A nurse is planning care for a group of clients following change-of-shift report. When using clinical decision making, which of the following clients should the nurse assess first?

A) "I'll use pursed-lip breathing when I feel short of breath.": Pursed-lip breathing is a beneficial technique for clients with COPD as it helps keep the airways open longer, reduces the work of breathing, and improves ventilation. This statement indicates the client understands a key management strategy for COPD.

B) "I'll skip my exercises for the week if I feel short of breath.": Regular exercise is important for managing COPD, and while adjustments may be necessary when symptoms are severe, completely skipping exercise can lead to deconditioning and worsening of symptoms. This statement does not reflect appropriate management of COPD.

C) "I will use my inhaler 30 minutes after each meal.": Inhalers should be used as prescribed, usually before activities that might trigger symptoms, such as eating, rather than on a fixed schedule unrelated to symptoms or physician's guidance. This statement indicates a misunderstanding of inhaler use.

D) "I will limit myself to drinking only 1 quart of water each day.": Staying hydrated is important for thinning mucus in COPD. Unless there are specific medical reasons to restrict fluids, such as heart failure, limiting water intake could lead to dehydration and thickened mucus, making breathing more difficult. This statement is not appropriate for managing COPD.

A) Sensorineural deafness
This is a possible complication of mumps but not a symptom indicating the illness stage. It can occur after the infection and does not reflect the active phase of the disease.

B) Maculopapular rash
This type of rash is not typically associated with mumps. It may indicate other viral infections, such as measles or rubella, rather than mumps.

C) Swelling of the parotid glands
Swelling of the parotid glands is a hallmark symptom of the illness stage of mumps. This swelling typically appears a few days after the onset of other symptoms like fever and malaise and signifies the active phase of the infection.

D) Nuchal rigidity
Nuchal rigidity can occur if there is mumps-related meningitis, but it is not a typical sign of the initial illness stage. It indicates potential complications involving the central nervous system.