A critical care nurse finds a postoperative client unresponsive and calls for a code blue. Which of the following next actions should the nurse take?

Retrieve the crash cart

Apply a bag valve mask and provide ventilation

Attach an automatic external defibrillator (AED)

Begin chest compressions

Answer and Explanation

The Correct Answer is D

A. While the crash cart is essential for advanced resuscitation, starting chest compressions takes priority. The nurse should begin CPR immediately while another team member retrieves the cart.

B. Ventilation is important, but chest compressions should be initiated first to maintain circulation and perfusion. Once compressions are underway, airway and breathing support can follow according to the CAB (Circulation, Airway, Breathing) sequence of Basic Life Support (BLS).

C. Attaching the AED is a crucial step, but it should occur after or while chest compressions are in progress, as delays in compressions reduce the chances of survival.

D. This is the first action the nurse should take after confirming unresponsiveness and calling for help. Immediate, high-quality compressions restore blood flow to vital organs and are the priority intervention in cardiac arrest management.

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Correct Answer is B

Explanation

A. Family information is considered a secondary source because it provides supportive data but may not fully reflect the client’s own experience or symptoms.
B. Client concerns are the primary source of accurate data because the client is the best authority on their own health, symptoms, feelings, and experiences.
C. Progress notes are secondary sources that document observations and interventions by healthcare providers, but they are not firsthand information from the client.
D. Medical history provides valuable background but is also a secondary source, as it is typically gathered from records or other providers rather than directly from the client at the time of admission.

A. Genetics B. Unhealthy diet C. Smoking D. Sunbathing

Correct Answer is A

Explanation

A. Genetic makeup is a non-modifiable risk factor because it cannot be changed or controlled by lifestyle modifications. A person’s inherited traits can predispose them to certain diseases, such as diabetes, hypertension, or some cancers. Recognizing genetic risk helps in early screening and preventive care, but the risk itself cannot be altered.

B. This is a modifiable risk factor, as individuals can improve their diet by choosing healthier foods, controlling portion sizes, and reducing intake of processed foods, thereby decreasing disease risk.

C. Smoking is modifiable because it can be stopped through behavioral interventions, medications, and support programs. Quitting significantly reduces the risk of cardiovascular and respiratory diseases.

D. Excessive sun exposure is also a modifiable risk factor. Protective measures like using sunscreen, wearing protective clothing, and avoiding peak sun hours can prevent skin damage and lower cancer risk.

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A critical care nurse finds a postoperative client unresponsive and calls for a code blue. Which of the following next actions should the nurse take?

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