A nurse is conducting a pain assessment for a client who reports discomfort. Which of the following actions is the most appropriate for the nurse to take to obtain a comprehensive understanding of the client's pain?
Observe the patient's facial expressions and body language for signs of discomfort.
Measure the patient's vital signs and note any changes.
Review the patient's medical history for past pain management interventions and their outcomes.
Ask the patient to describe the pain using a pain scale and provide details about its location, duration, and intensity.
The Correct Answer is D
A. Observe the patient's facial expressions and body language for signs of discomfort: While observation is important, it doesn't provide a complete picture of the client's pain experience and may not capture all aspects, such as intensity or location.
B. Measure the patient's vital signs and note any changes: Vital signs are important but can be nonspecific indicators of pain and are not as reliable for assessing pain intensity or quality.
C. Review the patient's medical history for past pain management interventions and their outcomes: While this is useful, it does not directly address the client's current pain experience.
D. Ask the patient to describe the pain using a pain scale and provide details about its location, duration, and intensity. A comprehensive pain assessment requires the client's self-report to fully understand the pain's characteristics. A pain scale (e.g., 0-10) helps quantify the intensity, and asking about its location, duration, and type allows for a thorough understanding of the pain's impact.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A. Observe the patient's facial expressions and body language for signs of discomfort: While observation is important, it doesn't provide a complete picture of the client's pain experience and may not capture all aspects, such as intensity or location.
B. Measure the patient's vital signs and note any changes: Vital signs are important but can be nonspecific indicators of pain and are not as reliable for assessing pain intensity or quality.
C. Review the patient's medical history for past pain management interventions and their outcomes: While this is useful, it does not directly address the client's current pain experience.
D. Ask the patient to describe the pain using a pain scale and provide details about its location, duration, and intensity. A comprehensive pain assessment requires the client's self-report to fully understand the pain's characteristics. A pain scale (e.g., 0-10) helps quantify the intensity, and asking about its location, duration, and type allows for a thorough understanding of the pain's impact.
Correct Answer is C
Explanation
A. Encouraging client feedback about satisfaction with the facility experience: This reflects client-centered care but does not directly demonstrate autonomy.
B. Explaining unit rules and policies regarding unacceptable behaviors: This action involves setting expectations rather than promoting client autonomy.
C. Supporting the client's wish to refuse prescribed medications. Autonomy involves respecting a client's right to make their own decisions about their care, including the decision to refuse treatment, as long as they have the capacity to do so.
D. Making sure the client understands expectations for client participation: This is about ensuring clarity of expectations rather than honoring the client's right to self-determination.
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