NCLEX PN Exam Bank Pain Assessment and
Non-Pharmacological Interventions
Table of Contents
Subtopic 1: Principles of Pain Assessment (Questions 1–20) ............................................ 2
Subtopic 2: Non-Pharmacological Pain Management in Acute Care .................................. 9
Subtopic 3: Pain Management in Pediatric and Geriatric Clients (Questions 41–60) ......... 16
Subtopic 4: Cultural and Psychosocial Factors Influencing Pain (Questions 61–80) .......... 24
Subtopic 5: Chronic Pain and Long-Term Non-Pharmacological Management (Questions
81–100) ...................................................................................................................... 31
Subtopic 6: Procedural and Post-Procedure Pain Management (Questions 101–120) ....... 38
Subtopic 7: Pain Assessment and Interventions in End-of-Life Care (Questions 121–140) . 46
Subtopic 8: Pain Assessment Tools and Documentation Accuracy (Questions 141–160) .. 53
Subtopic 9: Special Populations and Pain (Geriatric, Cognitive Impairment, Substance Use
History) (Questions 161–180) ....................................................................................... 60
Subtopic 10: Multimodal Pain Management and Interprofessional Collaboration (Questions
181–200) .................................................................................................................... 67
1
,Subtopic 1: Principles of Pain Assessment (Questions 1–
20)
1. A client recovering from abdominal surgery reports pain rated 8 out of 10. Which action
should the nurse take first?
A. Instruct the client to use deep breathing
B. Assess the location, quality, and characteristics of the pain
C. Administer prescribed non-opioid pain medication
D. Notify the physician immediately
Rationale: Pain should be assessed in detail before taking action. Gathering information
about the pain’s location, type, intensity, and onset helps guide appropriate interventions.
2. The nurse is assessing an older adult who denies pain but is grimacing and guarding the
abdomen. What should the nurse do next?
A. Document "no pain" as stated by the patient
B. Offer distractions and reposition the patient
C. Wait and reassess in an hour
D. Use a pain scale appropriate for older adults and rephrase the question
Rationale: Older adults may underreport pain. Using tools like the PAINAD or rephrasing
questions helps improve accuracy in assessing pain in older clients.
3. Which statement by a nurse reflects understanding of pain as a subjective experience?
A. “Pain must be verified with vital signs changes.”
B. “Pain is what the patient says it is, regardless of appearance.”
C. “If a patient is sleeping, they are not in pain.”
D. “Objective signs must match the pain score for it to be believed.”
2
,Rationale: Pain is subjective and should be believed and treated based on the patient's
report, not solely on physical signs.
4. A confused patient with dementia is post-op and may be in pain. What is the most
reliable approach for the nurse?
A. Ask the client to rate pain using a numeric scale
B. Administer a placebo to determine response
C. Observe non-verbal cues such as moaning and facial grimacing
D. Wait for the client to request medication
Rationale: For clients who cannot communicate effectively, nurses rely on non-verbal
indicators to assess pain.
5. Which pain assessment tool is best for a 5-year-old verbal child?
A. Numerical rating scale
B. Wong-Baker FACES scale
C. FLACC scale
D. Visual analog scale
Rationale: The Wong-Baker FACES scale is appropriate for children aged 3 and older who
can understand and express choices based on pictures.
6. What is the best method for assessing pain in a non-verbal, ventilated adult?
A. Ask the family what the patient would feel
B. Use the Critical-Care Pain Observation Tool (CPOT)
C. Wait for physical movement
3
, D. Guess based on clinical situation
Rationale: CPOT evaluates non-verbal indicators like facial expression, muscle tension,
and compliance with the ventilator to assess pain.
7. A nurse documents that a client’s pain is “severe, burning, and radiating down the leg.”
What component of pain assessment is this?
A. Intensity
B. Quality
C. Duration
D. Chronology
Rationale: Descriptors like “burning” and “radiating” refer to the quality or nature of the
pain, helping identify the source and type.
8. A patient has chronic arthritis and reports pain of 6/10 daily. Which nursing intervention
is most appropriate?
A. Explain pain tolerance develops with time
B. Document the pain and develop a consistent pain management plan
C. Reassure the patient that arthritis pain is common
D. Discontinue pain medication
Rationale: Chronic pain requires long-term management strategies, often involving
scheduled non-pharmacological and pharmacologic approaches.
