A nurse is prioritizing client care after receiving a change-of-shift report. Which of the following clients should the nurse plan to see first?
A client who told an assistive personnel he is short of breath
A client who has a prescription for discharge
A client who received oral pain medication 30 minutes ago
A client who is scheduled for an abdominal x-ray and is awaiting transport
The Correct Answer is A
Choice A reason (client care): A client reporting shortness of breath may be experiencing a life-threatening situation that aligns with the ABCs (Airway, Breathing, Circulation) of patient prioritization. This client requires immediate assessment and intervention.
Choice B reason (client care): While discharge is important, it does not take precedence over a client with potential respiratory distress.
Choice C reason (client care): A client who received pain medication 30 minutes ago is likely stable and can be seen after more urgent cases are addressed.
Choice D reason (client care): A client waiting for an abdominal x-ray is not a priority over a client with respiratory issues.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A reason: Rest pain is a symptom of advanced PAD and is not typically an early symptom.
Choice B reason: Dependent rubor may indicate PAD but is not as specific as intermitent claudication for early-stage PAD.
Choice C reason: Intermitent claudication, which is pain during exercise that resolves with rest, is a classic early symptom of PAD.
Choice D reason: Irregular foot ulcers are a sign of advanced PAD and are not typically found in the early stages of the disease.
Correct Answer is A
Explanation
Choice A reason: Evaluating the effectiveness of opioid analgesics is crucial as pain management is a primary concern for patients experiencing a sickle cell crisis.
Choice B reason: Limiting the patient's intake of oral and IV fluids is not recommended as hydration is important for patients with sickle cell crisis to reduce blood viscosity and improve circulation.
Choice C reason: Teaching the patient about high-protein, high-calorie foods is beneficial for long-term management but is not the immediate nursing intervention during a crisis.
Choice D reason: Encouraging ambulation may be part of recovery but is not the primary intervention during an acute sickle cell crisis due to the risk of pain exacerbation.
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