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
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. As people age, the glands in the ear may produce more cerumen (earwax), and the ear canal may also become narrower, leading to a buildup of wax. This can affect hearing and may require regular cleaning by a healthcare professional.
B. With aging, peripheral vision often decreases due to changes in the retina and other parts of the eye. Older adults may experience difficulties in peripheral awareness, making it harder to detect objects or movements outside their central line of sight.
C. As people age, they may experience decreased sensitivity to touch due to changes in nerve endings and skin elasticity. Many older adults report a reduced sense of touch, which can affect balance and coordination.
D. In fact, older adults typically experience decreased pupil size and a reduced response to changes in light. The pupils may become more fixed and less able to dilate quickly in response to dim light.
Correct Answer is B
Explanation
A. While EHRs can be used for research purposes, this is not a primary benefit for individual patients. The focus of EHRs is on improving patient care, not necessarily facilitating research.
B. This is a significant benefit of EHRs, as it empowers patients to take an active role in their healthcare. They can review their medical history, medication lists, test results, and appointment schedules at their convenience. This access can also help patients to better understand their health conditions and make informed decisions about their treatment.
C. While EHRs can help to coordinate care between different providers, they may not necessarily include all healthcare received, especially if it comes from providers who do not use the same EHR system.
D. Access to patient information is typically restricted to authorized individuals, such as the patient themselves and their healthcare providers. While there may be exceptions, such as in cases of emergency or with the patient's consent, granting significant others access is not a standard feature of EHRs.
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