A nurse is caring for four clients in an emergency department. The nurse should plan to see which of the following clients first?

A client who is confused, is febrile and has foul-smelling urine

A client who has sickle cell disease and reports severe joint pain

A client who has slurred speech, is disoriented, and reports a headache

A client who has a dislocated left shoulder

Answer and Explanation

The Correct Answer is C

A. A client who is confused, is febrile, and has foul-smelling urine: These symptoms suggest a urinary tract infection potentially progressing to sepsis, which is serious but does not take priority over signs of possible stroke or brain injury.
B. A client who has sickle cell disease and reports severe joint pain: Severe pain is expected in sickle cell crises and requires prompt management, but it is not as time-sensitive as neurologic deterioration.
C. A client who has slurred speech, is disoriented, and reports a headache: These findings suggest a possible stroke or other neurological emergency such as a brain hemorrhage or increased intracranial pressure, which requires immediate evaluation and intervention.
D. A client who has a dislocated left shoulder: Although painful and requiring attention, a shoulder dislocation is not immediately life-threatening and does not take precedence over potential neurologic compromise.

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Correct Answer is B

Explanation

A. Encourage the client to talk about his feelings: At a panic level of anxiety, the client’s ability to process information and communicate is significantly impaired, making it difficult to engage in meaningful conversation. This approach might increase frustration or agitation.
B. Use short sentences when communicating with the client: Using simple, clear, and concise sentences helps the client focus and understand instructions during a panic episode when cognitive processing is limited and overwhelmed.
C. Have the client journal about what is happening to him: Writing requires concentration and calm, which the client at a panic level of anxiety is unlikely to have, making journaling ineffective and potentially frustrating in this moment.
D. Tell the client to sit alone in a private place and reflect on the situation: Isolation during a panic attack can increase feelings of fear and abandonment. Providing supportive presence is more effective in helping the client regain control.

A. Position the client's knee slightly higher than the hips when up in a chair. B. Raise the head of the client's bed to a high-Fowlers position. C. Elevate the client's affected leg on a pillow when in bed. D. Keep an abduction pillow between the client's legs.

Correct Answer is D

Explanation

A. Position the client's knee slightly higher than the hips when up in a chair: This position can cause hip flexion greater than 90 degrees, increasing the risk of dislocation. Postoperative clients should keep their hips higher than their knees when sitting.
B. Raise the head of the client's bed to a high-Fowlers position: High-Fowlers positioning creates excessive hip flexion, which places strain on the new prosthesis and increases the likelihood of dislocation following hip replacement surgery.
C. Elevate the client's affected leg on a pillow when in bed: Elevating the leg can be appropriate for reducing swelling, but it does not prevent dislocation. Proper leg alignment is more critical than elevation in this context.
D. Keep an abduction pillow between the client's legs: An abduction pillow maintains the hip in proper alignment by preventing adduction and internal rotation, which are common causes of hip prosthesis dislocation in the early postoperative period.

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A nurse is caring for four clients in an emergency department. The nurse should plan to see which of the following clients first?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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