Situation 1: Nursing is a profession. The nurse should have a background on the theories and foundation of nursing as it influenced what is nursing today.

Nursing is the protection, promotion and optimization of health and abilities, prevention of illness and injury, alleviation of suffering through the diagnosis and treatment of human response and advocacy in the care of the individuals, families, communities and population. This is the most accepted definition of nursing as defined by the:A. PNAB. ANAC. NightingaleD. Henderson

Advancement in Nursing leads to the development of the Expanded Career Roles. Which of the following is NOT expanded career role for nurse?A. Nurse practitionerB. Clinical Nurse SpecialistC. Nurse ResearcherD. Nurse anaesthesiologist

The Board of Nursing regulated the Nursing profession in the Philippines and is responsible for the maintenance of the quality of nursing in the country. Powers and duties of the board of nursing are the following EXCEPT:A. Issue, suspend revoke certificates of registrationB. Issue subpoena duces tecum, ad testificandumC. Open and close colleges of nursingD. Supervise and regulate the practice

A nursing student or a beginning staff nurse who has not yet experienced enough in a situation to make judgments about them is in what stage of Nursing Expertise?A. NoviceB. NewbieC. Advanced BeginnerD. Competent

Benner’s “Proficient” nurse level is different from the other levels in nursing expertise in the context of having:A. The ability to organize and plan activitiesB. Having attained an advanced level of educationC. A holistic understanding and perception of the clientD. Intuitive and analytic ability in new situations

Situation 2: The nurse has been asked to administer an injection via Z TRACK technique. Questions 6 to 10 refer this.

The nurse prepares an IM injection for an adult client using the Z track techniques, 4 ml of medication is to be administered to the client. Which of the following site will you choose?A. Deltoid

B. Rectus FemorisC. VentroglutealD. Vastus lateralis

In infants 1 year old and below, which of the following is the site of choice in intramuscular injection?A. DeltoidB. Rectus FemorisC. VentroglutealD. Vastus lateralis

In order to decrease discomfort in Z track administration, which of theA. Pierce the skin quickly and smoothly at 90 degree angleB. Inject the medication at around 10 minutes per millilitreC. Pull back the plunger and aspirate for 1 minute t make sure that the needle did not hit a blood vesselD. Pierce the skin slowly and carefully at a 90 degree angle

After injection using the Z track technique, the nurse should know that she needs to wait for few second before withdrawing the needle and this is to allow the medication to disperse into the muscle tissue thus decreasing the client’s discomfort. How many seconds should the nurse wait before withdrawing the needle?A. 2 secondB. 5 secondsC. 10 secondsD. 15 seconds

The rationale in using the Z track technique in an intramuscular injection is:A. It decreases the leakage of discolouring and irritating medication into the subcutaneous tissue.B. It will allow a faster absorption of the medicationC. The Z track technique prevent irritation of the muscleD. It is much more convenient for the nurse

Situation 3: A client was rushed to the emergency room and you are his attending nurse. You are performing a vital sign assessment:

All of the following are correct methods in assessment of the blood pressure EXCEPT:A. Take the blood pressure reading on both arms for comparisonB. Listen to and identify the phases of Korotkoff soundC. Pump the cuff to around 50mmHg above the point where the pulse is obliteratedD. Observe procedures for infection control

You attached a pulse oximeter to the client. You know that the purpose id to:A. Determine if the client’s hemoglobin level is low and if he needs blood transfusionB. Check level of client’s tissue perfusionC. Measure the efficacy of the client’s anti-hypertension medicationsD. Detect oxygen saturation of arterial blood before symptoms of hypoxemia develops

After a few hours in the Emergency Room, the client is admitted to the ward with an order of hourly monitoring of blood pressure. The nurse finds that the cuff is too narrow and this will cause the blood pressure reading to be:A. InconsistentB. Low systolic and high diastolicC. Higher than what the reading should beD. Lower than what the reading should be

Through the client’s health history, you gather that the patient smokes and drinks coffee. When taking the blood pressure of a client who recently smoked or drank coffee, how long should the nurse wait before taking the client’s blood pressure for accurate reading?A. 15 minutesB. 30 minutesC. 1 hourD. 5 minutes

