The nurse is caring for a 4-year-old child who is demonstrating signs of pain. Which technique will the nurse use to best assess pain in this child?

Choice A reason: Expressive aphasia involves difficulty producing speech or writing, not understanding language, as seen here. The patient’s issue is comprehending spoken and written words, indicating receptive aphasia. Reporting expressive aphasia risks misdiagnosis, delaying targeted speech therapy critical for addressing comprehension deficits and improving communication in affected patients.

Choice B reason: Motor aphasia is not a standard term; it may confuse with expressive aphasia, which affects speech output, not comprehension. The patient’s difficulty understanding language points to receptive aphasia. Misreporting as motor risks incorrect treatment, delaying interventions like language therapy needed to support comprehension and functional communication recovery.

Choice C reason: Receptive aphasia, or Wernicke’s aphasia, involves impaired comprehension of spoken and written language due to temporal lobe damage, matching the patient’s symptoms. Reporting this ensures accurate communication to the next shift, guiding targeted speech therapy and care planning to improve language processing and patient interaction in clinical settings.

Choice D reason: Global aphasia involves severe deficits in both expression and comprehension, unlike the patient’s specific difficulty understanding language. Reporting global aphasia overstates the impairment, risking inappropriate interventions. Accurate identification of receptive aphasia ensures focused therapy, addressing comprehension deficits critical for effective communication and patient care.

Choice A reason: Depression is strongly linked to insomnia in older adults, causing difficulty falling asleep due to rumination, low mood, or altered sleep architecture. Assessing for depression is critical, as it may underlie the sleep disturbance, requiring targeted interventions like therapy or antidepressants to improve sleep and mental health.

Choice B reason: Muscle fatigue may cause physical discomfort but is not a primary cause of difficulty falling asleep. It is more likely to affect sleep quality than initiation. Depression is a more common and significant contributor to insomnia in older adults, making this an incorrect choice.

Choice C reason: Hypertension can be associated with sleep apnea but is not directly linked to difficulty falling asleep. It may result from poor sleep but is less likely the cause. Depression is a more prevalent cause of insomnia, making this a less relevant condition to assess.

Choice D reason: Hypothyroidism can cause fatigue and sleepiness, not difficulty falling asleep. It is less commonly associated with insomnia compared to depression, which significantly disrupts sleep onset in older adults. This condition is less relevant to the patient’s presentation, making it incorrect.