A home health nurse visits a 40-year-old patient with metastatic breast cancer who reports pain at 7/10. In prioritizing actions, which should be done first?

• A. Auscultate for breath sounds
• B. Administer PRN pain medication
• C. Check pressure points for skin breakdown
• D. Ask family about patient's dietary intake

Answer: (B)

Relieving severe pain promptly takes priority in palliative care. When a patient with metastatic cancer reports pain at 7/10, the immediate, most appropriate action is to administer the prescribed PRN pain medication. This directly targets the symptom causing the greatest distress, improves comfort, and can aid rest and functioning. After giving the PRN dose, the nurse should reassess the pain level and monitor for relief and any side effects, adjusting the plan as needed with clinician guidance.

Auscultating breath sounds, while important, is not the urgent step when pain is this severe. Checking pressure points for skin breakdown and asking about dietary intake address other aspects of care but do not alleviate the current, active distress caused by high pain.