Difficulty: Medium
Average Score: 78%
Full-length
The nurse is assessing a client who had surgery 12 hours ago and is receiving IV morphine for incisional pain. It would require immediate follow-up if the client
Correct answer
C
Rationale
Burning at the IV site suggests possible extravasation or phlebitis, which can lead to tissue damage or infection, requiring immediate intervention. Low blood pressure, falling asleep, and dizziness are less urgent and can be associated with morphine's expected effects.