A nurse in an emergency department is performing triage on a group of clients.
Which of the following clients should the nurse see first?

A client who has heart failure and peripheral edema.

A client who has cirrhosis of the liver and bruising on their arms.

A client who reports urinary burning and a temperature of 39.2° C (102.5° F).

A client who has a new onset of atrial fibrillation and a heart rate of 152/min.

Answer and Explanation

The Correct Answer is D

Atrial fibrillation with a rapid heart rate can lead to decreased cardiac output and compromised blood flow, which can have serious consequences, including stroke and heart failure. Therefore, this client requires immediate attention to assess and manage the cardiac rhythm.

While the other clients also have significant health concerns, they are not as acutely life-threatening as a new onset of atrial fibrillation with a high heart rate. Prioritizing care based on the urgency and severity of the condition is crucial in the emergency department setting.

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Correct Answer is C

Explanation

A. Health education. B. Health promotion. C. Holistic health. D. Disease prevention.

Correct Answer is B

Explanation

Choice A rationale:

Health education involves providing information and knowledge to clients about their health, which is essential but doesn't directly relate to the nurse's action of blood pressure screening. This choice is less appropriate in this context.

Choice B rationale:

Health promotion encompasses actions that aim to enhance an individual's well-being and prevent illness. Blood pressure screening is a preventive measure to identify individuals at risk of hypertension, making it a key component of health promotion. The nurse is contributing to the client's overall health by identifying potential hypertension issues.

Choice C rationale:

Holistic health refers to a broader approach to healthcare that considers the physical, mental, and social aspects of an individual. While it's essential, the nurse's specific action of blood pressure screening doesn't necessarily encompass all these aspects. It's more focused on identifying a specific health condition.

Choice D rationale:

Disease prevention involves activities to prevent the occurrence or progression of diseases. Blood pressure screening falls under this category as it aims to prevent complications related to hypertension, making this choice a relevant consideration. However, "Health promotion" is a more precise and comprehensive description of the nurse's role in this scenario.

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A nurse in an emergency department is performing triage on a group of clients. Which of the following clients should the nurse see first?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is C

Explanation

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Correct Answer is B

Explanation

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A nurse in an emergency department is performing triage on a group of clients.
Which of the following clients should the nurse see first?