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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Free Nursing Study Resources

Correct Answer is C

Explanation

A. Hyperthyroidism: Although thyroid function should be monitored, hyperthyroidism itself is not a contraindication for combination oral contraceptives. However, uncontrolled hyperthyroidism may require careful evaluation before starting any hormonal therapy.
B. Hypocalcemia: Low calcium levels do not directly affect the safety of combination oral contraceptives, so this condition is not a contraindication. Oral contraceptives do not typically influence calcium metabolism in a way that would cause harm in hypocalcemic patients.
C. Thrombophlebitis: This condition indicates a history of blood clots or venous inflammation, which significantly increases the risk of thromboembolism with combination oral contraceptives due to their estrogen content. Therefore, thrombophlebitis is a contraindication.
D. Diverticulosis: This condition affects the colon and is not related to the risks associated with combination oral contraceptives. It does not contraindicate their use.

A. Administer propranolol IV to the client B. Position the client on her side. C. Ask the client to increase her daily calcium intake. D. Use Leopold maneuvers to determine the fetal position.

Correct Answer is B

Explanation

A. Administer propranolol IV to the client: Propranolol is a beta-blocker used to treat hypertension and certain cardiac conditions. It is not indicated for sudden nausea during pregnancy and could be harmful if administered without cause.
B. Position the client on her side: At 36 weeks, the gravid uterus can compress the inferior vena cava when the client lies flat, reducing venous return and causing supine hypotensive syndrome, which often presents as nausea. Turning the client to her side relieves pressure and restores circulation.
C. Ask the client to increase her daily calcium intake: Calcium is important during pregnancy, especially for bone health, but increasing intake is not an acute intervention for nausea caused by positional blood flow issues.
D. Use Leopold maneuvers to determine the fetal position: Leopold maneuvers assess fetal position but do not address the client’s immediate symptom of nausea, which may indicate compromised circulation from lying supine. Position change is the priority action.

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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

A nurse is reviewing the medical record of a client who is requesting combination oral contraceptives. Which of the following conditions in the client's history is a contraindication to the use of combination oral contraceptives?

Correct Answer is C

Explanation

A nurse is measuring the fundal height of a client who is at 36 weeks of gestation. The client suddenly reports nausea. Which of the following actions should the nurse take?

Correct Answer is B

Explanation

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