A client with metastatic cancer reports a pain level of 10 on a scale of 0 to 10. Twenty minutes after the nurse administers an IV analgesic, the client reports no pain relief. Which intervention is most important for the nurse to include in this client's plan of care?

Replace transdermal analgesic patches every 72 hours.

Administer analgesics on a fixed and continuous schedule.

Monitor client for break through pain.

Frequently evaluate the client's pain.

Answer and Explanation

The Correct Answer is C

C. Breakthrough pain is a transient exacerbation of pain that occurs despite the use of around- the-clock analgesics for persistent pain. Breakthrough pain episodes require rapid intervention with additional analgesics or adjustments to the current pain management regimen to provide adequate pain relief and improve the client's quality of life.
A. Replacing transdermal analgesic patches every 72 hours is important for ensuring consistent delivery of medication, but it is not directly related to addressing breakthrough pain.
B. Administering analgesics on a fixed and continuous schedule is important for maintaining baseline pain control, but it may not address breakthrough pain adequately.
D. Frequently evaluating the client's pain is essential, but monitoring specifically for breakthrough pain ensures timely intervention when pain exacerbations occur.

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Correct Answer is C

Explanation

Choice A reason:This is incorrect because teaching the client to wear a mask, hand wash, and social distance is not the most important action for the nurse to take. These are preventive measures that should be followed by everyone, regardless of their COVID-19 status.

Choice Breason:This is incorrect because explaining to the client to inform others that they may have been potentially exposed in the last 14 days is not the most important action for the nurse to take. This is a moral and social responsibility that should be done as soon as possible, but it does not address the urgent need of isolating the client from potential sources of infection.

Choice Creason:This is correct because isolating the client from other clients, family, and healthcare workers not wearing proper PPE is the most important action for the nurse to take. This is to prevent transmission of COVID-19 to others who may be at risk of severe complications or death.

Choice Dreason:This is incorrect because reporting the COVID-19 result to the local health department according to CDC guidelines is not the most important action for the nurse to take. This is a legal and ethical obligation that should be done after confirming the diagnosis, but it does not have an immediate impact on the client's health or safety.

A. Exhibits angry outbursts when the subject of dying is approached. B. Increased intervals of sleep 18 out of 24 hours. C. A change has recently occurred in handwriting. D. Refuses to see friends or to return their phone calls.

Correct Answer is C

Explanation

C. One of the hallmark features of ADC is the development of cognitive impairment, including changes in memory, concentration, and problem-solving abilities. The change in handwriting (graphomotor impairment) is a specific neurological symptom that may indicate cognitive dysfunction and is consistent with the diagnosis of AIDS dementia.
A. This symptom suggests emotional distress or mood disturbances, which can occur in individuals with HIV/AIDS due to the psychological impact of the diagnosis and the uncertainty surrounding the disease progression. However, it is not specific to AIDS dementia
B. Increased sleepiness or hypersomnia can occur in individuals with AIDS dementia due to disruptions in sleep-wake cycles and alterations in brain function. However, increased sleepiness alone is not specific to AIDS dementia
D. Social withdrawal or isolation can occur in individuals with HIV/AIDS due to various reasons, including stigma, depression, or physical symptoms. However, it is not specific to AIDS dementia.

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A client with metastatic cancer reports a pain level of 10 on a scale of 0 to 10. Twenty minutes after the nurse administers an IV analgesic, the client reports no pain relief. Which intervention is most important for the nurse to include in this client's plan of care?

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Naxlex Comprehensive Predictor Exams

Two weeks after returning home from traveling, a client presents to the clinic with conjunctivitis and describes a recent loss in the ability to taste and smell. The nurse obtains a nasal swab to test for COVID 19 Which action is most important for the nurse to take?

Correct Answer is C

Explanation

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Correct Answer is C

Explanation

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