A nurse is caring for a client who states, "I did not take my medication because my partner forgot to remind me." The nurse should identify that the client is demonstrating which of the following defense mechanisms?

Choice A reason: This is not the correct answer because offering to notify the health care provider after morning rounds are completed is not the first action that the critically thinking nurse should take. The nurse should act promptly and advocate for the patient's pain management needs, rather than delaying the communication with the health care provider.

Choice B reason: This is the correct answer because exploring other options for pain relief is the first action that the critically thinking nurse should take. The nurse should assess the patient's pain level, location, quality, and contributing factors, and use a multimodal approach to pain management that includes pharmacological and non-pharmacological interventions, such as ice, heat, distraction, relaxation, or massage.

Choice C reason: This is not the correct answer because discussing the surgical procedure and reason for the pain is not the first action that the critically thinking nurse should take. The nurse should focus on alleviating the patient's pain, rather than educating the patient about the surgery. The nurse can provide information and reassurance to the patient after the pain is controlled.

Choice D reason: This is not the correct answer because explaining to the patient that nothing else has been ordered is not the first action that the critically thinking nurse should take. The nurse should not dismiss the patient's pain or imply that the patient has no other options for pain relief. The nurse should collaborate with the patient and the health care provider to find the best pain management plan for the patient.

Choice A reason: This is the correct answer because paralytic ileus is a condition in which the intestinal motility is decreased or absent, resulting in the inability to pass gas or stool. It is a common complication of abdominal surgery, as the manipulation of the bowel can cause inflammation and nerve damage. The nurse should monitor the client for signs of bowel obstruction, such as abdominal distension, nausea, vomiting, and pain.

Choice B reason: This is not the correct answer because Clostridium difficile colitis is a condition in which the normal flora of the colon is disrupted by antibiotic therapy, allowing the overgrowth of a toxin-producing bacteria that causes inflammation and diarrhea. It is not a common complication of abdominal surgery, but rather a risk associated with prolonged hospitalization and antibiotic use.

Choice C reason: This is not the correct answer because constipation is a condition in which the stool is hard, dry, and difficult to pass. It is not a common complication of abdominal surgery, but rather a side effect of opioid analgesics, which can slow down the bowel movements. The nurse should encourage the client to increase fluid and fiber intake, and use stool softeners as prescribed.

Choice D reason: This is not the correct answer because fecal impaction is a condition in which a large mass of stool is stuck in the rectum, preventing the passage of gas or stool. It is not a common complication of abdominal surgery, but rather a result of chronic constipation, dehydration, or immobility. The nurse should assess the client for signs of impaction, such as abdominal cramping, rectal pressure, and leakage of liquid stool.