OCN Pain, Fatigue and GI Symptoms Questions (15 Free)
Published 2026-10-22 · Facts and text checked 2026-10-16 · Questions from our OCN study guide · Reviewed by Hana N., Quality Reviewer
These free OCN practice questions cover Pain, Fatigue and GI Symptoms, part of IV. Symptom Management and Supportive Care on the exam. Assessing and managing pain, fatigue, nausea, mucositis and other GI effects. Each question comes from a practice test in our OCN study guide and shows the correct answer with an explanation.
Assessing and managing pain, fatigue, nausea, mucositis and other GI effects. On the exam this is part of IV. Symptom Management and Supportive Care (25%). Open each answer to read the explanation.
Question 1Hard
A patient on a continuous IV morphine infusion at 4 mg per hour requires conversion to IV hydromorphone. Using the equianalgesic ratio of IV morphine to IV hydromorphone, what is the equivalent hourly hydromorphone dose before applying any safety reduction?
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Correct answer: A. 0.8 mg
The equianalgesic ratio of IV morphine to IV hydromorphone is 5:1, meaning 5 mg morphine equals 1 mg hydromorphone. Dividing the morphine dose (4 mg/hour) by 5 yields 0.8 mg/hour. Multiplying instead (20 mg) is a common error that could cause overdose.
From practice test 6 of our OCN study guide (question 37). Original question, not an official exam item.
Question 2Easy
The analgesic effect of acupuncture is primarily attributed to:
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Correct answer: D. Stimulation of endorphin release and modulation of pain pathways
Acupuncture stimulates endorphin release and modulates pain pathways in the central nervous system. TENS activates gate control, and massage reduces muscle tension; these are different mechanisms.
From practice test 7 of our OCN study guide (question 117). Original question, not an official exam item.
Question 3Medium
A patient is scheduled for a bone marrow biopsy and expresses significant anticipatory anxiety. The nurse suggests a nonpharmacologic intervention. Which intervention is most likely to reduce both anxiety and pain perception during the procedure?
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Correct answer: D. Guided imagery
Guided imagery specifically reduces anticipatory anxiety and pain intensity by shifting attention to a safe, comfortable place. While other options may help, guided imagery is the most directly indicated for this purpose.
From practice test 5 of our OCN study guide (question 141). Original question, not an official exam item.
Question 4Medium
What distinguishes kyphoplasty from vertebroplasty?
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Correct answer: D. Kyphoplasty uses a balloon to create a cavity before cement injection; vertebroplasty does not.
The key procedural difference is that kyphoplasty involves balloon inflation to restore vertebral height and create a cavity for cement, whereas vertebroplasty is a simple cement injection without balloon assistance.
From practice test 5 of our OCN study guide (question 6). Original question, not an official exam item.
Question 5Hard
A patient with pancreatic cancer has severe epigastric pain that is poorly controlled despite high-dose opioids. The pain team recommends a celiac plexus block. Which of the following best describes the primary indication for this procedure?
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Correct answer: A. It is indicated for upper abdominal visceral pain from malignancies such as pancreatic cancer.
The celiac plexus block targets nociceptive signals from upper abdominal viscera, making it ideal for pancreatic and other upper abdominal cancers. It is not first-line and not for lower extremity or neuropathic pain.
From practice test 4 of our OCN study guide (question 131). Original question, not an official exam item.
Question 6Easy
When converting a patient from one opioid to another due to intolerable side effects, what is the recommended percentage reduction in the calculated equianalgesic dose to account for incomplete cross-tolerance?
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Correct answer: C. 25-50%
The standard safety reduction for opioid conversion is 25-50% to prevent respiratory depression from incomplete cross-tolerance. Lower reductions risk overdose; higher reductions may cause unnecessary pain.
From practice test 6 of our OCN study guide (question 26). Original question, not an official exam item.
Question 7Medium
A patient with chronic neuropathic pain from chemotherapy is not obtaining adequate relief from gabapentin. Which antidepressant would be most appropriate to add as an adjuvant?
