Nursing Acceleration Challenge Exam (NACE) PN-RN Practice Test

According to the WHO analgesic ladder, what medication may be required for moderate to severe pain unresponsive to NSAIDs?

1. Demerol

2. Codeine

3. Morphine

4. Acetaminophen

The correct answer is: Codeine

In the context of the WHO analgesic ladder, the correct approach to managing moderate to severe pain that does not respond to nonsteroidal anti-inflammatory drugs (NSAIDs) involves the use of stronger opioids. In this case, morphine is specifically recommended as it is the preferred opioid for managing such pain levels. Morphine has long been established for its efficacy in managing significant pain, particularly when other medications are insufficient. It acts on the central nervous system to alter the perception of and emotional response to pain, making it a powerful option for individuals suffering from more intense pain conditions. While codeine is also an opioid, it is generally considered a weaker option, often used for mild to moderate pain. Demerol, or meperidine, has become less favored due to safety concerns and the availability of better alternatives. Acetaminophen does not fit into the category of a strong analgesic for the indicated severity of pain. Thus, when moderate to severe pain remains unmanageable with NSAIDs, morphine is the most appropriate choice outlined in WHO's analgesic ladder guidelines.