A nurse is caring for a postoperative client who received a dose of opioid pain medication 30 min ago. The client is now requesting another dose of pain medication to relieve continuing acute pain. Which of the following actions should the nurse take first?

Offer to give the client a back massage using warm lotion.

Explain that the client might not receive another dose for a few hours.

Ask the client about his previous pain relief measures.

Request that the provider prescribe another dose of opioid analgesia.

Answer and Explanation

The Correct Answer is C

A. Offer to give the client a back massage using warm lotion. This is a non-pharmacological intervention but may not address the client's acute pain effectively.
B. Explain that the client might not receive another dose for a few hours. This does not address the client's immediate need for pain relief.
C. Ask the client about his previous pain relief measures. This allows the nurse to assess the effectiveness of previous interventions and understand the client's pain history.
D. Request that the provider prescribe another dose of opioid analgesia. This might be necessary, but assessment of the client's pain and relief measures should be conducted first.

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Correct Answer is D

Explanation

A. Place throw rugs over thresholds between rooms.Throw rugs can be a tripping hazard, especially for older adults who may have difficulty with balance and mobility.
B. Set the water heater to 54.5° C (130° F). This temperature is too high and can cause burns. It is recommended to set the water heater to no higher than 48.9° C (120° F) to prevent scalding.
C. Set the home thermostat to 26° C (79° F).This temperature might be uncomfortable and is not directly related to safety. It is more important to ensure the home is at a comfortable and safe temperature, typically around 21-23° C (70-73° F).
D. Replace the shower head with a hand-held nozzle. A hand-held shower nozzle can help prevent falls by allowing the client to remain seated while bathing, thereby reducing the risk of slipping.

A. Situation B. Recommendation C. Introduction D. Assessment

Correct Answer is D

Explanation

A. Situation This component includes the immediate issue or reason for the report.
B. Recommendation This includes what the nurse suggests or recommends should happen next.
C. Introduction This includes the nurse's name, role, and patient details.
D. Assessment This includes the nurse's findings, including lung sounds, vital signs, and other assessment data.

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A nurse is caring for a postoperative client who received a dose of opioid pain medication 30 min ago. The client is now requesting another dose of pain medication to relieve continuing acute pain. Which of the following actions should the nurse take first?

Nursing Test Bank

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A nurse is using the I-SBAR tool to provide report on a client to an oncoming nurse. In which of the following components of I-SBAR should the nurse include the client's lung sounds?

Correct Answer is D

Explanation

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