A charge nurse has reviewed fire safety procedures with staff members. Which of the following statements by a staff member indicates an understanding of the last action they should take?

The first client the nurse should assess is Client 3 (Pulmonary Edema) followed by Client 1 (Hip Fracture).

Rationale:

Client 3 (Pulmonary Edema) – Highest Priority:

1. 1. Pulmonary edema is a life-threatening condition that can impair oxygenation.
   2. The client has a history of congestive heart failure (CHF) and a chest x-ray confirming pulmonary edema.
   3. Immediate assessment is required to evaluate for respiratory distress, oxygenation status, and potential need for diuretics or oxygen therapy.

Client 1 (Hip Fracture) – Second Priority:

1. 1. The x-ray confirms a fractured femoral neck, which can cause severe pain, bleeding, and immobility.
   2. The nurse must assess for circulation, sensation, and movement (CSM) of the affected limb and manage pain.
   3. While this is urgent, it is not as immediately life-threatening as pulmonary edema.

Priority Order (Using ABCs & Maslow’s Hierarchy):

1. Client 3 – Pulmonary Edema (Airway/Breathing concern)
   2. Client 1 – Hip Fracture (Risk for bleeding, pain, mobility issues)
   3. Client 4 – Low Potassium (Risk for cardiac arrhythmias, needs electrolyte management)
   4. Client 6 – Poor Diabetes Control (HbA1c 9%, requires education & glucose monitoring)
   5. Client 5 – Malnutrition (Prealbumin 12 mg/dL, needs nutrition support for wound healing)
   6. Client 2 – Hyperlipidemia (Not an immediate concern, requires long-term management)

A. A 21-year-old client who had a normal Pap test one year ago. The American Cancer Society (ACS) and the U.S. Preventive Services Task Force (USPSTF) recommend that cervical cancer screening (Pap test) begin at age 21, regardless of sexual history. Screening should be done every 3 years for individuals aged 21-29, assuming results are normal. Since this client had a Pap test one year ago, they do not need immediate screening but should follow the standard 3-year interval.
B. A 32-year-old client who had a total vaginal hysterectomy last year. A total hysterectomy (removal of the uterus and cervix) for non-cancerous reasons generally means that Pap tests are no longer necessary. However, if the hysterectomy was due to cervical cancer, continued screening might be needed.
C. A 47-year-old client who had a negative combined Pap and HPV test 5 years ago. For clients 30-65 years old, Pap tests can be done every 3 years OR combined Pap and HPV (co-testing) every 5 years. Since this client had a negative co-test 5 years ago, they are due for screening now, but they would not have been referred earlier.
D. A 15-year-old client who recently completed the vaccine series for human papillomavirus (HPV). The HPV vaccine does not replace the need for Pap tests but helps reduce the risk of cervical cancer. Routine Pap testing does NOT begin before age 21, so this client does not yet need screening.