The nurse is performing an admission assessment on a stable patient admitted after a motor vehicle accident. The patient reports having "bad pain." What will the nurse do first?
a. Administer acetaminophen (Tylenol).
b. Ask the patient to rate the pain on a 1 to 10 scale.
c. Attempt to determine what type of pain the patient has.
d. Request an order for an intravenous opioid analgesic.
ANS: B
To ascertain severity of pain, the nurse should ask the patient to rate the pain on a scale of 1 to 10. Further assessments include location and type of pain. Pain medication should be given after the severity of pain is assessed so that an appropriate analgesic may be given.
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