For the past six hours, a postoperative male client has refused pain medication because he believed that he could "tough it out." When an opioid analgesic is administered, the client has difficulty obtaining a satisfactory level of comfort. Which action is best for the practical nurse (PN) to use in assisting this client to deal with his pain?

Dim the lights in the room and close the door.

Guide the client through slow, rhythmic breathing.

Turn the television on to the client's favorite show.

Obtain a prescription for a higher dose of pain medication.

Answer and Explanation

The Correct Answer is B

This is the best action for the PN to use in assisting this client to deal with his pain because it provides a non-pharmacological method of pain relief that can enhance the eﬀect of the opioid analgesic. Slow, rhythmic breathing can help the client relax, distract from the pain, and increase oxygenation and blood ﬂow.

A. Dimming the lights in the room and closing the door may not be enough to help the client deal with his pain and may not address his psychological or emotional needs.

C. Turning the television on to the client's favorite show may not be eﬀective in helping the client deal with his pain and may be distracting or irritating for him.

D. Obtaining a prescription for a higher dose of pain medication may not be necessary or appropriate for this client and may increase the risk of side eﬀects or dependence. The PN should assess the client's pain level and response to the current dose before requesting a change in medication.

Nursing Test Bank

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Naxlex Comprehensive Predictor Exams

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Correct Answer is A

Explanation

This is the most important follow-up assessment for the PN to implement because it can detect signs of bleeding, infection, or shock that may result from the unsecured surgical dressing. The PN should monitor the client's blood pressure, pulse, temperature, and respiratory rate and report any abnormal changes.

B. Fluid volume intake and output is not the most important follow-up assessment for this client and may not reﬂect the current status of the client's ﬂuid balance or blood loss.

C. Volume of peripheral pulses is not the most important follow-up assessment for this client and may not be aﬀected by the unsecured surgical dressing unless it is located on a limb or near a major artery.

D. Incisional pain scale rating is not the most important follow-up assessment for this client and may not indicate the severity or cause of the client's pain.

A. Use a cushion when sitting. B. Perform range of motion exercises. C. Document abdominal girth. D. Weigh every morning.

Correct Answer is D

Explanation

This is the best intervention for the PN to implement because it monitors the client's ﬂuid status and helps detect ﬂuid overload, which can cause hypertension and neurological changes. The PN should weigh the client at the same time, on the same scale, and with the same clothing every day.

A. Using a cushion when sitting is not a priority intervention for this client and may not address the BP or mental status issues.

B. Performing range of motion exercises is not a priority intervention for this client and may not address the BP or mental status issues.

C. Documenting abdominal girth is not a priority intervention for this client and may not be an accurate indicator of ﬂuid status.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The practical nurse (PN) finds a postoperative client lying in bed with an unsecured surgical dressing as seen in the picture. After reinforcing the dressing, which follow-up assessment is most important for the PN to implement?

Correct Answer is A

Explanation

A client is being treated for chronic kidney disease (CKD). On examination, the client has an elevated blood pressure (BP) and is exhibiting changes in mental status. Which intervention in the plan of care should the practical nurse (PN) implement?

Correct Answer is D

Explanation

The practical nurse (PN) believes that a prescription for a child is incorrect because the dosage prescribed is the usual adult dosage. Which action should the PN take?

An older male client is returning to the surgical unit after a total right knee replacement. Which assessment findings are most important for the practical nurse (PN) to document in this client's electronic medical record (EMR)?

The practical nurse (PN) is caring for a client who has darkened membranes of the mouth and a smoky breath. Which priority nursing problem should the PN include in the plan of care?

Which information should the practical nurse (PN) collect during admission assessment of a terminally ill client to an acute care facility?

The practical nurse (PN) observes unlicensed assistive personnel (UAP) bathing a bedfast client with the bed in a high position. Which action should the PN take?

An older client is admitted to an acute care facility with the diagnosis of left lower lobe pneumonia. How should the practical nurse (PN) position the client for auscultation of posterior lung fields?