A female client with breast cancer and metastasis to the liver and spine requires pain assessment. Which aspects should be assessed?

• A. Vital signs only
• B. Sensory pattern, area, intensity, and nature of the pain
• C. Functional ability
• D. Laboratory values

Answer: (B)

Pain must be understood from the patient’s perspective by detailing where it is, how it feels, how intense it is, and how it behaves over time. This comprehensive description—location, quality (the nature of the sensation), intensity, and pattern—directly informs what kind of relief to use and how to adjust treatment as the cancer responds or progresses. In metastatic cancer, bone pain from spine metastases and visceral pain from liver involvement can feel very different, so capturing these characteristics helps tailor analgesia and monitor effectiveness.

Relying on vital signs alone isn’t reliable because pain can be present even when vitals are normal, and vitals can be influenced by many other factors. Functional ability is important for understanding how pain affects daily life, but it doesn’t tell you the specifics of the pain itself. Laboratory values don’t measure pain directly and can’t substitute for the patient’s report.