The nursing diagnosis that would have the highest priority in the care of the client who has become comatose following cerebral hemorrhage is which of the following?

Disturbed body image

Risk for unstable blood glucose

Impaired urinary elimination

Ineffective airway clearance

Answer and Explanation

The Correct Answer is D

Choice A reason: Body image is psychosocial, not urgent in coma. Airway is critical. This errors per nursing priorities. It’s universally distinct, lower priority.

Choice B reason: Glucose risk is secondary; airway ensures survival in coma. This misaligns with nursing standards. It’s universally distinct, not immediate.

Choice C reason: Urinary issues rank below airway in comatose priority. This errors per nursing hierarchy. It’s universally distinct, less urgent than breathing.

Choice D reason: Airway clearance is top priority in coma, ensuring oxygenation. This aligns with nursing standards. It’s universally recognized, distinctly life-saving.

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Correct Answer is D

Explanation

Choice A reason: Cocaine reduces appetite; high energy is a symptom. This errors per nursing pharmacology. It’s universally distinct, opposite effect.

Choice B reason: Cocaine raises heart rate, not lowers it. Energy fits, per standards. This misaligns with drug effects. It’s universally distinct, incorrect.

Choice C reason: Drowsiness opposes cocaine’s stimulant nature; energy is correct. This errors per nursing knowledge. It’s universally distinct, sedative-based.

Choice D reason: High energy is a key sign of cocaine intoxication, per pharmacology. This aligns with nursing standards. It’s universally recognized, distinctly accurate.

A. Having the knowledge and skill set needed to provide culturally competent care. B. Having the knowledge and skill set needed to advocate for the patient, but not being able to act on it due to not having the authority to do so. C. Having the authority to override a physician’s order for pain medication. D. Having the authority to call off a code, then realizing the decision was harmful to the patient.

Correct Answer is B

Explanation

Choice A reason: Competence isn’t distress; inability to act is. This errors per nursing ethics. It’s universally distinct, lacks conflict element.

Choice B reason: Moral distress occurs when knowing right but unable to act. This fits nursing ethics standards. It’s universally recognized, distinctly accurate.

Choice C reason: Overriding orders isn’t distress; it’s authority use. This misaligns with nursing definitions. It’s universally distinct, not a moral conflict.

Choice D reason: Harm realization is regret, not distress from inaction. This errors per ethics standards. It’s universally distinct, different issue.

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The nursing diagnosis that would have the highest priority in the care of the client who has become comatose following cerebral hemorrhage is which of the following?

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Naxlex Comprehensive Predictor Exams

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Correct Answer is D

Explanation

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Correct Answer is B

Explanation

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