Which condition is included in the diagnosis of chronic obstructive pulmonary disease (COPD)?

Choice A reason: FACE pain rating scale is not the most useful assessment tool for a cognitively impaired patient who cannot accurately report pain, as it relies on the patient's ability to match their pain intensity to a series of facial expressions. The patient may not be able to understand or use the scale appropriately.

Choice B reason: OLDCART-based assessment tool is not the most useful assessment tool for a cognitively impaired patient who cannot accurately report pain, as it relies on the patient's ability to provide detailed information about the onset, location, duration, characteristics, aggravating factors, relieving factors, and treatment of their pain. The patient may not be able to recall or communicate this information effectively.

Choice C reason: PAINAD scale is the most useful assessment tool for a cognitively impaired patient who cannot accurately report pain, as it relies on the nurse's observation of the patient's behavior and physiological responses to pain. The scale consists of five items: breathing, vocalization, facial expression, body language, and consolability. Each item is scored from 0 to 2, and the total score ranges from 0 to 10. A higher score indicates more pain.

Choice D reason: 0 to 10 numeric pain scale is not the most useful assessment tool for a cognitively impaired patient who cannot accurately report pain, as it relies on the patient's ability to rate their pain intensity on a scale from 0 (no pain) to 10 (worst possible pain). The patient may not be able to comprehend or use the scale correctly.

Choice E reason: None of the above is not the correct answer, as there is one choice that is the most useful assessment tool for a cognitively impaired patient who cannot accurately report pain.

Choice A reason: Older adult's self-report is a subjective measure of pain that may not reflect the actual intensity or quality of pain. It may also be influenced by factors such as cognitive impairment, mood, or cultural norms.

Choice B reason: FPSR stands for Face, Pain Scale-Revised, which is a tool to assess pain in infants and children who cannot verbalize their pain. It is not suitable for older adults, who may have different facial expressions or reactions to pain.

Choice C reason: Pain medication frequency is an indirect measure of pain that may not capture the effectiveness or side effects of pharmacotherapy. It may also vary depending on the type, dose, and route of administration of pain medication.

Choice D reason: Older adult's pain diary is a comprehensive and reliable measure of pain that can track the changes in pain level, quality, and location over time. It can also record the impact of pain on daily activities, mood, sleep, and quality of life. It can help the nurse to evaluate the outcomes of comfort measures and pharmacotherapy, and to adjust the pain management plan accordingly.