For the past six hours, a postoperative male client has refused pain medication because he believed that he could "tough it out." When an opioid analgesic is administered, the client has difficulty obtaining a satisfactory level of comfort.

Which action is best for the practical nurse (PN) to use in assisting this client to deal with his pain?

The correct answer is Choice C:

Suggest that an increase in fruits and vegetables is more beneficial.

Choice C rationale:

While dairy products do provide essential nutrients like calcium and vitamin D, there is no strong evidence to suggest that increasing dairy intake alone will significantly reduce the risk of cancer. On the other hand, fruits and vegetables are known to be rich in antioxidants and phytochemicals that have been associated with a reduced risk of cancer. Therefore, suggesting an increase in fruits and vegetables is a more evidence-based approach to reducing cancer risk.

Choice A rationale:

Encouraging exercise is a good recommendation for overall health, but it does not directly address the client's concern about reducing cancer risk. Focusing on a balanced diet, including plenty of fruits and vegetables, is more relevant to the client's specific concern.

Choice B rationale:

Reminding the client about Vitamin D-fortified dairy products may be helpful for addressing Vitamin D intake, but it doesn't necessarily address the broader concern of reducing cancer risk. Moreover, the link between dairy and cancer risk reduction is not as well-established as the benefits of fruits and vegetables.

Choice D rationale:

Providing information about cancer warning signs is important for cancer awareness but doesn't address the client's current dietary choices and concerns about cancer prevention. The focus should be on evidence-based dietary recommendations to reduce cancer risk.

Choice A rationale:

Crushing the medication and administering it in applesauce might alter its pharmacokinetics, rendering it ineffective or causing it to act too quickly. Sublingual tablets are designed to dissolve under the tongue for rapid absorption into the bloodstream. Crushing the tablet and mixing it with applesauce could change its intended mode of action.

Choice B rationale:

Placing the tablet under the client's tongue is the correct action for a sublingual tablet. Sublingual administration allows the medication to dissolve directly into the bloodstream through the sublingual mucosa, bypassing the digestive system and providing rapid onset of action.

Choice C rationale:

Obtaining a liquid form of the medication might be an option, but it may not always be available. Additionally, some medications are not available in liquid forms, and the liquid form might have a slower onset of action compared to the sublingual route.

Choice D rationale:

Placing the tablet inside the client's cheek is known as the buccal route of administration. While this route is also for oral absorption, sublingual administration is preferred for specific medications designed for rapid absorption.