Deliver the bolus dose per standing order.
b. Contact the physician to increase the dose.
c. Try non-pharmacological comfort measures.
d. Assess the pain for location, quality, and intensity.
20.Which non-pharmacological measure is particularly useful for a client
with acute pancreatitis?
a. Diversional therapy, such as playing cards or board games
b. Massage of back and neck with warmed lotion
c. Side-lying position with knees to chest and pillow against abdomen
d. Transcutaneous electrical nerve stimulation (TENS)
College 2022/2023 updated with rationale
CHAPTER 1
PAIN
1. A chronic pain client reports to you, the charge nurse, that the nurse
have not been responding to requests for pain medication. What is
your initial action?
a. Check the MARs and nurses’ notes for the past several days.
b. Ask the nurse educator to give an in-service about pain management.
c. Perform a complete pain assessment and history on the client.
d. Have a conference with the nurses responsible for the care of this client
2. Family members are encouraging your client to “tough it out” rather
than run the risk of becoming addicted to narcotics. The client is
stoically abiding by the family’s wishes. Priority nursing interventions
for this client should target which dimension of pain?
a. Sensory
b. Affective
c. Sociocultural
d. Behavioral
e. Cognitive
3. A client with diabetic neuropathy reports a burning, electrical-type in
the lower extremities that is not responding to NSAIDs. You
anticipate that the physician will order which adjuvant medication for
this type of pain?
a. Amitriptyline (Elavil)
b. Corticosteroids
c. Methylphenidate (Ritalin)
d. Lorazepam (Ativan)
4. Which client is most likely to receive opioids for extended periods of
time?
a. A client with fibrolyalgia
b. A client with phantom limb pain
c. A client with progressive pancreatic cancer
d. A client with trigeminal neuralgia
5. As the charge nurse, you are reviewing the charts of clients who were
assigned to a newly graduated RN. The RN has correctly charted dose
and time of medication, but there is no documentation regarding non-
pharmaceutical measures. What action should you take first?
a. Make a note in the nurse’s file and continue to observe clinical
performance
b. Refer the new nurse to the in-service education department.
c. Quiz the nurse about knowledge of pain management
d. Give praise for the correct dose and time and discuss the deficits in
charting.
6. In caring for a young child with pain, which assessment tool is the
most useful?
,a. Simple description pain intensity scale
b. 0-10 numeric pain scale
, c. Faces pain-rating scale
d. McGill-Melzack pain questionnaire
7. In applying the principles of pain treatment, what is the first
consideration?
a. Treatment is based on client goals.
b. A multidisciplinary approach is needed.
c. The client must be believed about perceptions of own pain.
d. Drug side effects must be prevented and managed.
8. Which route of administration is preferred if immediate analgesia and
rapid titration are necessary?
a. Intraspinal
b. Patient-controlled analgesia (PCA)
c. Intravenous (IV)
d. Sublingual
9. When titrating an analgesic to manage pain, what is the priority goal?
a. Administer smallest dose that provides relief with the fewest side
effects.
b. Titrate upward until the client is pain free.
c. Titrate downwards to prevent toxicity.
d. Ensure that the drug is adequate to meet the client’s subjective needs.
10.In educating clients about non-pharmaceutical alternatives, which
topic could you delegate to an experienced LPN/LVN, who will
function under your continued support and supervision?
a. Therapeutic touch
b. Use of heat and cold applications
c. Meditation
d. Transcutaneous electrical nerve stimulation (TENS)
11.Place the examples of drugs in the order of usage according to the
World Health Organization (WHO) analgesic ladder.
a. Morphine, hydromorphone, acetaminophen and lorazepam
b. NSAIDs and corticosteroids
c. Codeine, oxycodone and diphenhydramine
, ,
12.Which client is at greater risk for respiratory depression while
receiving opioids for analgesia?
a. An elderly chronic pain client with a hip fracture
b. A client with a heroin addiction and back pain
c. A young female client with advanced multiple myeloma
d. A child with an arm fracture and cystic fibrosis
13.A client appears upset and tearful, but denies pain and refuses pain
medication, because “my sibling is a drug addict and has ruined out
lives.” What is the priority intervention for this client?
a. Encourage expression of fears on past experiences
b. Provide accurate information about use of pain medication
c. Explain that addiction is unlikely among acute care clients.
d. Seek family assistance in resolving this problem.
, 14.A client is being tapered off opioids and the nurse is watchful for
signs of withdrawal. What is one of the first signs of withdrawal?
a. Fever
b. Nausea
c. Diaphoresis
d. Abdominal cramps
15.In caring for clients with pain and discomfort, which task is most
appropriate to delegate to the nursing assistant?
a. Assist the client with preparation of a sitz bath.
b. Monitor the client for signs of discomfort while ambulating
c. Coach the client to deep breathe during painful procedures
d. Evaluate relief after applying a cold application.
16.The physician has ordered a placebo for a chronic pain client. You are
newly hired nurse and you feel very uncomfortable administering the
medication. What is the first action that you should take?
a. Prepare the medication and hand it to the physician
b. Check the hospital policy regarding use of the placebo.
c. Follow a personal code of ethics and refuse to give it.
d. Contact the charge nurse for advice.
17.For a cognitively impaired client who cannot accurately report pain,
what is the first action that you should take?
a. Closely assess for nonverbal signs such as grimacing or rocking.
b. Obtain baseline behavioral indicators from family members.
c. Look at the MAR and chart, to note the time of the last dose and
response.
d. Give the maximum PRS dose within the minimum time frame for relief.
18.Which route of administration is preferable for administration of daily
analgesics (if all body systems are functional)?
a. IV
b. IM or subcutaneous
c. Oral
d. Transdermal
e. PCA
19.A first day post-operative client on a PCA pump reports that the pain
control is inadequate. What is the first action you should take?
a. Deliver the bolus dose per standing order.
b. Contact the physician to increase the dose.
c. Try non-pharmacological comfort measures.
d. Assess the pain for location, quality, and intensity.
20.Which non-pharmacological measure is particularly useful for a client
with acute pancreatitis?
a. Diversional therapy, such as playing cards or board games
b. Massage of back and neck with warmed lotion
c. Side-lying position with knees to chest and pillow against abdomen
d. Transcutaneous electrical nerve stimulation (TENS)
