A nurse working in the emergency department is assessing several clients. Which of the following clients is the highest priority?

A client who has active bleeding from a puncture wound to the groin area

A client who has a raised red skin rash on his arms, neck, and face

A client who reports shortness of breath and left shoulder and neck pain

A client who reports right-sided flank pain

Answer and Explanation

The Correct Answer is C

A. A client who has active bleeding from a puncture wound to the groin area is urgent but not immediately life-threatening compared to a potential heart attack. Active bleeding requires immediate intervention, but this is often manageable with pressure and quick action.

B. A client who has a raised red skin rash on his arms, neck, and face could indicate an allergic reaction or infection, but it's generally not as life-threatening as signs of a myocardial infarction.

C. A client who reports shortness of breath and left shoulder and neck pain is the highest priority. These are classic signs of a myocardial infarction (heart attack), which is a life-threatening emergency. Shortness of breath and pain in the left shoulder and neck indicate a need for immediate assessment and intervention to prevent cardiac arrest or other complications.

D. A client who reports right-sided flank pain is likely experiencing kidney stones, which can cause significant pain, but it is generally not life-threatening and can be managed after a more urgent situation like a heart attack is addressed.

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Correct Answer is C

Explanation

a. Documenting that an incident report has been filed is important but should come after informing appropriate personnel about the incident.
b. Calling risk management may be necessary, but the immediate action should be to notify the nurse manager.
c. Contacting the nurse manager allows for immediate action to be taken to address the client's concerns and investigate the incident further.
d. Reassuring the client that the staff is well trained may be appropriate, but it does not address the immediate need to address the incident and ensure the client's safety and well-being.

A. Limited social support B. Decreased self-esteem C. Inadequate food supply D. Low pain tolerance

Correct Answer is D

Explanation

a. Limited social support is important for recovery but may not be immediately life-threatening or significantly impact the client's ability to manage postoperative care compared to untreated pain.
b. Decreased self-esteem may affect the client's emotional well-being but is not as urgent as addressing pain management.
c. Inadequate food supply can be addressed through various resources and support systems but is not as critical as managing pain postoperatively.
d. Low pain tolerance can hinder the client's ability to participate in postoperative rehabilitation and increase the risk of complications, making it a priority issue to address in the discharge plan.

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A nurse working in the emergency department is assessing several clients. Which of the following clients is the highest priority?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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