A nurse is caring for a client who has COPD. The client tells the nurse, "I get short of breath during meals. It is too much trouble to eat." Which of the following instructions should the nurse suggest?

A. Instruct the client to report the theft to the police: While reporting to law enforcement is an option, the client may feel intimidated or unsafe doing so, and immediate protection and assessment of the situation are more urgent. The nurse’s priority is ensuring safety and initiating appropriate protective services.

B. Report the possible abuse to adult protective services: Financial exploitation is a form of elder abuse. Nurses are mandated reporters and should notify adult protective services to investigate and intervene as needed. This ensures the client’s safety, prevents further exploitation, and connects them with resources for protection and support.

C. Ask the client if there is another family member they can call for financial help: While exploring support systems is important, relying on another family member without assessment may not address potential abuse and does not fulfill the nurse’s legal obligation to report suspected exploitation.

D. Restrict visitation for the client's family until discharge: Restricting visitation may limit contact temporarily, but it does not address the underlying abuse or ensure ongoing protection. Reporting to protective services provides a structured and legal mechanism for safeguarding the client.

A. Administer pain medication on a regular schedule: In palliative care, maintaining consistent pain control is essential for comfort and quality of life. Scheduled administration prevents the recurrence of severe pain, reduces stress on the client, and avoids peaks and troughs in analgesic effect, which is more effective than waiting for pain to become severe.

B. Administer pain medication with caution to avoid addiction: In terminal cancer, the priority is comfort. Concerns about addiction are less relevant because the goal is effective pain management rather than long-term dependence. Opioid use in palliative care is aimed at symptom relief, not recreational use.

C. Administer a placebo if it is not time for pain medication: Placebos are unethical and ineffective in palliative care. Using a placebo can damage trust between the family, client, and healthcare team and does not provide actual analgesic benefit.

D. Administer scheduled doses of medication from a patient-controlled analgesia (PCA) pump: PCA pumps allow the client to self-administer doses and are not typically used for routine scheduled administration by family members. Family-administered dosing should follow prescribed schedules rather than PCA programming, which requires monitoring and education.