While the client has pulse oximeter on his fingertip, you notice that the sunlight is shining on the area where the oximiter is. Your action will be to:A. Set and turn on the alarm of the oximeterB. Do nothing since there is no identified problemC. Cover the fingertip sensor with a towel or bedsheetD. Change the location of the sensor every four hours

The nurse finds it necessary to recheck the blood pressure reading. In case of such reassessment, the nurse should wait for a period of:A. 15 secondsB. 1 to 2 minutesC. 30 minutesD. 15 minutes

17. If the arm is said to be elevated when taking the blood pressure. It will create a:A. False high readingB. False low readingC. True False readingD. Indeterminate

You are to assessed the temperature of the client the next morning and found out that he ate ice cream. How many minutes should you wait before assessing the client’s oral temperature?A. 10 minutesB. 20 minutesC. 30 minutesD. 15 minutes

When auscultating the client’s blood pressure the nurse hears the following: From 150 mmHg to 130 mmHg: Silence, Then: a thumping sound continuing down to 100 mmHg: muffled sound continuing down to 80 mmHg and then silence. What is the client’s pressure?A. 130/80B. 150/100

C. 100/80D. 150/100

. In a client with a previous blood pressure of 130/80 4 hours ago, how long will it take to release the blood pressure cuff to obtain an accurate reading?A. 10 – 20 secondsB. 30 – 45 secondsC. 1 - 1.5 minutesD. 3 – 3.5 minutes

Situation 4 – Oral care is an important part of hygienic practices and promoting clientcomfort.

An elderly client, 84 years old, is unconscious. Assessment of the mouth reveals excessive dryness and presence of sores. Which of the following is BEST to use for oral care?A. lemon glycerineB. hydrogen peroxideC. Mineral oilD. Normal saline solution

. When performing oral care to an unconscious client, which of the following is a special consideration to prevent aspiration of fluids into the lungs?A. Put the client on a sidelying position with head of bed loweredB. Keep the client dry by placing towel under the chinC. Wash hands and observe appropriate infection controlD. Clean mouth with oral swabs in a careful and an orderly progression

The advantages of oral care for a client include all of the following, EXCEPT:A. decreases bacteria in the mouth and teethB. reduces need to use commercial mouthwash which irritate the buccalmucosaC. improves client’s appearance and self-confidenceD. improves appetite and taste of food

A possible problem while providing oral care to unconscious clients is the risk of fluidaspiration to lungs. This can be avoided by:A. Cleaning teeth and mouth with cotton swabs soaked with mouthwash to avoidrinsing the buccal cavityB. swabbing the inside of the cheeks and lips, tongue and gums with dry cotton swabsC. use fingers wrapped with wet cotton washcloth to rub inside the cheeks, tongue,lips and umsD. suctioning as needed while cleaning the buccal cavity

25. Your client has difficulty of breathing and is mouth breathing most of the time. This causes dryness of the mouth with unpleasant odor. Oral hygiene is recommended for the client and in addition, you will keep the mouth moistened by using:A. salt solutionB. water

C. petroleum jellyD. mentholated ointment

Situation 5: Ensuring safety before, during and after a diagnostic procedure is an important responsibility of the nurse.

To help Fernan better tolerate the bronchoscopy, you should instruct him to practice which of the following prior to the procedure:A. Clenching his fist every 2 minutesB. Breathing in and out through the nose with his mouth openC. Tensing the shoulder muscles while lying on his backD. Holding his breath periodically for 30 seconds

27. Following a bronchoscopy, which of the following complains to Fernan should be noted as a possible complication:A. Nausea and vomitingB. Shortness of breath and laryngeal stridorC. Blood tinged sputum and coughingD. Sore throat and hoarseness

28. Immediately after bronchoscopy, you instructed Fernan to:A. Exercise the neck musclesB. Breathe deeplyC. Refrain from coughing and talkingD. Clear his throat

. Thoracentesis may be performed for cytologic study of pleural fluid. As a nurse your most important function during the procedure is to:A. Keep the sterile equipment from contaminationB. Assist the physicianC. Open and close the three-way stopcockD. Observe the patient’s vital signs

30. Right after thoracentesis, which of the following is most appropriate intervention?A. Instruct the patient not to cough or deep breathe for two hoursB. Observe for symptoms of tightness of chest or bleedingC. Place an ice pack to the puncture siteD. Remove the dressing to check for bleeding

Situation 6: Knowledge of the acid base disturbance and the functions of the electrolytes is necessary to determine appropriate intervention and nursing actions.

