A nurse is conducting a pain assessment for a client who reports discomfort. Which of the following actions is the most appropriate for the nurse to take to obtain a comprehensive understanding of the client's pain?

Observe the patient's facial expressions and body language for signs of discomfort.

Measure the patient's vital signs and note any changes.

Review the patient's medical history for past pain management interventions and their outcomes.

Ask the patient to describe the pain using a pain scale and provide details about its location, duration, and intensity.

Answer and Explanation

The Correct Answer is D

A. Observe the patient's facial expressions and body language for signs of discomfort: While observation is important, it doesn't provide a complete picture of the client's pain experience and may not capture all aspects, such as intensity or location.

B. Measure the patient's vital signs and note any changes: Vital signs are important but can be nonspecific indicators of pain and are not as reliable for assessing pain intensity or quality.

C. Review the patient's medical history for past pain management interventions and their outcomes: While this is useful, it does not directly address the client's current pain experience.

D. Ask the patient to describe the pain using a pain scale and provide details about its location, duration, and intensity. A comprehensive pain assessment requires the client's self-report to fully understand the pain's characteristics. A pain scale (e.g., 0-10) helps quantify the intensity, and asking about its location, duration, and type allows for a thorough understanding of the pain's impact.

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Correct Answer is A

Explanation

A. Insomnia: Physical manifestations of grief often include insomnia, fatigue, appetite changes, headaches, and muscle tension due to the emotional and psychological stress of loss.

B. Bradycardia: Bradycardia is not a common physical manifestation of grief. Increased stress may more commonly cause tachycardia.

C. Blurred vision: While stress-related symptoms can occur, blurred vision is not typically associated with grief.

D. Increased ability to concentrate: Grief often reduces the ability to concentrate, not increases it.

A. Pain that has been present for more than six months and is associated with ongoing tissue damage. B. Pain that occurs suddenly and is typically related to a specific injury or trauma. C. Pain that fluctuates in intensity and is often accompanied by changes in mood and behavior. D. Pain that is described as dull and persists despite the absence of an obvious cause.

Correct Answer is B

Explanation

A. Pain that has been present for more than six months and is associated with ongoing tissue damage: This describes chronic pain, which persists over time and is not indicative of acute pain.

B. Pain that occurs suddenly and is typically related to a specific injury or trauma. Acute pain is characterized by its sudden onset, often associated with a specific cause, such as injury or surgery.

C. Pain that fluctuates in intensity and is often accompanied by changes in mood and behavior: This describes chronic pain, which may have episodic flare-ups and can impact emotional well-being.

D. Pain that is described as dull and persists despite the absence of an obvious cause: This is more indicative of chronic pain, which may not be directly linked to ongoing tissue damage.

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A nurse is conducting a pain assessment for a client who reports discomfort. Which of the following actions is the most appropriate for the nurse to take to obtain a comprehensive understanding of the client's pain?

Nursing Test Bank

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