A client who has just returned from surgery refuses additional pain medication despite reporting severe pain. What would the nurse do first?

Correct Answer: B

Rationale: The nurse would first try to determine why the client is refusing additional pain medication despite severe pain, as understanding the reasonfear of addiction, side effects, or cultural beliefsguides effective, respectful care. Post-surgical pain needs management, but forcing treatment violates autonomy. Choice A, forcing medication, is unethical and illegal, ignoring consent and escalating distress. Choice C, telling the client it's needed, assumes refusal stems from ignorance, not addressing underlying concerns, and may erode trust. Choice D, reporting to the surgeon, delays action; nurses assess first to inform reports with data. Choice B is correct, reflecting nursing's patient-centered approachasking open-ended questions (e.g., What worries you about the medication?') uncovers barriers, enabling education (e.g., on safety) or alternatives (e.g., non-opioids), ensuring pain relief aligns with the client's values and needs post-surgery.

Correct Answer: B

Rationale: The basis of the nurse's response is that aspirin reduces inflammation, as it inhibits cyclooxygenase (COX) enzymes, decreasing prostaglandin productionchemicals that sensitize nociceptors and swell tissues, driving pain in conditions like arthritis. This anti-inflammatory action is aspirin's core pain-relief mechanism. Choice A, blocks nerve impulses, is wrongnerve blockers (e.g., lidocaine) do this, not aspirin, which acts peripherally. Choice C, numbs the skin, applies to topical anesthetics, not oral aspirin, which targets systemic inflammation. Choice D, increases blood flow, isn't primaryaspirin thins blood, but pain relief ties to inflammation reduction. Choice B is correct, enabling nurses to explain aspirin's role in inflammatory pain (e.g., headaches, joint pain), distinguishing it from opioids, and advising on use (e.g., with food) to manage mild-to-moderate pain effectively.

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.