A nurse is caring for a postoperative patient.
When helping to manage the patient’s pain, which of the following principles should the nurse apply? (Select all that apply)

Expect the patient to express his pain both verbally and nonverbally

Administer opioids with caution because they will eventually lead to addiction

Consider the patient’s individual expression of pain

Use a scale from 0 to 10 to monitor the severity of the patient’s pain

Answer and Explanation

Correct Answer : A,C,D

Choice A rationale

Pain is a subjective experience and can be expressed both verbally and nonverbally. It is important for the nurse to be attentive to both types of expressions to effectively manage the patient’s pain.
Choice B rationale
While it is true that opioids should be used with caution due to the risk of addiction, this statement can be misleading. Opioids are often necessary for managing postoperative pain, and the risk of addiction is low when they are used appropriately and under medical supervision.
Choice C rationale
Considering the patient’s individual expression of pain is crucial in pain management. Pain is a subjective experience and can vary greatly between individuals. Tailoring pain management strategies to the individual patient can improve pain control.
Choice D rationale
Using a pain scale is a common and effective way to monitor the severity of a patient’s pain. It provides a quantifiable measure of pain that can be used to guide treatment decisions.

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Correct Answer is D

Explanation

Choice A rationale
Chlorhexidine is an antiseptic that is used for cleaning the skin or the hands and helps to prevent infections caused by bacteria. However, it is not the recommended cleansing agent for hand hygiene in a Clostridium difficile infection.
Choice B rationale
Alcohol-based antiseptics are commonly used for hand hygiene in healthcare settings. However, they are not effective against Clostridium difficile spores.
Choice C rationale
Povidone-iodine is an antiseptic used for skin disinfection before and after surgery. It may not be effective against Clostridium difficile spores.
Choice D rationale
Soap and water are recommended for hand hygiene when caring for a patient with a Clostridium difficile infection. This is because soap and water are effective in removing C. difficile spores from hands.

A. Maintain bed rest for 48 hr following surgery. B. Irrigate the nasogastric tube every 4 to 8 hr. C. Encourage hourly use of an incentive spirometer while awake. D. Perform leg exercises every 2 hr.

Correct Answer is ["A","B","C"]

Explanation

Choice A rationale
Maintaining bed rest for 48 hours following surgery is a common practice to allow the body to heal and recover.
Choice B rationale

Irrigating the nasogastric tube every 4 to 8 hours is necessary to maintain patency and prevent blockage.
Choice C rationale
Encouraging hourly use of an incentive spirometer while awake can help prevent postoperative complications such as pneumonia and atelectasis.
Choice D rationale
Performing leg exercises every 2 hours is not typically included in the plan of care for a client who had surgery for a bowel obstruction and has a nasogastric tube in place.

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A nurse is caring for a postoperative patient. When helping to manage the patient’s pain, which of the following principles should the nurse apply? (Select all that apply)

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a patient who has a Clostridium difficile infection. Which cleansing agent should the nurse use for hand hygiene?

Correct Answer is D

Explanation

A nurse is assisting in the plan of care for a client who had surgery for a bowel obstruction. The client has a nasogastric tube in place.Which of the following actions should the nurse include in the client’s plan of care? (Select all that apply)

Correct Answer is ["A","B","C"]

Explanation

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A nurse is caring for a postoperative patient.
When helping to manage the patient’s pain, which of the following principles should the nurse apply? (Select all that apply)