The nurse is caring for the following clients. Which client should the nurse assess first?

A 60-year-old client who has end-stage renal disease with a creatinine of 5.1

A 50-year-old client who has chronic pancreatitis and is reporting a pain level of 6 out of 10

A 54-year-old client with cirrhosis and jaundice who is reporting itchiness and drowsiness

A 47-year-old client with esophageal varices and influenza and has been coughing for 30 minutes

Answer and Explanation

The Correct Answer is D

Choice A reason: Creatinine 5.1 in ESRD is chronic, not acute, and stable unless symptomatic; it’s less urgent than potential bleeding risks in other clients.

Choice B reason: Pain (6/10) in pancreatitis is significant but not immediately life-threatening compared to airway or bleeding risks, manageable with scheduled interventions.

Choice C reason: Itchiness and drowsiness in cirrhosis suggest liver dysfunction, concerning but not acute threats like variceal rupture, prioritizing more critical symptoms.

Choice D reason: Coughing with esophageal varices risks rupture and massive bleeding, a life-threatening emergency, making this client the priority for immediate assessment.

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Correct Answer is A

Explanation

Choice A reason: Albuterol, a bronchodilator, rapidly opens airways in COPD, relieving acute shortness of breath and improving oxygenation from 85% by relaxing bronchial smooth muscle.

Choice B reason: Mucolytics thin mucus over time, not addressing acute dyspnea or low saturation (85%) quickly, lacking the immediacy needed in this scenario.

Choice C reason: Montelukast prevents asthma inflammation long-term via leukotriene blockade, not providing rapid relief for COPD’s acute bronchospasm or hypoxia here.

Choice D reason: Prednisone reduces COPD inflammation systemically, but its slow onset doesn’t acutely reverse shortness of breath or oxygen drop like a bronchodilator.

A. Hydroxychloroquine B. Levothyroxine C. Potassium iodide D. Methotrexate

Correct Answer is C

Explanation

Choice A reason: Hydroxychloroquine treats autoimmune diseases like lupus by modulating immunity, not hyperthyroidism’s excess thyroid hormone production, irrelevant here.

Choice B reason: Levothyroxine supplements thyroid hormone in hypothyroidism, worsening this patient’s hyperthyroidism (high T3/T4), contraindicated for her symptoms.

Choice C reason: Potassium iodide inhibits thyroid hormone release, reducing T3 and T4 in hyperthyroidism (e.g., Graves’), addressing her goiter, exophthalmos, and weight loss effectively.

Choice D reason: Methotrexate suppresses immunity in cancer or autoimmunity, not targeting thyroid overactivity or hormone levels, unsuitable for hyperthyroidism management.

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The nurse is caring for the following clients. Which client should the nurse assess first?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is caring for a client with COPD who develops severe shortness of breath upon walking to the bathroom and oxygen saturation of 85% on room air. Which of the following medications would be a priority to treat these symptoms?

Correct Answer is A

Explanation

Correct Answer is C

Explanation

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