A case manager is preparing a discharge plan for a client following coronary artery bypass grafting surgery. Which of the following client issues should the nurse address first?

Inadequate food supply

Limited social support

Low pain tolerance

Decreased self-esteem

Answer and Explanation

The Correct Answer is A

A. Inadequate food supply is a basic physiological need that directly affects recovery, wound healing, and overall postoperative outcomes after coronary artery bypass grafting. Ensuring access to adequate nutrition is essential for physical recovery and takes priority in discharge planning.

B. Limited social support is important for long-term recovery and adherence to care but does not address an immediate physiological need. It is typically addressed after basic needs are secured.

C. Low pain tolerance affects comfort and recovery experience but is managed through pain control strategies and does not take priority over essential survival needs like nutrition.

D. Decreased self-esteem is a psychosocial concern that, while important for holistic recovery, is addressed after physiological and safety needs have been met.

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Correct Answer is B

Explanation

A. Pouching a client's ostomy bag for a new colostomy requires specialized training and should typically be performed by a nurse.
B. Performing nasal hygiene for a client with an NG tube involves basic hygiene tasks that can be safely delegated to an assistive personnel after proper training and supervision.
C. Measuring oxygen saturation for a client who has dyspnea requires a basic skill that can be delegated to an assistive personnel.
D. Inserting a rectal suppository for a vomiting client involves a nursing task that should be performed by a nurse due to the client's condition and the nature of the task.

A. A client who reports right-sided flank pain and is diaphoretic B. A client who reports shortness of breath and left neck and shoulder pain C. A client who has active bleeding from a puncture wound of the left groin area D. A client who has a raised red skin rash on his arms, neck, and face

Correct Answer is B

Explanation

A: Right-sided flank pain and diaphoresis could indicate a kidney stone or infection, which is painful but not immediately life-threatening.

B: Shortness of breath combined with pain in the neck and shoulder could suggest a myocardial infarction (heart attack), which is a medical emergency requiring immediate attention.

C: Active bleeding from a puncture wound is concerning and requires prompt intervention, but it may not be as immediately life-threatening as a potential heart attack.

D: A raised red skin rash could be a sign of an allergic reaction or infection. While it may require medical attention, it is not as urgent as a potential myocardial infarction.

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A case manager is preparing a discharge plan for a client following coronary artery bypass grafting surgery. Which of the following client issues should the nurse address first?

Nursing Test Bank

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