For a cognitively impaired patient who cannot accurately report pain, which assessment tool would be most useful?

Choice A reason: Over-the-counter NSAIDs are generally harmless is not a true statement, as NSAIDs can cause serious adverse effects in older adults, such as gastrointestinal bleeding, renal impairment, hypertension, and heart failure. NSAIDs should be used with caution and under medical supervision in older adults.

Choice B reason: Stool softeners and laxatives should be used with opioids is a true statement, as opioids can cause constipation in older adults, which can lead to discomfort, abdominal pain, fecal impaction, and bowel obstruction. Stool softeners and laxatives can help prevent and treat constipation and promote regular bowel movements.

Choice C reason: Opioids are less effective in older clients than in younger clients is not a true statement, as opioids can have the same or even greater analgesic effect in older adults, depending on the dose, route, and duration of administration. However, opioids can also cause more side effects in older adults, such as sedation, confusion, respiratory depression, and falls. Opioids should be used with caution and under medical supervision in older adults.

Choice D reason: The dose limit for acetaminophen is difficult to reach for older adults is not a true statement, as older adults may be more susceptible to acetaminophen toxicity, especially if they have liver disease, malnutrition, or chronic alcohol use. The dose limit for acetaminophen is 4 grams per day for adults, but it may be lower for older adults or those with risk factors. Acetaminophen should be used with caution and under medical supervision in older adults.

Choice A reason: Constipation is the nurse's priority for preventive care, as it is a common and serious side effect of morphine and other opioids, which can slow down the bowel movements and cause hard, dry stools. The nurse would advise the older adult to increase their fiber and fluid intake, use stool softeners or laxatives as prescribed, and report any signs of bowel obstruction, such as abdominal pain, bloating, nausea, or vomiting.

Choice B reason: Poor liquid intake is not the nurse's priority for preventive care, as it is not directly related to the use of morphine, although it can contribute to constipation and dehydration. The nurse would advise the older adult to drink enough fluids, unless they have a fluid restriction, and to monitor their urine output, color, and specific gravity.

Choice C reason: Diarrhea is not the nurse's priority for preventive care, as it is not a common side effect of morphine, although it can occur in some cases due to an allergic reaction, intolerance, or overdose. The nurse would advise the older adult to report any episodes of diarrhea, as it can cause dehydration, electrolyte imbalance, or malabsorption.

Choice D reason: Poor solid food intake is not the nurse's priority for preventive care, as it is not directly related to the use of morphine, although it can affect the nutritional status and wound healing of the older adult. The nurse would advise the older adult to eat a balanced diet that meets their caloric and protein needs, and to avoid foods that can cause gas, indigestion, or constipation.