A) The client is the best authority on the pain experience.
B) Chronic pain is mostly psychological in nature.
C) Regular use of analgesics leads to drug addition.
D) The amount of tissue damage is accurately reflected in the degree of pain perceived.
Correct Answer: A
. Which one of the following nursing interventions for a client in pain is based on the gate-control theory?
A) Giving the client a back massage
B) Changing the client’s position in bed
C) Giving the client a pain medication
D) Limiting the number of visitors
Correct Answer: A
Which of the following statements made by a client's family is the most reliable for use in the evaluation of a client's outcome?
"Mom has been eating 90% of all of her meals since she's been home."
17. Nursing interventions should be documented according to specific criteria in order that they may be clearly understood by other members of the nursing team. The most appropriate of the following intervention statements is the following:
4. "Apply two 4 × 4 dry gauze dressing pads tid."
During the admission history, the client states that he has trouble breathing at night. In obtaining data for a problem-oriented database, the nurse should first question the client about:
The onset and duration of his present breathing problem
3. The client is to receive a medication via the buccal route. The nurse plans to implement which of the following actions?
1. Place the medication inside the cheek.
2. Crush the medication before administration.
3. Offer the client a glass of orange juice after administration.
4. Use sterile technique to administer the medication.
Place the medication inside the cheek.
23. The client is to receive heparin by injection. The nurse prepares to inject this medication in the client's:
4. Abdomen
28. The nurse is administering an injection at the ventrogluteal site. On aspiration, the nurse notices that there is blood in the syringe. The nurse should:
4. Discontinue the injection and prepare the medication again
4. The client is able to ambulate without signs or symptoms of shortness of breath. Which statement by the nurse is the best example of an objective evaluation of the client's goal attainment? "Client has no evidence of respiratory distress when ambulating."
A newly admitted client was found wandering the hallways for the past two nights. The most appropriate nursing interventions to prevent a fall for this client would include:
B. Use an electronic bed-monitoring device
A patient is getting up for the first time after a period of bed rest The nurse should first? OBTAIN A BASE LINE BLOOD PRESSURE
2. The nurse formulates a diagnosis of knowledge deficit related to complications of pregnancy. One outcome criterion is that the client can state five symptoms that indicate a possible problem that should be reported. The client is able to tell the nurse three symptoms. The evaluation statement would be:
4. Goal partially met; client able to state three symptoms
16. After visiting with the client, the nurse documents the assessment data. Both objective and subjective information have been obtained during the assessment. Which of the following is classified as subjective data?
1. "Client appears sleepy"
17. The most effective way in the acute care environment to determine the client's identity before administering medications is to:
4. Check the client's name band
8. For a client with a nursing diagnosis of impaired physical mobility related to bilateral arm casts, the nurse should select which of the following methods of nursing intervention?
4. Assisting with activities of daily living (ADLs)
5. The client recently became febrile and stated he "felt hot." The nurse takes the client's temperature and finds it to be 38.2° C. In addition, the pulse rate is 88 beats per