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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A rationale:
Metabolic acidosis would likely present with rapid, deep breathing (Kussmaul respirations), not slow and shallow breathing.
Choice B rationale:
The client’s symptoms of vomiting (which can cause a loss of stomach acid), dizziness, palpitations, and numbness and tingling in the extremities and around the mouth are consistent with metabolic alkalosis.
Choice C rationale:
Respiratory alkalosis would likely present with rapid breathing, not slow and shallow breathing.
Choice D rationale:
Respiratory acidosis would likely present with rapid, shallow breathing, not slow and shallow breathing.
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.
Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.
Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today
Report Wrong Answer on the Current Question
Do you disagree with the answer? If yes, what is your expected answer? Explain.
Kindly be descriptive with the issue you are facing.