1. A client reports acute pain in the lower back after lifting a heavy object. Which nursing intervention should the nurse prioritize?
• A. Administering an opioid analgesic
• B. Encouraging bed rest for 24 hours
• C. Applying cold compresses to the affected area
• D. Teaching relaxatio...
1. A client reports acute pain in the lower back after lifting a heavy object.
Which nursing intervention should the nurse prioritize?
• A. Administering an opioid analgesic
• B. Encouraging bed rest for 24 hours
• C. Applying cold compresses to the affected area
• D. Teaching relaxation techniques
Correct Answer: C. Applying cold compresses to the affected area
Rationale: Cold therapy is effective in reducing inflammation and pain in acute injuries by
numbing the area and reducing swelling. Bed rest and relaxation techniques may follow, but
immediate intervention focuses on reducing pain and inflammation. Opioids may be considered
later if non-pharmacologic methods are ineffective.
2. Which statement by a client indicates a need for further teaching about pain
management?
• A. "I will take my pain medication before the pain becomes severe."
• B. "I will ask for pain medication only when the pain is unbearable."
• C. "I can use heat packs to relieve muscle tension."
• D. "I will report any side effects from the pain medications."
Correct Answer: B. "I will ask for pain medication only when the pain is unbearable."
Rationale: Pain medications are most effective when taken before pain becomes severe. Waiting
until pain is unbearable can make it harder to control. Education should focus on using
medications preemptively.
3. A client receiving morphine for postoperative pain is found to be unresponsive
with a respiratory rate of 6 breaths/min. What is the nurse’s next best action?
• A. Administer naloxone
• B. Call the rapid response team
• C. Provide oxygen therapy
• D. Elevate the head of the bed
Correct Answer: A. Administer naloxone
Rationale: Naloxone is an opioid antagonist that reverses the effects of opioid overdose,
including respiratory depression. Administering naloxone immediately is crucial in opioid
toxicity.
,4. During a pain assessment, the nurse asks the client to rate their pain. Which
pain scale is most appropriate for an adult client who can verbalize and quantify
their pain?
• A. FLACC Scale
• B. Faces Pain Scale
• C. Numerical Rating Scale
• D. CRIES Scale
Correct Answer: C. Numerical Rating Scale
Rationale: The Numerical Rating Scale (0-10) is commonly used for adult clients who can
verbalize and quantify their pain. The other scales are more suitable for non-verbal or pediatric
clients.
5. A client with chronic cancer pain is taking an extended-release opioid every 12
hours. The client reports breakthrough pain. Which medication should the nurse
anticipate being prescribed?
• A. An additional dose of the extended-release opioid
• B. A short-acting opioid
• C. A non-opioid analgesic
• D. A muscle relaxant
Correct Answer: B. A short-acting opioid
Rationale: Breakthrough pain is common in clients on extended-release opioids and is best
managed with a short-acting opioid for rapid pain control. A non-opioid may help with chronic
pain, but breakthrough pain requires quick relief.
6. Which client is at highest risk for opioid addiction?
• A. A client with chronic back pain taking prescribed opioids for 3 years
• B. A postoperative client who has received opioids for 2 days
• C. A client with cancer pain receiving palliative care
• D. A client using non-opioid medications for pain
Correct Answer: A. A client with chronic back pain taking prescribed opioids for 3 years
Rationale: Chronic use of opioids increases the risk of addiction, especially in clients who take
opioids over an extended period for non-terminal conditions such as chronic back pain. Clients
on short-term or palliative care regimens are less likely to develop addiction.
, 7. A client with osteoarthritis is prescribed acetaminophen for pain relief. Which
statement indicates the client needs further teaching?
• A. "I can take acetaminophen every 4-6 hours."
• B. "I will avoid alcohol while taking acetaminophen."
• C. "I will limit my dose to 3,000 mg daily."
• D. "I can take more acetaminophen if the pain doesn't go away after an hour."
Correct Answer: D. "I can take more acetaminophen if the pain doesn't go away after an hour."
Rationale: Acetaminophen has a maximum daily dose of 3,000 mg to prevent liver toxicity.
Taking extra doses within short intervals can increase the risk of overdose.
8. A client with severe postoperative pain is prescribed patient-controlled
analgesia (PCA) with morphine. Which of the following is a priority nursing
action?
• A. Assess the client's pain level every 4 hours
• B. Teach the client to administer the medication as frequently as possible
• C. Monitor the client’s respiratory status
• D. Increase the basal rate if pain persists
Correct Answer: C. Monitor the client’s respiratory status
Rationale: PCA administration of opioids, such as morphine, can lead to respiratory depression.
Monitoring respiratory rate and sedation level is a priority to prevent complications.
9. Which assessment finding in a client taking opioids for pain management
should the nurse report immediately?
• A. Constipation
• B. Drowsiness
• C. Respiratory rate of 10 breaths/min
• D. Mild nausea
Correct Answer: C. Respiratory rate of 10 breaths/min
Rationale: Opioids can cause respiratory depression, and a respiratory rate below 12 breaths per
minute is concerning. The nurse should report this finding immediately as it may indicate opioid
toxicity.
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