A nurse is assessing a patient's pain level after surgery. The patient rates their pain as 8 out of 10 and says it feels like a sharp stabbing pain in the surgical site. What should the nurse say to the patient?

"I will give you some medication to help with your pain.”

"Can you describe how your pain affects your daily activities?”

"How long have you had this pain and what makes it better or worse?”

"That sounds very painful, I'm sorry you are going through this."

Answer and Explanation

The Correct Answer is B

Choice A reason:

This is not the best response because it does not address the patient's pain experience or offer any empathy. It also implies that medication is the only option for pain relief, which may not be true.

Choice B reason:

This is the best response because it acknowledges the patient's pain and asks them to elaborate on how it affects their daily activities. This can help the nurse assess the impact of pain on the patient's quality of life and plan appropriate interventions.

Choice C reason:

This is not the best response because it focuses on the duration and triggers of pain, which are more relevant for chronic pain than acute pain. It also does not show empathy or validate the patient's pain rating.

Choice D reason:

This is not the best response because it only expresses sympathy but does not ask the patient any questions or offer any solutions. It may also sound patronizing or dismissive to some patients.

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Correct Answer is B

Explanation

A. Administering oxygen may help improve oxygen saturation, but the primary concern is hypotension and tachycardia, which suggest possible hypovolemia.
B. The patient’s vital signs, BP 90/60 mmHg, pulse 120 beats/min, urine output 20 mL/h, indicate early hypovolemic shock. The priority intervention is to increase intravenous fluids to restore circulating volume and perfusion.
C. Notifying the physician is important but should follow initiating immediate interventions to stabilize the patient.
D. Administering pain medication does not address the patient’s hemodynamic instability and is not a priority at this time.

A. Keep the dressing clean and dry. B. Change the dressing every day or as needed. C. Wash the wound with soap and water. D. Apply antibiotic ointment to the wound. E. Report any signs of infection to the physician or surgeon.

Correct Answer is ["A","B","E"]

Explanation

Choice A reason:

Keeping the dressing clean and dry prevents contamination and infection of the wound. It also helps the wound heal faster by protecting it from further injury. This is a standard instruction for wound care after a minor surgical procedure.

Choice B reason:

Changing the dressing every day or as needed helps keep the wound clean and allows the doctor or nurse to monitor the healing process. It also prevents the dressing from sticking to the wound or becoming too wet or soiled. This is another common instruction for wound care after a minor surgical procedure.

Choice C reason:

Washing the wound with soap and water is not recommended for wound care after a minor surgical procedure. Soap can irritate the wound and delay healing. Water can wash away the protective scab and cause bleeding. The wound should be rinsed with sterile water or saline solution instead.

Choice D reason:

Applying antibiotic ointment to the wound is not advised for wound care after a minor surgical procedure unless prescribed by the doctor or surgeon. Antibiotic ointment can cause allergic reactions, increase resistance to bacteria, or interfere with the healing process. The wound should be covered with a sterile dressing and left alone.

Choice E reason:

Reporting any signs of infection to the physician or surgeon is an important instruction for wound care after a minor surgical procedure. Signs of infection include redness, swelling, warmth, pain, pus, fever, or foul odor. Infection can delay healing, cause complications, or spread to other parts of the body.

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A nurse is assessing a patient's pain level after surgery. The patient rates their pain as 8 out of 10 and says it feels like a sharp stabbing pain in the surgical site. What should the nurse say to the patient?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Correct Answer is B

Explanation

A nurse is teaching a patient about wound care after a minor surgical procedure. Which of the following instructions should the nurse include? (Select all that apply.)

Correct Answer is ["A","B","E"]

Explanation

A nurse is monitoring a patient's temperature after surgery. The patient has a fever of 38.5°C (101.3°F) and chills. What is the most likely cause of the fever?

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