31. A client with diabetes milletus has glucose level of 644 mg/dL. The nurse interprets that this client is at most risk for the involvement at which type of acid base imbalance?A. Respiratory acidosisB. Respiratory alkalosisC. Metabolic acidosisD. Metabolic alkalosis

In a client in the health care clinic, arterial blood gas analysis gives the following results: pH 7.48, PCO2 32mmHg, PO2 94 mmHg, HCO3 24 mEq/L. The nurse interprets that the client has which acid base disturbance?A. Respiratory acidosisB. Respiratory alkalosisC. Metabolic acidosisD. Metabolic alkalosis

. A client has an order for ABG analysis on radial artery specimens. The nurse ensures that which of the following has been performed or tested before the ABG specimen are drawn?A. Guthing testB. Allen’s testC. Romberg’s testD. Weber’s test

34. A nurse is reviewing the arterial blood gas values of a client and notes that the pH is 7.31, Pco2 is 500 mmHg, and the bicarbonate is 27 mEq/L. The nurse concludes that which acid base disturbance is present in this client?

A. Respiratory acidosisB. Respiratory alkalosisC. Metabolic acidosisD. Metabolic alkalosis

35. Allen’s test checks the patency of the:A. Ulnar arteryB. Radial arteryC. Carotid arteryD. Brachial artery

37. After IVP a renal stone was confirmed, a left nephrectomy was done. Her post operative order includes “daily urine specimen to be sent to the laboratory” . Eileen has a foley catheter attached to a urinary drainage system. How will you collect the urine specimen?A. remove urine from drainage tube with sterile needle and syringe and empty urine from the syringe into the specimen containerB. empty a sample urine from the collecting bag into the specimen containerC. disconnect the drainage tube from the indwelling catheter and allow urine to flow from catheter into the specimen container.D. disconnect the drainage the from the collecting bag and allow the urine to flow from the catheter into the specimen container.

38. Where would the nurse tape Eileen’s indwelling catheter in order to reduce urethral irritation?A. to the patient’s inner thigh B. to the patient’s lower thigh C. to the patient’s buttocks D. to the patient lower abdomen

39. Which of the following menu is appropriate for one with low sodium diet?

A. instant noodles, fresh fruits and ice teaB. ham and cheese sandwich, fresh fruits and vegetablesC. white chicken sandwich, vegetable salad and teaD. canned soup, potato salad, and diet soda

40. Howe will you prevent ascending infection to Eileen who has an indwelling catheter?A. see to it that the drainage tubing touches the level of the urineB. change he catheter every eight hoursC. see to it that the drainage tubing does not touch the level of the urineD. clean catheter may be used since urethral meatus is not a sterile area

Situation 7: Hormones are secreted by the various glands in the body. Basic knowledge of the endocrine system is necessary.

41. Somatotropin or the Growth Hormone releasing hormone is secreted by the anterior pituitary gland:A. HypothalamusB. Anterior pituitary glandC. Posterior pituitary glandD. Thyroid gland

42. All of the following are secreted by the anterior pituitary gland except:A. Somatotropin/Growth hormoneB. Follicle stimulating hormoneC. Thyroid stimulating hormoneD. Gonadotropin hormone releasing hormone

43. All of the following hormones are hormones secreted by the Posterior pituitary gland except:A. VasopressinB. OxytocinC. Anti-diuretic hormoneD. Growth hormone

44. Calcitonin, a hormone necessary for calcium regulation is secreted in the:A. Thyroid glandB. HypothalamusC. Parathyroid glandD. Anterior pituitary gland

45. While Parathormone, a hormone that regulates the effect of calcitonin is secreted by the:A. Thyroid glandB. HypothalamusC. Parathyroid glandD. Anterior pituitary gland

Situation 8 – The staff nurse supervisor requests all the staff nurses to “brainstorm” andlearn ways to instruct diabetic clients on self-administration of insulin. She wants to ensurethat there are nurses available daily to do health education classes.

