After receiving change-of-shift report about the following four clients, which client should the nurse assess first?

56-year-old client with chronic stable angina who is due to receive a dose of nifedipine.

59-year-old with unstable angina who has just returned to the unit after having a heart catheterization with balloon angioplasty.

65-year-old who had a myocardial infarction (MI) 4days ago and is anxious about the planned discharge.

Client who is post coronary artery bypass, with potassium 4.2 mEq/L.

Answer and Explanation

The Correct Answer is B

A. A stable client with chronic angina is not in immediate danger, and the scheduled dose of nifedipine is not an urgent priority.

B. The client with unstable angina who has just undergone a heart catheterization with balloon angioplasty requires immediate assessment for complications such as bleeding, clot formation, or re-occlusion of the artery.

C. The 65-year-old post-MI client is stable, and while their anxiety is important to address, it is not an immediate concern compared to other clients.

D. The client post-coronary artery bypass with a potassium level of 4.2 mEq/L is stable and does not require urgent intervention.

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Correct Answer is D

Explanation

A. Increasing normal saline infusion is appropriate for treating dehydration and hypovolemia.

B. Collecting blood cultures and administering antibiotics is appropriate for treating possible sepsis, given the fever and elevated WBC count.

C. Collecting a urine sample for culture and sensitivity is appropriate to investigate a potential urinary source of infection.

D. Administering furosemide, a diuretic, is inappropriate in a client with signs of dehydration and hypovolemia (e.g., low CVP and PAWP) as it can worsen fluid depletion.

A. Client who needs a beta blocker, and has a blood pressure of 98/58 mm Hg. B. Hypertensive client with a blood pressure of 156/90 mm Hg. C. Client who needs pain medication prior to a dressing change of a surgical wound. D. Client who had a first dose of captopril and needs to use the bathroom.

Correct Answer is A

Explanation

A. A client with low blood pressure (98/58 mm Hg) who requires a beta blocker should be seen first because beta blockers can lower blood pressure further, possibly leading to hypotension or dizziness.

B. A hypertensive client with a blood pressure of 156/90 mm Hg is stable and does not require immediate intervention.

C. While pain medication is important, it is not as urgent as addressing a client with low blood pressure and a medication that can worsen the condition.

D. The client who just had captopril can wait to use the bathroom, as the priority is addressing their blood pressure and captopril's effect.

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Test Name	Results	Reference Range
WBC	12, 000	4, 000- 11, 000
Na+	149 mEq/L	135-145 mEq/L
K+	5.0 mEq/L	3.5- 5.0 mEq/L
Cl-	110 mEq/L	96-106 mEq/L
pH	7.34	7.35-7.45
PaCO2	34 mmHg	35- 45 mmHg
PaO2	78 mm Hg	80-100 mmHg
HCO3	21 mEq/L	22- 26 mEq/L

After receiving change-of-shift report about the following four clients, which client should the nurse assess first?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Correct Answer is D

Explanation

A nurse is caring for four clients. Which one would the nurse see first?

Correct Answer is A

Explanation

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