The nurse is caring for clients on a medical floor. Which client should be assessed first?

The hemodialysis client who is experiencing anuria

The client diagnosed with cirrhosis who is complaining of itching

The client diagnosed with peripheral arterial disease who is complaining of pain when walking

The client diagnosed with lupus who is complaining of chest pain

Answer and Explanation

The Correct Answer is D

Choice A reason: Anuria in hemodialysis is expected due to renal failure; it’s not acute unless accompanied by distress, less urgent than chest pain’s potential severity.

Choice B reason: Itching in cirrhosis from bile salts is uncomfortable but not life-threatening, ranking below chest pain, which could indicate critical cardiac or pulmonary issues.

Choice C reason: Pain when walking in PAD (claudication) is chronic and stable, not an immediate threat compared to chest pain, which requires urgent evaluation.

Choice D reason: Chest pain in lupus may signal pericarditis or pleuritis, potentially life-threatening complications, prioritizing assessment for rapid intervention over stable conditions.

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Correct Answer is A

Explanation

Choice A reason: CT scan rapidly detects ischemic stroke or hemorrhage in the brain, critical for numbness, headache, and speech issues, guiding urgent treatment decisions.

Choice B reason: Hemoglobin and hematocrit assess blood count, not brain pathology like stroke, which requires imaging to identify infarction or bleeding, not anemia.

Choice C reason: MRI offers detailed stroke imaging but is slower than CT, less ideal for acute ER settings needing immediate diagnosis of neurological symptoms.

Choice D reason: Pulmonary angiography evaluates lung vessels for embolism, irrelevant to stroke symptoms (numbness, headache, speech difficulty), which localize to brain issues.

A. The client has a nasogastric tube connected to suction B. The client is having a panic attack C. The client has end-stage renal disease (ESRD) D. The client has an epidural catheter for pain control

Correct Answer is A

Explanation

Choice A reason: Nasogastric suction removes gastric acid (HCl), reducing hydrogen ions, raising pH, and causing metabolic alkalosis, a common post-surgical complication here.

Choice B reason: Panic attacks cause respiratory alkalosis from hyperventilation, lowering CO2, not metabolic alkalosis, which involves base excess, unrelated to this ABG.

Choice C reason: ESRD typically causes metabolic acidosis from acid retention, not alkalosis, as kidneys fail to excrete hydrogen, opposing this patient’s ABG findings.

Choice D reason: Epidural catheters manage pain with analgesics, not affecting acid-base balance or causing metabolic alkalosis, irrelevant to the ABG shift observed.

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The nurse is caring for clients on a medical floor. Which client should be assessed first?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A patient presents to the ER with numbness in the left arm, a severe headache, and trouble speaking. Which of the following diagnostic tests do you anticipate the healthcare provider to order?

Correct Answer is A

Explanation

The nurse is caring for a client who underwent a colon resection yesterday due to having a bowel obstruction. ABGs show metabolic alkalosis. The nurse expects this finding is because of:

Correct Answer is A

Explanation

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