A nurse is caring for an adolescent who has a brain tumor and is receiving hospice care. The nurse is providing counseling regarding the stages of grief, which of the following statements by the adolescent is an example of the bargaining stage?

Rationale:

• Sensation: Tingling indicates possible nerve irritation or mild neurovascular compromise. This is often seen in fractures when swelling or bone displacement compresses nerves near the injury site, especially in long bones like the radius.
• Edema: Swelling is a nonspecific but common response to tissue injury. It occurs with ligament strain (sprain), bone disruption (fracture), and joint trauma (dislocation), all of which lead to localized inflammation and fluid accumulation.
• Ecchymosis: Bruising results from soft tissue bleeding and is common in all three conditions due to trauma to blood vessels. Ligament tears (sprain), bone injury (fracture), and capsule damage (dislocation) can all lead to ecchymosis.
• Pain level: Moderate pain, such as a 4/10 rating, is consistent with both sprains and fractures. Sprains stretch or tear ligaments, while fractures disrupt bone structure. Dislocations usually present with severe, sharp pain that impairs joint movement entirely.

Rationale:

A. Naloxone: Naloxone is an opioid antagonist used to reverse opioid overdose. It does not provide pain relief and is not appropriate for managing acute exacerbations of chronic pain.

B. Acetaminophen: Acetaminophen is useful for mild to moderate pain but may be insufficient for an acute exacerbation of chronic pain, especially if the client has severe or breakthrough pain.

C. Fentanyl: Fentanyl is a potent opioid analgesic appropriate for managing severe acute pain or acute exacerbations of chronic pain. It acts rapidly to relieve pain and is often used in clients already tolerant to opioids.

D. Zolpidem: Zolpidem is a sedative-hypnotic used to treat insomnia. It does not have analgesic properties and is not indicated for pain management.