Orthopaedic Nurse Test Pharmacology & Pain Management

Question 1

Which class of medications works by inhibiting cyclooxygenase (COX) enzymes to reduce inflammation and pain in orthopaedic patients?

Accepted Answer

Nonsteroidal anti-inflammatory drugs (NSAIDs)

Answer

NSAIDs inhibit COX-1 and COX-2 enzymes, thereby reducing prostaglandin synthesis and decreasing inflammation, pain, and fever.

Question 2

A patient recovering from total knee replacement is on a PCA (patient-controlled analgesia) pump with morphine. The nurse notes a respiratory rate of 8 breaths/min and pinpoint pupils. What is the priority intervention?

Accepted Answer

Administer naloxone (Narcan) as prescribed

Answer

Respiratory depression with pinpoint pupils indicates opioid toxicity; naloxone is the opioid antagonist that rapidly reverses this life-threatening complication.

Question 3

Which anticoagulant is most commonly prescribed for venous thromboembolism (VTE) prophylaxis after total hip arthroplasty?

Accepted Answer

Rivaroxaban (Xarelto)

Answer

Rivaroxaban, a direct factor Xa inhibitor, is widely used for VTE prophylaxis after major joint replacement due to its predictable pharmacokinetics and oral route.

Question 4

A bisphosphonate such as alendronate is prescribed for an orthopaedic patient with osteoporosis. Which instruction is most important to include in patient teaching?

Accepted Answer

Remain upright for at least 30 minutes after taking

Answer

Bisphosphonates can cause esophageal irritation and esophagitis; patients must remain upright for 30–60 minutes after ingestion to prevent reflux and mucosal damage.

Question 5

The maximum recommended daily dose of acetaminophen for an adult without liver disease is:

Accepted Answer

4,000 mg/day

Answer

The FDA recommends a maximum of 4,000 mg/day of acetaminophen for healthy adults, though many clinicians recommend ≤3,000 mg/day in at-risk populations.

Orthopaedic Nurse Test Practice Test

Orthopaedic Nurse Test Practice Test

Orthopaedic Nurse Test Pharmacology & Pain Management