A nurse is receiving change-of-shift report on four clients.
Which of the following clients should the nurse plan to see first?
A client who has cirrhosis and severe pruritus.
A client who has a femur fracture and reports numbness of the toes.
A client who had a laparoscopic appendectomy 8 hr ago and is awaiting discharge.
A client who had a renal biopsy 3 hr ago and has pink-tinged urine.
The Correct Answer is B
Choice A rationale:
The client with cirrhosis and severe pruritus is experiencing discomfort, but it is not an immediate life-threatening situation. The priority should be given to clients with conditions that pose an immediate risk to life.
Choice B rationale:
Numbness of the toes in a client with a femur fracture can indicate compromised circulation or nerve damage. This is a critical situation that requires immediate assessment and intervention to prevent complications like compartment syndrome or permanent nerve damage.
Choice C rationale:
A client who had a laparoscopic appendectomy 8 hours ago and is awaiting discharge is likely stable. While they need monitoring, it is not an urgent priority compared to the client with a potential vascular or nerve issue.
Choice D rationale:
Pink-tinged urine after a renal biopsy could indicate some bleeding, but it is not as urgent as the situation of the client with a femur fracture and numbness of the toes.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A rationale:
Thick, white vaginal discharge is a common symptom of candidiasis, which is a fungal infection caused by Candida species. It is a characteristic finding in this condition.
Choice B rationale:
A hard, painless chancre is associated with syphilis, not candidiasis. This finding is not related to candidiasis.
Choice C rationale:
A feeling of pelvic heaviness is not a typical symptom of candidiasis. It may be associated with other gynecological conditions but is not specific to candidiasis.
Choice D rationale:
Frothy, malodorous discharge is characteristic of trichomoniasis, another type of vaginal infection caused by Trichomonas vaginalis. It is not a typical finding in candidiasis.
Correct Answer is C
Explanation
Choice A rationale:
Enabling the airbag when the baby is in the front seat of the car is incorrect. Airbags can be dangerous for infants and young children, and it is recommended to keep them in the rear seat, preferably in a rear-facing car seat.
Choice B rationale:
Positioning the car seat's retainer clip at the level of the baby's belly button is incorrect. The retainer clip should be at armpit level to ensure proper positioning and safety.
Choice C rationale:
Keeping the baby rear-facing in the car seat until she is 2 years old is the correct understanding of car seat safety. This statement aligns with the American Academy of Pediatrics (AAP) recommendations, which suggest keeping infants rear-facing as long as possible, ideally until they reach the maximum height and weight limits of their car seat.
Choice D rationale:
Placing the baby in the car seat at a 90-degree angle is incorrect. The correct angle for a rear-facing car seat depends on the manufacturer's guidelines but typically ranges from 30 to 45 degrees. The 90-degree angle is not safe and can compromise the baby's airway.
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