Fundamentals Of Nursing NCLEX Quiz 44
All questions are shown, but the results will only be given after you’ve finished the quiz. You are given 1 minute per question, a total of 10 minutes in this quiz.
- 1.
Place the examples of drugs in the order of usage according to the World Health Organization (WHO) analgesic ladder. (1. Morphine. hydromorphone. acetaminophen and lorazepam || 2. NSAIDs and corticosteroids || 3. Codeine. oxycodone and diphenhydramine)
- A.
3 ,2 ,1
- B.
2 ,3 ,1
- C.
1 ,2 ,3
- D.
1 ,3 ,2
Correct Answer
B. 2 ,3 ,1Explanation
Step 1 includes non-opioids and adjuvant drugs. Step 2 includes opioids for mild pain plus Step 1 drugs and adjuvant drugs as needed. Step 3 includes opioids for severe pain (replacing Step 2 opioids) and continuing Step 1 drugs and adjuvant drugs as needed.Rate this question:
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- 2.
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
Correct Answer
D. A child with an arm fracture and cystic fibrosisExplanation
At greatest risk are elderly clients. opiate naïve clients. and those with underlying pulmonary disease. The child has two of the three risk factors.Rate this question:
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- 3.
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.
Correct Answer
A. Encourage expression of fears on past experiences.Explanation
This client has strong beliefs and emotions related to the issue of sibling addiction. First. encourage expression. This indicated to the client that the feelings are real and valid. It is also an opportunity to assess beliefs and fears. Giving facts and information is appropriate at the right time. Family involvement is important. bearing in mind that their beliefs about drug addiction may be similar to those of the client.Rate this question:
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- 4.
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
Correct Answer
C. DiapHoresisExplanation
Diaphoresis is one of the early signs that occur between 6 and 12 hours. Fever. nausea. and abdominal cramps are late signs that occur between 48 and 72 hours.Rate this question:
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- 5.
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.
Correct Answer
A. Assist the client with preparation of a sitz bath.Explanation
The nursing assistant is able to assist the client with hygiene issues and knows the principles of safety and comfort for this procedure. Monitoring the client. teaching techniques. and evaluating outcomes are nursing responsibilities.Rate this question:
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- 6.
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.
Correct Answer
D. Contact the charge nurse for advice.Explanation
The charge nurse is a resource person who can help locate and review the policy. If the physician is insistent. he or she could give the placebo personally. but delaying the administration does not endanger the health or safety of the client. While following one’s own ethical code is correct. you must ensure that the client is not abandoned and that care continues.Rate this question:
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- 7.
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.
Correct Answer
B. Obtain baseline behavioral indicators from family members.Explanation
Complete information from the family should be obtained during the initial comprehensive history and assessment. If this information is not obtained. the nursing staff will have to rely on observation of nonverbal behavior and careful documentation to determine pain and relief patterns.Rate this question:
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- 8.
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
Correct Answer
C. OralExplanation
If the gastrointestinal system is function. the oral route is preferred for routine analgesics because of lower cost and ease of administration. Oral route is also less painful and less invasive than the IV. IM. subcutaneous. or PCA routes. Transdermal route is slower and medication availability is limited compared to oral forms.Rate this question:
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- 9.
A first day postoperative 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.
Correct Answer
D. Assess the pain for location. quality. and intensity.Explanation
Assess the pain for changes in location. quality. and intensity. as well as changes in response to medication. This assessment will guide the next steps.Rate this question:
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- 10.
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)
Correct Answer
C. Side-lying position with knees to chest and pillow against abdomenExplanation
The side-lying. knee-chest position opens retroperitoneal space and provides relief. The pillow provides a splinting action. Diversional therapy is not the best choice for acute pain. especially if the activity requires concentration. TENS is more appropriate for chronic muscular pain. The additional stimulation of massage may be distressing to the client.Rate this question:
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Mar 22, 2023Quiz Edited by
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Aug 31, 2017Quiz Created by
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