46. The plan of the nurse supervisor is an example ofA. in service education processB. efficient management of human resourcesC. increasing human resourcesD. primary prevention

47. When Mrs. Guevarra, a nurse, delegates aspects of the clients care to the nurse-aidewho is an unlicensed staff, Mrs. GuevarraA. makes the assignment to teach the staff memberB. is assigning the responsibility to the aide but not the accountability forthose tasksC. does not have to supervise or evaluate the aideD. most know how to perform task delegated

48. Connie, the new nurse, appears tired and sluggish and lacks the enthusiasm she had sixweeks ago when she started the job. The nurse supervisor shouldA. empathize with the nurse and listen to herB. tell her to take the day offC. discuss how she is adjusting to her new jobD. ask about her family life

49. Process of formal negotiations of working conditions between a group of registerednurses and employer isA. grievanceB. arbitrationC. collective bargainingD. strike

50. You are attending a certification on cardiopulmonary resuscitation (CPR) offered andrequired by the hospital employing you. This isA. professional course towards creditsB. inservice educationC. advance trainingD. continuing education

Situation 11: The nurse is responsible to accurately records and reports patient’s progress. She is able to communicate to the other member of the team by documenting the nursing care plan and the appropriate nursing intervention.

51. A main function of the patient’s records is to: A. prepare the nurse for the shift worked B. serve as a record of financial charges C. serve as a vehicle for communication D. ensure that the message is received

52. When the nurse writes in the chart and discovers an error has been made, which is the BEST approach? A. erase the erroneous material B. carefully ink out the erroneous material C. place as asterisk next to the statement, then footnote it D. draw a straight line through the error and initial it.

53. Which of the following persons cannot have the access to the patient record? A. physical therapist C. the patient B. lawyer of the family D. speech therapist

54. POMR charting is different from traditional method because of which of the following practices? 1. SOAP charting 3. narrative charting 2. use of flow sheet 4 . use of checklist A. 3 & 4 B. 1 & 2 C. 1 & 3 D. 2 & 3

55. Which of the following qualities are relevant in documenting patients care?1. Accuracy and consciousness2. thoroughness and currentness3. systematic and orderly4. legibly, properly dated and signed5. use of locally accepted abbreviation

A. 1,3,4 & 5 B. 2,3,4 & 5 C. 1,2,3 & 5 D. 1,2,3 & 4

Situation 12: The practice of primary nurse in primary nursing is preferred by many nurses because it supports professional autonomy and accountability of the nurses>

56. What is the function of the primary nurse in primary nursing? A. acts as patient advocate and coordinate the health care team for specific group of patients B. act as the charge nurse, organizing staff assignments and help in solving problem in the unit C. plans and coordinate the patient care assigned to her from admission to discharge D. coordinates the care given to a group of patients by support staff

57. Primary nursing is MOST advantageous and satisfying to the patient and nurse because of which of the following principles? A. autonomy and authority for planning care are best delegated to a nurse B. accountability is clearest since our nurse is responsible for the overall plan and implementation of careC. the holistic approach provides fro a therapeutic relationship continuity of care and efficient nursing careD. continuity of patients care promotes efficient nursing care.

58. Which is the role of the associate nurse in primary nursing? A. over-all manager of the unit B. responsible for the over-all care of the patient during off days of primary nurse C. patient advocate in the health care team D. coordinator of comprehensive, holistic patient care

59. In primary nursing, the nurse is responsible for which of the following group of patient? A. the whole ward B. small group of patient like 3-5 patients C. big group of patients like 10-15 patients D. the whole unit

60. In primary nursing who among the following is needed to her leadership and quality control in the ward? A. the chief nurse C. the nurse supervisor B. the head nurse D. the service director

Situation 13: Your nursing unit plans to conduct a study on the use of structured preoperative preparation in lessening the demand for post-operative pain medications.

61. Which of the following research activities should you initially do? A. find out from interview how many patients are willing to participate B. get the permission from the hospital director C. review literature on the topic D. prepare the tool for collecting data

62. Which of the following statements do NOT contribute to the researchabilty of your proposed problem? A. potential use of findings C. well-defined problem statement B. readability of findings D. measurability of variables

63. A study /research table should NOT contain which of the following ? A. categories of data collected C. specific title of table B. relevant rows and columns D. names and sample of the selected

64. Which of the following actions will facilitate analysis of research data? A. consult a physician C. consult a complete expert B. consult an adviser D. categorize data collected

65. The research methodology that is appropriate for the above problem would be: A. descriptive B. normative C. experimental D. quasi experimental

Situation 14: The nurse meets a new client, Mr. Principe, 50 years old. During the initial interview, the nurse begins to feel irritated towards the client. Shortly after, he becomes uncomfortable and politely leaves the room. The nurse realizes the behavior and mannerism of Mr. Principe reminds him of his strict disciplinarian father who abused him physically.

