The nurse is assessing a client's pain experience. Which nursing intervention is most effective in determining the severity of a client's pain?
Review the client's medical history and admission assessment.
Compare the client's current vital signs to the admission baseline.
Note how frequently doses of analgesics have been administered.
Ask the client to describe the intensity of the pain being experienced.
The Correct Answer is D
Choice A reason: While the client's medical history and admission assessment provide valuable information, they do not directly measure the current pain experience.
Choice B reason: Vital signs can indicate pain but are not a definitive measure of pain severity as they can be influenced by other factors.
Choice C reason: The frequency of analgesic administration may suggest the level of pain control but does not measure the current pain intensity experienced by the client.
Choice D reason: Asking the client to describe the intensity of the pain is the most direct and effective way to assess pain severity. Pain is subjective, and the client's self-report is considered the gold standard for pain assessment.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
The correct answer is choice D. Paper mask and gown.
Choice A rationale:
The stethoscope is not typically placed in a biohazard bag. It is cleaned and disinfected after each use, especially when used with a patient with an infectious disease like MRSA.
Choice B rationale:
Bed linens are usually placed in a designated linen bag, not a biohazard bag, even when the patient has an infectious disease. The linens are then laundered according to the healthcare facility’s infection control guidelines.
Choice C rationale:
A sputum specimen is typically placed in a designated specimen container, not a biohazard bag. The container is then sent to the lab for analysis.
Choice D rationale:
The paper mask and gown used while caring for a patient with MRSA should be placed in a designated biohazard bag before being removed from the room. This is because these items may have come into contact with the bacteria and could potentially spread the infection.
Correct Answer is B
Explanation
Choice A reason: Starting with the most difficult questions can make the client uncomfortable and less likely to be open in the discussion.
Choice B reason: Beginning with less sensitive questions can help build rapport and make the client feel more comfortable discussing more intimate details later in the interview.
Choice C reason: Asking questions in a vague, non-specific format can lead to confusion and may not yield the necessary information.
Choice D reason: Sharing personal values is not appropriate as it can bias the interaction and may make the client feel judged or uncomfortable.
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