To assess the quality of an adult client's pain, which approach should the nurse use?

Identify effective pain relief measures.

Provide a numeric pain scale.

Ask the client to describe the pain.

Observe body language and movement.

Answer and Explanation

The Correct Answer is C

C. Asking the client to describe their pain allows the nurse to gather subjective information directly from the client, which can provide valuable insight into the quality, intensity, location, and duration of the pain.

A. This option focuses on pain management rather than pain assessment. While identifying effective pain relief measures is important, it does not directly address the need to assess the quality of the client's pain.

B. While numeric pain scales can be useful for quantifying pain intensity, they do not capture the quality or characteristics of the pain.

D. Observing body language and movement can provide valuable information about the client's pain experience, such as grimacing, guarding, or difficulty moving. However, this approach primarily assesses pain behaviors rather than the quality of the pain itself.

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Correct Answer is A

Explanation

A Hematemesis refers to vomiting blood, which can occur when esophageal varices rupture and bleed into the gastrointestinal tract. It is a hallmark sign of upper gastrointestinal bleeding and requires immediate medical attention. Monitoring for hematemesis allows for early detection of variceal bleeding and prompt intervention to prevent further complications.

B Brown, foamy urine may indicate the presence of blood or protein in the urine, which can occur in various kidney and urinary tract disorders.

C Clay-colored stool may indicate a lack of bile in the stool, which can occur in conditions affecting the liver or bile ducts, such as obstructive jaundice.

D Anorexia, or loss of appetite, is a common symptom in clients with chronic liver disease, including cirrhosis. However, while anorexia may impact nutritional status and overall health, it is not directly related to the complications of esophageal varices.

A. Loperamide. B. Ipratropium. C. Famotidine. D. Aspirin.

Correct Answer is D

Explanation

D. Bismuth subsalicylate, a component of the regimen, has salicylate in its composition, which can lead to an increased risk of bleeding when taken with aspirin, a known blood thinner.

A. Loperamide is an antidiarrheal medication commonly used to treat diarrhea. It is not directly related to the treatment of Helicobacter pylori (H. pylori) infection.

B. Ipratropium is a bronchodilator medication used to treat conditions such as chronic obstructive pulmonary disease (COPD) and asthma. It is not directly related to the treatment of H. pylori infection.

C. Famotidine is a histamine-2 (H2) receptor antagonist commonly used to reduce stomach acid production. It is not directly related to the treatment of H. pylori infection.

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To assess the quality of an adult client's pain, which approach should the nurse use?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client with chronic cirrhosis has esophageal varices. It is most important for the nurse to monitor the client for the onset of which problem?

Correct Answer is A

Explanation

The healthcare provider prescribes bismuth subsalicylate, metronidazole, tetracycline, and pantoprazole for a client with a Helicobacter pylori (H. pylori) infection. Prior to administering the H. pylori treatment regimen, the nurse should review the electronic medical record for which medication?

Correct Answer is D

Explanation

A client who is experiencing respiratory distress is admitted with respiratory acidosis. Which pathophysiological process supports the client's respiratory acidosis?

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A client with cholelithiasis has a gallstone lodged in the common bile duct and is unable to eat or drink without becoming nauseated and vomiting. Which finding should the nurse report to the healthcare provider?