66. The recognize that his feeling for the client is known as: A. denial B. counter transference C. revenge D. transference

67. Seeing that his negative feelings for Mr. Principe could affect his nursing care, the nurse applies the concept of therapeutic use of self when: A. the nurse talks about his personal feelings towards the client B. the nurse suppresses his feelings and continue to take care of the client

C. the nurse uses his awareness and asks to be reassigned to another client D. the nurse uses self-awareness to manage his feelings and thoughts towards the client

68. Mr. Principe is terminally ill and his family is coping with his impending death. The nurse has to deal with his own thoughts and personal feelings about death and grieving in order to: A. avoid sharing personal thought about their impending loss and feeling of grief since this is very subjective B. get self out of the way while he assists the client and his family express their feelings of impending loss C. prevent self from being affected by the family’s grief and remain objective D. help the family plan for the funeral arrangement and burial services

69. One morning when the nurse enters the client’s room. Mr. Principe asks the nurse to “leave me alone and stop bothering me and I don’t want your pity”. The following response by the nurse would be MOST appropriate? A. “You seem upset this morning” and remains with the client B. “You are probably upset because you don’t feel well” C. “Why you are angry with me? What did I do anything to upset you? D. “I understand and will leave you for a while”

70. The nurse understands that the nurse-client relationship is a therapeutic alliance when: A. the nurse is a role model for a client B. this is an essential part of the nursing process C. the nurse has to be therapeutic at all times D. how the nurse thinks and feels affects her actions and behavior towards her client and her work Situation 15: Mr. Ong is for admission to the medical unit and you are his nurse.

71. The MOST important initial nursing approach when admitting client is to: A. introduce the client to the ward staff B. orient the client to the physical set up of the unit C. identify the most immediate needs of the client and implement the necessary intervention D. take V/S fro baseline assessment

72. When gathering baseline data, the BEST way for you to check if the client has pedal edema is to: A. talk to the relatives C. do auscultation B. interview the client D. do a physical assessment

73. You want to know the sleeping pattern of Mr. Ong You will: A. interview the clients and relatives B. take his BP before sleeping and upon waking up

C. observe his sleeping pattern over a period of timeD. perform physical assessment

74. Mr. Ong has severe pedal edema. Which accessory device would be appropriate for his condition? A. footboard B. cradle C. bed board D. rolled pillows

75. A student nurse is observed putting a standard size cuff on an obese client. The action would probably result in BP reading that is: A. false high B. false low C. normal D. undetectable

Situation 16: Health is wealth specifically in this time of the century. The nurse is trained to promote well being of the people.

76. How does a nurse promote one’s well being? A. periodic travels for rest and recreation B. faithful and observance of healthy simple lifestyle C. run away from polluted, stressful areas D. avoid sleepless, over fatigue nights

77. The nurse can be involved with health promotion as a significant person in helping the family:

A. become a better family B. prevent disease C. control their symptoms D. modify health promotive behaviors

78. The nurse should NOT leave medication at the bedside because: a. the bedside table is not sterile b. it is convenient for the nurse c. the nurse will not be able to accurately document that the patient actually took the medication d. the patient may forget to take it.

79. Non-pharmacologic pain management includes all the following EXCEPT: a. relaxation techniques c. use of herbal medicines b. massage d. body movement

80. When assessing a client’s blood pressure, the nurse finds it necessary to recheck the reading. How many seconds after deflating the cuff should the nurse wait before rechecking the pressure?

a. 10 b. 30 c. 45 d. 60

Situation 17: Safe nursing practice involves an understanding of the law.

