A nurse is assisting with the care of a client who is receiving a PCA pump following a hysterectomy. Which of the following findings should the nurse identify as an indicator of unrelieved pain?
Urinary retention
Constipation
Difficulty swallowing
Clenched teeth
The Correct Answer is D
Choice A Reason:
Urinary retention can be a side effect of opioids used in PCA, but it is not a direct indicator of unrelieved pain.
Choice B Reason:
Constipation is a potential side effect of opioid medications, but it does not directly indicate unrelieved pain.
Choice C Reason:
Difficulty swallowing is not a typical indicator of unrelieved pain but may be related to other factors such as postoperative effects or medication side effects.
Choice D Reason:
Clenched teeth can be an indicator of unrelieved pain in a client receiving patient-controlled analgesia (PCA). It suggests that the client is experiencing discomfort and may be trying to endure the pain rather than using the PCA pump to self-administer pain relief. Clients who are in pain may clench their teeth as a response to pain or discomfort.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A Reason:
Canned green beans is incorrect. While green beans can contain some potassium, they typically have lower potassium content compared to sweet potatoes.
Choice B Reason:
Sweet potatoes are one of the foods highest in potassium. They are an excellent dietary source of potassium, along with other essential nutrients like vitamins and fiber.
Choice C Reason:
Baked chicken breast: Chicken is a good source of protein, but it is not a significant source of potassium.
Choice D Reason:
D. Wheat bread: Wheat bread is not a significant source of potassium either. It is primarily a source of carbohydrates and fiber.
Correct Answer is D
No explanation
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