A nurse is reinforcing teaching about pain control with a client who has acute pain following a subtotal gastric resection.
Which of the following client statements indicates an understanding of pain control?

Choice A rationale:

The nurse recommends that normal sleep and rest patterns can best be acquired by suggesting that the patient exercises in the mornings. Morning exercise can help regulate the circadian rhythm and improve sleep-wake patterns. It helps to reset the internal body clock, making it easier to fall asleep at night. However, exercise should not be too close to bedtime, as it may have a stimulating effect.

Choice B rationale:

Taking a nap during the day may provide a short-term boost in alertness but is not recommended as the primary method to acquire normal sleep and rest patterns. Daytime naps should be brief (20-30 minutes) and should not interfere with nighttime sleep. Excessive daytime napping can disrupt the regular sleep cycle.

Choice C rationale:

Drinking wine is not a recommended approach for acquiring normal sleep and rest patterns. Alcohol consumption, especially in the evening, can disrupt sleep cycles and negatively affect the quality of sleep. It may lead to frequent awakenings during the night and contribute to sleep disturbances.

Choice D rationale:

Smoking cigarettes is not a recommended approach for acquiring normal sleep and rest patterns. Nicotine is a stimulant that can interfere with sleep by increasing alertness and heart rate. Smoking can contribute to sleep difficulties and should be avoided, especially close to bedtime. .

Choice A rationale:
IM injections of pain medication may be contraindicated for patients who have small, poorly developed muscles. The rationale for this is that IM injections require adequate muscle mass to ensure proper absorption and distribution of the medication. If a patient has small, poorly developed muscles, the injection may not be as effective, and there's a risk of improper medication delivery, which can lead to reduced pain relief and potential complications.
Choice B rationale:
IM injections are not primarily contraindicated for patients based on their cognitive abilities. However, the patient's cognitive abilities may affect their ability to understand and follow instructions related to the injection process. It's essential for healthcare providers to ensure that the patient comprehends the procedure and can cooperate. Patients with cognitive impairments may require additional assistance or alternative methods of pain management, but it's not a direct contraindication to IM injections.
Choice C rationale:
Needing short-term pain management is not a contraindication for IM injections of pain medication. IM injections can be suitable for short-term pain relief, as they can provide relatively rapid and effective pain control. The choice of pain management method should depend on the specific circumstances and the patient's condition, but the duration of pain management needed is not a direct contraindication to IM injections.
Choice D rationale:
Having multiple drug allergies can be a concern when considering IM injections of pain medication, but it is not a direct contraindication. The healthcare provider should carefully assess the patient's allergies and select a medication that is safe and appropriate for the individual. In some cases, alternative routes of administration may be considered to avoid allergenic reactions. However, having multiple drug allergies alone does not necessarily contraindicate IM injections.