81. In the Philippines, this law is : a. The Philippine Nursing Act of 2002 or R.A. 9173 b. the Philippine Nursing Act of 1991 or R.A. 7164 c. IRR or Resolution 425 of 2003 d. Republic Act No. 8981

82. The Philippine Nursing Act delineates the scope of nursing. It specifies that independent practicing nurse is responsible for:

a. health promotion and prevention of illness b. administration of written prescription for treatment and therapies c. rehabilitative aspect of care d. Collaborating with other healthcare providers for health restoration and alleviation of suffering

83. Standards of care provide the legal basis for evaluation of nursing practice or malpractice. Its functions include all EXCEPT:

a. used by nurse experts to define what appropriate nursing practice is in a given situation b. used to measure or evaluate nursing conduct to determine if the nurse acted reasonably as any

prudent nurse would under similar circumstances c. used to delineate the scope, function and role of the nurse d. use to measure or evaluate the conduct of nurse specialists who are certified in their own

specialty fields

84. As a standard in ethics, this represents an understanding and agreement to respect another person’s right to decide a course his or her own destiny:

a. Autonomy c. Beneficence b. justice d. nonmalifecence

85. The Code of Ethics refers to standards of behavior or ideals of conduct. The ability to answer for and stand by one’s action refers to:

a. accountability c. advocacy b. veracity d. responsibility

Situation 18: An understanding of the factors influencing the health care delivery system will enable nurses to adjust to change, create better ways of providing nursing care and develop new nursing roles.

86. Wellness clinics and health education activities have been integrated in government hospitals to render appropriate services. Which of the following purposes LEAST helps clients in cases of these health promotion activities? A. maintain maximum functions C. promote health habits B. reduce the costs of health care D. identify disease symptoms

87. With regards to illness prevention activities as part of nursing care, which of the following will help clients MOST? A. maintain maximum function C. promote habits related to health care B. reduce risk factor D. manage stress

88. By experience, which of the following nursing goals are MOST often overlooked by nurses and other members of the hospital team in the care of their clients in the hospital? A. illness prevention C. diagnosis and treatment B. health promotion D. rehabilitation of patients

89. Which of the following health care agencies is usually family-centered, relatively recent in popularity and oftentimes focuses on maintenance of comfort and satisfactory lifestyle of clients in the terminal phase of illness? A. non-government organization C. community health center B. hospice D. support group

90. Which of the following is NOT a legally binding document but nonetheless very important in the care of all patients in any setting? A. Bill of rights as provided in the Philippine Constitution B. Scope of nursing practice as defined in R.A. 9173 C. Patient’s Bill of Rights ( as adopted by American Nurses Association ) D. Board of Nursing resolution adopting the Code of Ethics

Situation 19: One of the professional competencies that nurse must always demonstrate is in the area of communication:

91. Which communication technique would be MOST effective in eliciting detailed information from the client? A. open-ended questioning C. active listening B. verbalizing observations D. summarizing clients views

92. Which of the following terms refer to the sender’s attitude towards the self, the message and the listener? A. verbal communication C. non-verbal communication B. double-bind communication D. meta communication

93. In interacting with patients, the nurses should remember that a client’s personal space is: A. that which revolves around the client

B. highly mobile depending upon certain situation C. clearly visible to others D. the same as that of the nurse

94. In interpersonal communication is LEAST threatening during what type of relationship? A. social C. personal B. intimate D. professional

95. In demonstrating the method for deep breathing exercises, the nurse places the hands on the client’s abdomen to explain diaphragmatic movement. This technique involves the use of which element of communication? A. appropriateness C. channel B. feedback D. message

Situation 20: Roy, an adolescent, was diagnosed to have pneumonia. He constantly complains of chest pain and has a standing order of Morphine SO4.

96. Which of the following MOST appropriately describe pain sensation that has periods of remission and exacerbation? A. chronic C. acute B. intractable D. Psychosomatic

97. Roy is constantly asking to be relieved from pain. Since morphine is an addicting drug, which of the following is BEST for the patient? A. administer morphine SO4 PRN B. administer morphine on a routine schedule as ordered C. give instructions on relaxation technique to reduce frequency of pain sensation D. divert the attention by not limiting visitors

98. To get accurate information about the quality of pain the patient is experiencing, which of the following statements would be MOST APPROPRIATE? A. “What cause you the pain?” C. “Have you taken something to relieve the pain?” B. “ Tell me what your pain feels like” D. “Is it stubbing or radiating pain?”

99. As the nurse assigned to Ray, which of the following can decrease his chest pain? A. supporting his rib cage when he coughs C. teaching him B. advising him D. encouraging him to breathe deeply

100. Which of the following is the nurse’s primary goal in caring for clients with chronic pain? A. change the clients perception of pain B. reduce the clients perception of pain C. change the clients reaction to pain D. enumerate the source of pain