A client asks the nurse why pain medication is given around-the-clock for the first few days after surgery rather than just when the pain is severe. What would be the basis of the nurse's response?

Correct Answer: B

Rationale: The basis of the nurse's response is to maintain a stable blood level of the drug, as around-the-clock (ATC) dosing post-surgery prevents pain peaks by keeping analgesic levels consistent, blocking nociceptive signals before they escalate. This contrasts with PRN's reactive approach. Choice A, keeping the client sedated, isn't the goalsedation may occur, but pain control drives scheduling. Choice C, reducing total drug amount, is falseATC may use more initially to preempt pain, not less. Choice D, preventing addiction, isn't relevant; short-term post-op use rarely causes dependence. Choice B is correct, explaining ATC's pharmacokinetic logicnurses educate that steady levels (e.g., via morphine every 4 hours) optimize comfort, reduce breakthrough pain, and aid healing, a standard in acute post-surgical management.

Correct Answer: B

Rationale: The nurse would suggest applying heat to the area for chronic pain worse in the morning, as heat boosts blood flow, relaxes stiff muscles, and eases joint paincommon with conditions like arthritis, where inactivity overnight stiffens tissues. This targets morning exacerbation. Choice A, increase activity, may help later but risks strain when pain peaks; gradual movement post-relief is better. Choice C, take medication at noon, misses the morning windowpain needs earlier control (e.g., bedtime dosing). Choice D, sleep later, avoids the issue; pain persists regardless of wake time. Choice B is correct, offering a practical, nonpharmacological fix nurses recommend, paired with meds if needed, to reduce morning stiffness and improve daily function for chronic pain clients.

Correct Answer: B

Rationale: The nurse expects a dull ache in somatic pain, as it arises from musculoskeletal tissues (e.g., bones, muscles) due to injury or inflammation, producing a localized, throbbing or aching qualitydistinct from neuropathic pain's neural feel. Choice A, burning sensation, fits neuropathic pain (e.g., nerve damage), not somatic's mechanical origin. Choice C, tingling, also suggests neuropathy (e.g., pinched nerve), not the deeper ache of somatic pain like fractures. Choice D, numbness, indicates nerve dysfunction or anesthesia, not pain itselfsomatic pain is felt, not absent. Choice B is correct, guiding nurses to identify somatic pain's hallmarke.g., post-op or arthritis discomfortprompting treatments like NSAIDs or rest, tailored to its tissue-based source, unlike neuropathic options.

Correct Answer: B

Rationale: Primary prevention focuses on preventing health issues before they occur, such as through immunizations or health education. Administering a measles, mumps, and rubella (MMR) immunization to an infant (Choice B) is a classic example of primary prevention because it protects against diseases before exposure. In contrast, administering digoxin (Choice A) is a treatment for an existing condition (heart failure), making it tertiary prevention aimed at managing or reducing complications. Obtaining a Papanicolaou smear (Choice C) is secondary prevention, as it involves early detection of cervical cancer rather than preventing it outright. Similarly, using occupational therapy for arthritis (Choice D) is tertiary prevention, helping a patient manage an existing condition rather than preventing its onset. The distinction lies in the timing and intent: primary prevention occurs before any disease process begins, and the MMR vaccine fits this definition perfectly by building immunity proactively. Thus, Choice B is correct, aligning with the goal of stopping health problems at their root.

Correct Answer: D

Rationale: The nursing process is a dynamic, cyclical framework guiding patient care, and revision of a care plan occurs during the evaluation step (Choice D). In evaluation, the nurse assesses whether the established goals (set during planning) were met, partially met, or unmet, using outcome criteria. If goals aren't achievede.g., a patient's pain remains uncontrolledthe nurse revises the plan, adjusting interventions or goals based on new data. Assessment (Choice A) is data collection, not revision, though it informs the process. Planning (Choice B) involves creating the initial care plan, not modifying it. Implementation (Choice C) is executing the plan, not evaluating or revising it. For example, if a wound isn't healing despite dressings, evaluation reveals the need for a new approach (e.g., different dressings), prompting revision. This step ensures care remains patient-centered and effective, adapting to changes in condition. Thus, Choice D, evaluation, is where revision occurs, making it the correct answer.