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Correct answer: C. Amitriptyline
Tricyclic antidepressants like amitriptyline are effective adjuvants for neuropathic pain. SSRIs such as fluoxetine and paroxetine are not first-line, and bupropion is not typically used for this indication.
From practice test 3 of our OCN study guide (question 110). Original question, not an official exam item.
Question 8Easy
Transcutaneous electrical nerve stimulation (TENS) is believed to relieve pain through which mechanism?
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Correct answer: D. Gate control theory by stimulating large-diameter afferent fibers
TENS activates large-diameter Aβ fibers, which 'close the gate' in the spinal cord to reduce pain signal transmission (gate control theory). Option B is incomplete; endogenous opioids play a minor role.
From practice test 5 of our OCN study guide (question 45). Original question, not an official exam item.
Question 9Easy
A 68-year-old patient with advanced breast cancer reports deconditioning and muscle weakness after prolonged bed rest. Which nonpharmacologic intervention is most appropriate to address deconditioning-related pain and maintain function?
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Correct answer: B. Therapeutic exercise
Therapeutic exercise under the guidance of a physical therapist helps maintain function and reduce deconditioning-related pain. TENS is for localized pain, relaxation reduces stress, and aromatherapy provides distraction but does not address deconditioning.
From practice test 8 of our OCN study guide (question 96). Original question, not an official exam item.
Question 10Easy
After performing an opioid conversion, which of the following must be documented in the patient's record?
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Correct answer: C. Equianalgesic ratio used and the rationale for dose reduction
Documentation should include the ratio, the calculated dose, and the safety reduction applied to ensure accurate care and follow-up.
From practice test 2 of our OCN study guide (question 122). Original question, not an official exam item.
Question 11Hard
A 65-year-old patient with metastatic lung cancer is started on oral morphine 15 mg every 4 hours for severe pain. Which nursing intervention is most important to implement concurrently?
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Correct answer: C. Administer a daily stimulant laxative and an antiemetic
Opioid-induced constipation and nausea are expected; a bowel regimen and antiemetic should be initiated prophylactically at the start of therapy. Around-the-clock dosing is preferred over PRN, and while respiratory monitoring is important, concurrent side-effect management is crucial from day one.
From practice test 3 of our OCN study guide (question 33). Original question, not an official exam item.
Question 12Medium
When initiating a new opioid after conversion, the calculated equianalgesic dose should be reduced by what percentage to account for incomplete cross-tolerance?
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Correct answer: B. 25-50%
The standard safety reduction for incomplete cross-tolerance is 25 to 50 percent to prevent relative overdose.
From practice test 2 of our OCN study guide (question 73). Original question, not an official exam item.
Question 13Easy
A patient reports a pain score of 5 on a 0-10 scale. According to the WHO analgesic ladder, what is the most appropriate initial pharmacologic approach?
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Correct answer: D. Weak opioid plus non-opioid analgesic
Starting with a strong opioid would be too aggressive for this level.
From practice test 8 of our OCN study guide (question 164). Original question, not an official exam item.
Question 14Medium
A patient with pancreatic cancer undergoes a celiac plexus block. Post-procedure, the nurse should monitor for which pair of common side effects?
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Correct answer: A. Orthostatic hypotension and diarrhea
Autonomic effects from celiac plexus blockade include orthostatic hypotension (due to splanchnic vasodilation) and diarrhea (from unopposed parasympathetic activity). The other options are not characteristic of this procedure.
From practice test 7 of our OCN study guide (question 98). Original question, not an official exam item.
Question 15Medium
A patient with metastatic bone pain is scheduled for an epidural steroid injection tomorrow. The patient currently receives hydromorphone 2 mg orally every 4 hours. Which action demonstrates appropriate coordination with the pain team?
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Correct answer: B. Notify the pain team to adjust analgesic orders after the procedure based on pain response
Post-procedure analgesic adjustment requires collaboration with the pain team to safely reduce opioid doses if pain improves. Options that involve discontinuing or increasing opioids without specialist input are unsafe. Benzodiazepines are not indicated as routine adjuncts.
From practice test 6 of our OCN study guide (question 80). Original question, not an official exam item.
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