The nurse is assessing a patient's pain using the pain scale. The patient is tearful, hesitant to move, and grimacing. The patient rates the pain at this time as a 2 using the pain scale. The nurse should conclude which of the following?
A) The patient has rated the pain as minimal according to the scale.
B) The nurse should reinforce teaching about the pain scale number system.
C) The nurse should reassess the pain in 30 minutes.
D) The medication the patient is receiving is not adequate for pain relief.
Ans: B
Feedback: The patient is physically exhibiting signs and symptoms of pain. Further teaching may need to be done so the patient can correctly rate the pain. The nurse may also verify that the same scale is being used by the patient and caregiver to promote continuity.
You might also like to view...
During a routine checkup, a client refers to a recent change in the color of the skin. Which of the following should the nurse suggest to the client?
A) Get a biopsy done as soon as possible. B) Make an appointment for a medical examination as soon as possible. C) Consider skin grafting. D) Start chemotherapy.
The nurse is instructing a patient diagnosed with AIDS regarding foods that will increase caloric intake. Which meal choice indicates that the patient understands which types of foods to consume?
1. spaghetti and meat sauce, raisin salad, whole grain roll with butter, vanilla milkshake (with Ensure), and a piece of pecan pie 2. baked chicken (thigh), cabbage, small green salad, slice of white bread, dried prunes, and a soda 3. red beans and rice, slaw, tomato, crackers, chocolate pudding, and iced tea 4. vegetable soup, small piece of cornbread, banana pudding, and water
A patient who has burns on the arms, legs, and chest from a house fire has become agitated and restless 8 hours after being admitted to the hospital. Which action should the nurse take first?
a. Stay at the bedside and reassure the patient. b. Administer the ordered morphine sulfate IV. c. Assess orientation and level of consciousness. d. Use pulse oximetry to check the oxygen saturation.
The physician orders an adult dose of morphine for a 14-year-old who weighs 55 kilograms
The nurse administering opioid pain medication to children is aware then checking the physician's orders that it is safe to give an adult dose to children who weigh more than how many kilograms? a. 35 c. 45 b. 40 d. 50