9. Which factor most influences how a patient perceives pain?
A. Age
4
Non-Pharmacological Interventions
Table of Contents
Subtopic 1: Principles of Pain Assessment (Questions 1–20) ............................................ 2
Subtopic 2: Non-Pharmacological Pain Management in Acute Care .................................. 9
Subtopic 3: Pain Management in Pediatric and Geriatric Clients (Questions 41–60) ......... 16
Subtopic 4: Cultural and Psychosocial Factors Influencing Pain (Questions 61–80) .......... 24
Subtopic 5: Chronic Pain and Long-Term Non-Pharmacological Management (Questions
81–100) ...................................................................................................................... 31
Subtopic 6: Procedural and Post-Procedure Pain Management (Questions 101–120) ....... 38
Subtopic 7: Pain Assessment and Interventions in End-of-Life Care (Questions 121–140) . 46
Subtopic 8: Pain Assessment Tools and Documentation Accuracy (Questions 141–160) .. 53
Subtopic 9: Special Populations and Pain (Geriatric, Cognitive Impairment, Substance Use
History) (Questions 161–180) ....................................................................................... 60
Subtopic 10: Multimodal Pain Management and Interprofessional Collaboration (Questions
181–200) .................................................................................................................... 67
1
,Subtopic 1: Principles of Pain Assessment (Questions 1–
20)
1. A client recovering from abdominal surgery reports pain rated 8 out of 10. Which action
should the nurse take first?
A. Instruct the client to use deep breathing
B. Assess the location, quality, and characteristics of the pain
C. Administer prescribed non-opioid pain medication
D. Notify the physician immediately
Rationale: Pain should be assessed in detail before taking action. Gathering information
about the pain’s location, type, intensity, and onset helps guide appropriate interventions.
2. The nurse is assessing an older adult who denies pain but is grimacing and guarding the
abdomen. What should the nurse do next?
A. Document "no pain" as stated by the patient
B. Offer distractions and reposition the patient
C. Wait and reassess in an hour
D. Use a pain scale appropriate for older adults and rephrase the question
Rationale: Older adults may underreport pain. Using tools like the PAINAD or rephrasing
questions helps improve accuracy in assessing pain in older clients.
3. Which statement by a nurse reflects understanding of pain as a subjective experience?
A. “Pain must be verified with vital signs changes.”
B. “Pain is what the patient says it is, regardless of appearance.”
C. “If a patient is sleeping, they are not in pain.”
D. “Objective signs must match the pain score for it to be believed.”
2
,Rationale: Pain is subjective and should be believed and treated based on the patient's
report, not solely on physical signs.
4. A confused patient with dementia is post-op and may be in pain. What is the most
reliable approach for the nurse?
A. Ask the client to rate pain using a numeric scale
B. Administer a placebo to determine response
C. Observe non-verbal cues such as moaning and facial grimacing
D. Wait for the client to request medication
Rationale: For clients who cannot communicate effectively, nurses rely on non-verbal
indicators to assess pain.
5. Which pain assessment tool is best for a 5-year-old verbal child?
A. Numerical rating scale
B. Wong-Baker FACES scale
C. FLACC scale
D. Visual analog scale
Rationale: The Wong-Baker FACES scale is appropriate for children aged 3 and older who
can understand and express choices based on pictures.
6. What is the best method for assessing pain in a non-verbal, ventilated adult?
A. Ask the family what the patient would feel
B. Use the Critical-Care Pain Observation Tool (CPOT)
C. Wait for physical movement
3
, D. Guess based on clinical situation
Rationale: CPOT evaluates non-verbal indicators like facial expression, muscle tension,
and compliance with the ventilator to assess pain.
7. A nurse documents that a client’s pain is “severe, burning, and radiating down the leg.”
What component of pain assessment is this?
A. Intensity
B. Quality
C. Duration
D. Chronology
Rationale: Descriptors like “burning” and “radiating” refer to the quality or nature of the
pain, helping identify the source and type.
8. A patient has chronic arthritis and reports pain of 6/10 daily. Which nursing intervention
is most appropriate?
A. Explain pain tolerance develops with time
B. Document the pain and develop a consistent pain management plan
C. Reassure the patient that arthritis pain is common
D. Discontinue pain medication
Rationale: Chronic pain requires long-term management strategies, often involving
scheduled non-pharmacological and pharmacologic approaches.
9. Which factor most influences how a patient perceives pain?
A. Age
4
