A nurse has received change-of-shift report on four clients.
Which of the following clients should the nurse plan to see first?
A client who is short of breath.
A client who received pain medication 30 min ago.
A client who is to be discharged at 11:00.
A client who is ambulatory and going for an x-ray at 10:00.
The Correct Answer is A
Choice A rationale:
A client who is short of breath is experiencing a life-threatening situation and should be seen first.
Choice B rationale:
A client who received pain medication 30 min ago is likely to be comfortable and can be seen later.
Choice C rationale:
A client who is to be discharged at 11:00 can be seen closer to the discharge time.
Choice D rationale:
A client who is ambulatory and going for an x-ray at 10:00 can be seen after the x-ray.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A rationale:
Obtaining the number of the client’s provider is not the immediate action to take. The client is showing signs of a possible stroke (right-sided weakness and slurred speech), which is a medical emergency.
Choice B rationale:
Finding a location for the client to sit is not the immediate action to take. The client needs medical attention immediately due to the signs of a possible stroke.
Choice C rationale:
Driving the client to the nearest emergency room is not the best action to take. It would be faster and safer to call emergency medical services who are trained to handle such situations.
Choice D rationale:
Calling emergency medical services is the correct action. The client is showing signs of a possible stroke, which requires immediate medical attention.
Correct Answer is C
Explanation
Choice A rationale:
An angle of 60° is not typically used for IM injections. It is more commonly used for subcutaneous injections.
Choice B rationale:
An angle of 45° is also more commonly used for subcutaneous injections, not IM injections.
Choice C rationale:
An angle of 90° is the correct angle for an IM injection into the ventrogluteal muscle. This allows for the needle to penetrate deep into the muscle tissue.
Choice D rationale:
An angle of 75° is not typically used for any type of injection. It could potentially cause injury to the client if used for an IM injection.
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