A nurse is caring for a client who is postoperative. The nurse should recognize that which of the following methods is the most reliable source when determining the intensity of the client's pain?

Vital sign measurement

Nature of invasiveness of the surgical procedure

Visual observation for nonverbal signs of pain

Client's self-report of pain

Answer and Explanation

The Correct Answer is D

A.   While changes in vital signs, such as increased heart rate and blood pressure, may indicate pain, they are not specific to pain and can be influenced by other factors.
B.   The type of surgery can provide some clues about the potential for pain, but it does not accurately reflect the individual's pain experience.
C.   Nonverbal cues like grimacing, guarding, or restlessness can suggest pain, but they are not always reliable indicators. Some clients may not exhibit obvious signs of pain, even if they are experiencing significant discomfort.
D.   This is the most reliable source of information about a client's pain intensity. Only the client can accurately describe their own pain experience, including its location, severity, and quality.

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Correct Answer is D

Explanation

A. While it's important to be flexible and anticipate interruptions, planning for them can lead to inefficient time management. It's better to focus on completing tasks and addressing disruptions as they arise.
B. While helping colleagues is important, taking on additional tasks can overload your workload and hinder your own time management.
C. Skipping meals is not a sustainable solution for time management. It can lead to fatigue, decreased productivity, and potential health problems.
D. This strategy helps to build momentum and a sense of accomplishment, making it easier to tackle more challenging tasks later. It also helps to reduce stress and procrastination.

A. Pivot their feet in the direction of the move. B. Tighten their abdominal muscles. C. Place their feet in line with their shoulders. D. Raise the height of the client's bed.

Correct Answer is C

Explanation

A. This action is important for maintaining balance during the move, but it should be done after establishing a strong base of support.
B. Engaging core muscles can help protect the nurse's back during lifting and moving, but it's not the first step in the process.
C. This provides a strong base of support, which is crucial for safe and efficient patient repositioning.
D. While raising the bed can help reduce the nurse's bending and straining, it's not the initial step. Proper body mechanics should be prioritized first.

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A nurse is caring for a client who is postoperative. The nurse should recognize that which of the following methods is the most reliable source when determining the intensity of the client's pain?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is D

Explanation

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Correct Answer is C

Explanation

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