A client with chronic myelogenous leukemia (CML) who has been on long-term corticosteroid therapy develops oral candidiasis. The client informs the nurse that the pain makes it difficult to chew or swallow. Which action should the nurse implement first?

Choice A reason: Cleansing the mouth with swabs supports oral hygiene and reduces fungal load, but performing mouth care without first addressing pain may increase discomfort and reduce client cooperation. Pain can limit the effectiveness of oral care if not controlled, making this intervention less appropriate as the initial priority. Choice B reason: Administering a topical analgesic is the priority intervention because pain relief is necessary before the client can tolerate eating, drinking, or performing oral hygiene. Oral candidiasis causes inflamed, painful mucosal lesions, and unmanaged pain can lead to poor nutritional intake, dehydration, and further mucosal injury. Addressing pain first promotes comfort and enables subsequent interventions such as mouth care and adequate nutrition. Choice C reason: Encouraging frequent mouth care is an important long-term management strategy for oral candidiasis; however, it does not immediately address the client’s report of pain. Without analgesia, frequent mouth care may exacerbate discomfort and reduce adherence to care recommendations. Choice D reason: Obtaining a soft diet can reduce mechanical irritation during chewing and swallowing, but this intervention does not directly treat the underlying pain or inflammation. Dietary modification is supportive but should follow adequate pain control to ensure the client can safely and comfortably eat.