A nurse working in the emergency department is assessing several clients. Which of the following clients is the highest priority?
A client who reports shortness of breath and left neck and shoulder pain
A client who has active bleeding from a puncture wound of the left groin area
A client who has a raised red skin rash on his arms, neck, and face
A client who reports right-sided flank pain and is diaphoretic
The Correct Answer is B
Choice A reason: A client who reports shortness of breath and left neck and shoulder pain may have a cardiac problem, which is a serious condition. However, this client is not the highest priority, as the symptoms are not life-threatening at the moment.
Choice B reason: A client who has active bleeding from a puncture wound of the left groin area is the highest priority, as this client is at risk of hemorrhage, shock, and infection. The nurse should apply direct pressure to the wound, elevate the leg, and monitor the vital signs.
Choice C reason: A client who has a raised red skin rash on his arms, neck, and face may have an allergic reaction, which is a potential emergency. However, this client is not the highest priority, as the symptoms are not severe enough to indicate anaphylaxis.
Choice D reason: A client who reports right-sided flank pain and is diaphoretic may have a kidney stone, which is a painful condition. However, this client is not the highest priority, as the symptoms are not life-threatening unless there is an obstruction or infection.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A reason: A physical therapist is not the most appropriate member of the interprofessional health care team to consult for a child who has oppositional defiant disorder. A physical therapist helps clients with physical impairments or disabilities to improve their mobility, function, and quality of life. A child who has oppositional defiant disorder may not have any physical problems that require a physical therapist's intervention.
Choice B reason: A speech pathologist is not the most appropriate member of the interprofessional health care team to consult for a child who has oppositional defiant disorder. A speech pathologist helps clients with communication disorders, such as speech, language, voice, or swallowing problems. A child who has oppositional defiant disorder may not have any communication problems that require a speech pathologist's intervention.
Choice C reason: An occupational therapist is not the most appropriate member of the interprofessional health care team to consult for a child who has oppositional defiant disorder. An occupational therapist helps clients with physical, mental, or developmental challenges to perform daily activities, such as self-care, work, or leisure. A child who has oppositional defiant disorder may not have any occupational problems that require an occupational therapist's intervention.
Choice D reason: A social worker is the most appropriate member of the interprofessional health care team to consult for a child who has oppositional defiant disorder. A social worker helps clients with psychosocial issues, such as family conflicts, behavioral problems, or emotional distress. A child who has oppositional defiant disorder may benefit from a social worker's services, such as counseling, case management, or referral to community resources.
Correct Answer is A
Explanation
Choice A reason: The charge nurse should address the situation of the emergency department nurse waiting to give report on a new admission first. This is the most urgent and time-sensitive issue that affects the client's safety and continuity of care. The charge nurse should assign a staff nurse to receive the report and prepare for the admission.
Choice B reason: The charge nurse should address the situation of a nurse on the previous shift writing an incident report about a medication error second. This is an important and serious issue that requires follow-up and corrective actions. The charge nurse should review the incident report, talk to the nurse involved, and implement measures to prevent future errors.
Choice C reason: The charge nurse should address the situation of two staff members calling to say they will be absent third. This is a significant and challenging issue that affects the staffing and workload of the unit. The charge nurse should contact the staffing office, request replacements, and adjust the assignments accordingly.
Choice D reason: The charge nurse should address the situation of transport assistance being unavailable to take a client to occupational therapy last. This is a minor and temporary issue that does not compromise the client's health or well-being. The charge nurse should contact the transport department, reschedule the therapy session, and inform the client and the therapist.
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