A nurse in an emergency department is assessing four clients. Which of the following clients should the nurse see first?

A client who reports a sudden onset of dizziness when sitting up

A client who has new onset urticaria and angioedema

A client who has numerous rectal polyps and blood-tinged stools

A client who has a subluxation of the fifth digit on the left foot

Answer and Explanation

The Correct Answer is B

Rationale:

A. A client who reports a sudden onset of dizziness when sitting up: Although concerning, dizziness on position change may indicate orthostatic hypotension and is not immediately life-threatening. This client requires monitoring but is not the top priority based on airway or circulatory compromise.

B. A client who has new onset urticaria and angioedema: New urticaria and angioedema suggest a potential anaphylactic reaction, which can quickly progress to airway obstruction. This is a life-threatening emergency requiring immediate intervention to secure the airway and administer epinephrine.

C. A client who has numerous rectal polyps and blood-tinged stools: This condition could indicate a colorectal condition such as polyposis or malignancy, but it is not acutely life-threatening. The client needs evaluation, but not before those with airway or circulatory risks.

D. A client who has a subluxation of the fifth digit on the left foot: A subluxation is a partial dislocation, which can be painful but does not involve vital organ systems. This musculoskeletal issue is stable and can be addressed after more urgent needs are met.

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Correct Answer is B

Explanation

Rationale:

A. Ketorolac: Ketorolac is a nonsteroidal anti-inflammatory drug (NSAID) that can cause gastrointestinal irritation and increase the risk of bleeding, especially in clients with a history of peptic ulcer disease. It should be avoided in this population.

B. Acetaminophen: Acetaminophen is the safest option for relieving headache in clients with a history of peptic ulcers because it lacks the gastrointestinal side effects associated with NSAIDs. It provides effective pain relief without increasing ulcer risk.

C. Ibuprofen: Ibuprofen, another NSAID, also carries a high risk of gastric irritation and peptic ulcer exacerbation. Chronic or even short-term use can worsen ulcers and lead to GI bleeding.

D. Aspirin: Aspirin has strong antiplatelet effects and is highly ulcerogenic. It increases the risk of gastric mucosal damage and should be avoided in clients with known peptic ulcer disease.

A. The client reports a pain level of 6 on a scale from 0 to 10 B. The client refuses to look at the colostomy C. The colostomy has had no output D. The stoma appears dark purple in color

Correct Answer is D

Explanation

Rationale:

A. The client reports a pain level of 6 on a scale from 0 to 10: Moderate pain is expected postoperatively and should be managed, but it does not indicate an immediate threat to tissue viability or life. It is not the top priority when compared to signs of stoma compromise.

B. The client refuses to look at the colostomy: Emotional adjustment is important and should be addressed with sensitivity, but it is a psychosocial concern rather than a physiological emergency. This can be prioritized after physical complications are ruled out.

C. The colostomy has had no output: Absence of output within the first 24 hours may be related to bowel manipulation during surgery. While it should be monitored, it is not as urgent as signs suggesting stoma necrosis or ischemia.

D. The stoma appears dark purple in color: A dark purple stoma indicates poor perfusion or possible necrosis, which is a surgical emergency. A healthy stoma should appear pink or red and moist. Immediate intervention is required to preserve tissue viability.

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A nurse in an emergency department is assessing four clients. Which of the following clients should the nurse see first?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who reports a headache and has a history of a peptic ulcer. Which of the following medications should the nurse administer?

Correct Answer is B

Explanation

A nurse is assessing a client who had a colostomy 24 hr ago. Which of the following findings is the nurse's priority?

Correct Answer is D

Explanation

A nurse is preparing to administer a blood transfusion to a client. Which of the following actions should the nurse take?

A nurse is initiating bladder retraining for a client who has urge urinary incontinence. Which of the following instructions should the nurse give the client?

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A nurse is reviewing admission prescriptions for a group of clients. Which of the following prescriptions should the nurse identify as complete?

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A nurse is reviewing the medical record of a client who has a prescription for intermittent heat therapy for a foot injury. Which of the following findings should the nurse identify as a contraindication for heat therapy?

A nurse is preparing to administer an autologous blood product to a client. Which of the following actions should the nurse take to identify the client?

A nurse is assessing a client prior to administering the influenza vaccine. The nurse should assess if the client has an allergy to which of the following foods?