What is the most appropriate intervention for an older adult with known alcohol use disorder who presents with symptoms of alcohol withdrawal, including tremors and agitation?

A. Encouraging the client to express pain using long sentences is inappropriate. Elderly clients with cognitive impairment may have difficulty articulating pain verbally, so expecting complex verbal descriptions can lead to underassessment.

B. Administering pain medications based on verbal reports only is insufficient. Clients with cognitive impairment may underreport or be unable to communicate pain, so relying solely on verbal reports risks undertreatment.

C. Monitoring for behavioral cues such as guarding or grimacing is correct. pain assessment in cognitively impaired elderly emphasizes that nonverbal indicators—facial expressions, body movements, vocalizations, changes in activity or sleep patterns—are key to recognizing pain in this population. Nurses must assess pain through both behavioral and physiological cues, ensuring timely and appropriate pain management.

D. Presuming no pain unless the client reports it directly is unsafe and can lead to undertreatment and unnecessary suffering. Cognitive impairment often limits verbal reporting, making proactive assessment essential.

A. "Do you need any more resources or information?" is a closed-ended question focused on gathering factual information rather than exploring the client’s feelings. It does not invite the client to clarify emotions or internal experiences, so it is not the best therapeutic communication technique in this context.

B. "You feel like you have the support needed to be successful." is a reflective statement but assumes the client’s feelings rather than inviting clarification. This could limit the client’s response or lead to agreement without true exploration of emotions.

C. "Do you understand your next step in treatment?" is a closed-ended question focused on cognitive understanding rather than emotional expression. It helps assess knowledge but does not encourage discussion of feelings.

D. "Tell me what kind of coping skills you have." is correct. This open-ended question invites the client to explore and clarify personal experiences, feelings, and strategies for managing stress or challenges. It encourages the client to reflect on their emotions and behaviors, which is a key element of therapeutic communication and building rapport. Open-ended questions that prompt discussion of feelings facilitate a deeper understanding of the client’s emotional state.