The nurse would expect a client receiving an opioid analgesic to report which of the following side effects?

Correct Answer: B

Rationale: The nurse expects constipation from an opioid analgesic, as opioids slow gastrointestinal motility by binding to mu receptors in the gut, reducing peristalsisa common, dose-related side effect. Proactive management (e.g., laxatives) is standard. Choice A, increased appetite, is unlikelyopioids may cause nausea, suppressing hunger, not boosting it. Choice C, fever, isn't typical; opioids don't induce temperature spikes unless allergic reactions occur, which is rare. Choice D, diarrhea, contradicts opioids' constipating effectantidiarrheals mimic this action. Choice B is correct, reflecting a frequent issue nurses monitor, educating clients on hydration, diet, or stool softeners to mitigate discomfort, ensuring opioid benefits (pain relief) outweigh this manageable drawback in acute or chronic use.

Correct Answer: A

Rationale: The basis of the nurse's response is reduced pain tolerance, as fatigue lowers the brain's ability to modulate pain signals, heightening perceptionexhaustion depletes coping reserves, making pain feel worse without changing its source. This is a psychological-physiological link. Choice B, increased inflammation, isn't fatigue-driven; inflammation ties to disease, not tiredness alone. Choice C, poor circulation, may worsen some pain (e.g., ischemia), but fatigue's effect is broader, not vascular-specific. Choice D, muscle tension, could contribute, but fatigue typically relaxes muscles, not tenses themtolerance is key. Choice A is correct, guiding nurses to explain this perception shift, suggesting rest or timed analgesics to bolster tolerance, helping clients manage pain's amplified feel when tired.

Correct Answer: B

Rationale: The basis of the nurse's response is to reduce discomfort, as pain medication before dressing changes preempts pain from tissue manipulation, especially in wounds (e.g., burns), ensuring the procedure is tolerable and effective. Timing (e.g., 30 minutes prior) aligns peak relief with activity. Choice A, prevent infection, is unrelatedanalgesics don't sterilize; that's antiseptics' role. Choice C, speed healing, isn't directpain control aids comfort, not tissue repair rates. Choice D, increase sedation, may occur but isn't the goalrelief, not sleep, drives dosing. Choice B is correct, explaining preemptive analgesianurses use this to minimize procedural pain, enhancing client cooperation and healing by preventing distress spikes during sensitive interventions like dressing changes.

Correct Answer: B

Rationale: When assessing a patient's abdomen, the nurse must follow a systematic approach to ensure accurate findings, starting with the least invasive technique. Inspection (Choice B) is the first step because it involves observing the abdomen for visible signs like distension, scars, or asymmetry without altering the body's natural state. Auscultation (Choice A) comes next, as it listens to bowel sounds, but performing percussion (Choice C) or palpation (Choice D) first could stimulate bowel motility or cause discomfort, potentially skewing the auscultation results. Inspection provides a baseline visual assessment, allowing the nurse to note abnormalities before proceeding to hands-on techniques. For instance, palpating or percussing too early might increase peristalsis, leading to misleading bowel sound interpretations. This sequenceinspection, auscultation, percussion, palpationis a standard protocol in nursing practice to maintain accuracy and patient comfort. Therefore, starting with inspection (Choice B) ensures the assessment is both logical and effective, making it the correct answer.

Correct Answer: C

Rationale: Diabetes mellitus delays wound healing due to impaired circulation, reduced immune response, and poor collagen formation, complicating predictions for a 65-year-old patient with a large wrist laceration. Choice C'With your history and the type of location of the injury, it's hard to say'is the best response because it acknowledges these variables without giving a definitive, potentially inaccurate timeline. Choice A (2 to 3 years') refers to the remodeling phase but overgeneralizes, as diabetes may prolong this. Choice B (within 4 months') is overly optimistic, as diabetic healing often exceeds this, especially for large wounds. Choice D (1 to 3 years') assumes no infection but still provides a broad, uncertain range. The nurse must avoid false reassurance; diabetes and age increase infection risk and slow tissue repair, while the wrist's mobility may further delay healing. Choice C's ambiguity reflects clinical reality, encouraging follow-up discussion, making it the most appropriate and correct response.