A nurse on a medical-surgical unit is caring for a group of clients. Which of the following clients should the nurse see first?
A client who is postoperative and reports intermittent nausea
A client whose blood pressure is 160/90 mm Hg and reports a headache
A client who is scheduled for surgery in 2 hr
A client who is postoperative and has a Jackson-Pratt drain
The Correct Answer is B
Hypertensive crisis is a severe increase in blood pressure that can lead to organ damage or other complications. Prompt assessment and intervention are necessary to prevent further escalation of blood pressure and potential complications.
While all the clients mentioned require attention, the client with elevated blood pressure and a headache poses a higher immediate risk. The nurse should assess the client's blood pressure, evaluate for signs of target organ damage, and initiate appropriate interventions, which may include administering antihypertensive medications as prescribed and monitoring closely for any changes in the client's condition.
The client who is postoperative and reports intermittent nausea can be assessed and managed after addressing the client with the elevated blood pressure and headache.
The client scheduled for surgery in 2 hours can be addressed according to the scheduled timeline.
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Related Questions
Correct Answer is C
Explanation
Neisseria gonorrhoeae is a sexually transmitted infection that is reportable to public health authorities due to its potential for spreading rapidly within a population and its significant public health implications. Reporting cases of Neisseria gonorrhoeae infection allows for appropriate monitoring, treatment, and control measures to be implemented to prevent further transmission and protect public health.
Sarcoptes scabiei, which causes scabies, is a contagious skin infestation but is not typically a reportable condition to the state health department.
Human papillomavirus (HPV) is a common sexually transmitted infection, but it is not generally reportable unless it is associated with certain high-risk strains and leads to specific conditions such as cervical cancer.
Impetigo contagiosa, a bacterial skin infection, is not usually a reportable condition unless there is an outbreak or unusual circumstances warranting public health intervention.
Correct Answer is D
Explanation
Explanation:
Avoid pregnancy for at least 28 days after receiving the vaccine: This is a crucial instruction for women of childbearing age. The MMR vaccine is a live attenuated vaccine, and women should avoid becoming pregnant for at least 28 days after receiving it to reduce the theoretical risk to the developing fetus. Pregnant women should not receive the MMR vaccine, and women who receive the vaccine should avoid getting pregnant for at least 28 days afterward.
Incorrect:
A- Avoid breastfeeding for 3 days after receiving the vaccine: This statement is not accurate. Breastfeeding is not contraindicated after receiving the MMR vaccine. In fact, breastfeeding is safe and can be continued as usual.
B- Your partner should also receive the MMR vaccine: While it is essential for individuals to be vaccinated against measles, mumps, and rubella for their own protection and to contribute to herd immunity, it is not a specific instruction given to the postpartum client.
C- If you are allergic to gluten, you should not receive this vaccine: The MMR vaccine does not contain gluten, and a gluten allergy is not a contraindication for receiving the vaccine.
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