A nurse in the PACU is caring for a client.
Which of the following assessments is the nurse's priority?
Respiratory status.
Surgical site.
Level of consciousness.
Pain level.
The Correct Answer is A
The nurse’s priority assessment in the PACU (Post-Anesthesia Care Unit) should be the client’s respiratory status.
This is because the client is recovering from anesthesia and may have an altered respiratory function.
Choice B, assessing the surgical site, is not an answer because it is not the priority assessment for a client in the PACU.
Choice C, assessing the level of consciousness, is not an answer because it is not the priority assessment for a client in the PACU.
Choice D, assessing the pain level, is not an answer because it is not the priority assessment for a client in the PACU.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Hepatitis A is a highly contagious liver infection caused by the hepatitis A virus and is most likely to be contracted from contaminated food or water or from close contact with a person or object that’s infected.
The hepatitis A vaccine can protect against hepatitis A and is recommended for travelers to high-risk areas.
Choice B is incorrect because hepatitis A is not transmitted through blood-to-blood exposure but rather through ingestion of contaminated food or water or through direct contact with an infectious person.
Choice C is incorrect because antibiotics are not used to treat viral infections such as hepatitis
A. Choice D is incorrect because the incubation period of hepatitis A is typically 2-6 weeks, not 5-10 days.
Correct Answer is A
Explanation
A decrease in the Glasgow Coma Scale (GCS) score indicates a decline in the client’s level of consciousness and neurological function.
This can be a sign of increased intracranial pressure or other complications related to the skull fracture.
Choice B is incorrect because an increase in WBC count may indicate an infection, but it is not as concerning as a decrease in GCS score.
Choice C is incorrect because a change in pulse pressure may indicate changes in cardiovascular function, but it is not as concerning as a decrease in GCS score.
Choice D is incorrect because a change in pupil diameter may indicate changes in neurological function, but it is not as concerning as a decrease in GCS score.
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