A nurse receives report on four clients at the beginning of the shift. Which of the following clients should the nurse place priority on assessing first?

A client who had a myocardial infarction two days ago, and complains of soft stools after taking docusate sodium.

A client being treated for thrombotic thrombocytopenic purpura (TTP) who has had 120 mL of urine output in the last 12 hours.

A client who was admitted for premature atrial contractions (PACS) and whose most recent blood pressure is 148/89.

A client receiving furosemide for heart failure whose daily weight shows that he has lost 0.5 kg since yesterday.

Answer and Explanation

The Correct Answer is B

A. While soft stools after taking docusate sodium is noteworthy, it is not immediately life-threatening and does not require urgent intervention.
B. Oliguria (low urine output) in a client with TTP is concerning because it may indicate acute kidney injury or worsening of the condition, requiring immediate assessment and intervention.
C. An elevated blood pressure in a client with PACs is important but not as critical as potential kidney dysfunction in the TTP patient.
D. A weight loss of 0.5 kg in a client with heart failure on furosemide may be expected and does not require immediate intervention.

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Correct Answer is C

Explanation

A. Pleural effusion may be a complication of heart failure but does not directly explain the decreased urine output and elevated serum creatinine.

B. Myocardial infarction would present with different symptoms, such as chest pain, rather than decreased urine output and elevated creatinine.

C. Cardiorenal syndrome refers to the interdependence of the heart and kidneys, where chronic heart failure leads to worsening kidney function, causing symptoms like decreased urine output and elevated serum creatinine.

D. Heparin-induced thrombocytopenia (HIT) is related to the use of heparin and presents with low platelet counts, not decreased urine output and elevated creatinine.

A. Educate the client to go to the hospital if she experiences alopecia after receiving this medication. B. Administer loperamide to prevent chemotherapy-induced nausea. C. Assess the client's skin for desquamation caused by this medication. D. Review the results of the client's most recent echocardiogram.

Correct Answer is D

Explanation

A. Alopecia is a common side effect of chemotherapy but does not necessitate immediate hospital visit.
B. Loperamide is used to treat diarrhea, not nausea. Antiemetics are used for chemotherapy-induced nausea.
C. Desquamation is not a typical side effect of daunorubicin; skin assessment is not the primary concern.
D. Daunorubicin can cause cardiotoxicity; therefore, reviewing the client's most recent echocardiogram is essential to assess cardiac function before administration.

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A nurse receives report on four clients at the beginning of the shift. Which of the following clients should the nurse place priority on assessing first?

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Naxlex Comprehensive Predictor Exams

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Correct Answer is C

Explanation

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Correct Answer is D

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