The UAP (Unlicensed Assistive Personnel) has just completed taking vital signs. She notifies the nurse of the results. Based on these results with adult patients, which patient would the nurse be most concerned about?

Choice A reason: Elderly patients admitted from long-term care facilities are at high risk for hospital-acquired infections due to frequent exposure to healthcare environments, colonization with resistant organisms, and age-related immune decline. Long-term care residents often have indwelling devices such as catheters or feeding tubes, which further increase infection risk. Their frailty and comorbidities make them more susceptible to complications once infected.

Choice B reason: Patients with HIV have compromised immune systems, making them more vulnerable to opportunistic infections and hospital-acquired pathogens. Even if they are on antiretroviral therapy, their immune defenses may be weakened, especially during acute illness or hospitalization. Living in a group home also increases exposure to communal environments where infections can spread more easily.

Choice C reason: A history of depression alone does not increase the risk of hospital-acquired infections. While depression may affect self-care or adherence to treatment, it is not a direct immunocompromising condition. Unless combined with other risk factors such as malnutrition or chronic disease, depression does not inherently predispose a patient to hospital-acquired infections.

Choice D reason: An elderly patient admitted from home who has been sick multiple times in the year is at increased risk because recurrent illness suggests weakened immunity or chronic disease. Frequent infections may indicate underlying conditions such as diabetes, COPD, or heart failure, all of which compromise the body’s ability to fight new pathogens. Advanced age further reduces immune response, making hospital-acquired infections more likely.

Choice E reason: A patient admitted for elective knee surgery with no comorbidities is generally low risk. While any surgical patient faces some risk of infection, elective procedures in otherwise healthy individuals carry far fewer complications compared to elderly or immunocompromised patients. With proper sterile technique and postoperative care, their risk remains minimal compared to the other groups listed.

Choice A reason: Notifying the physician is important, but it is not the immediate first step. Before contacting providers, the nurse must determine whether the patient sustained injuries and provide urgent care if needed.

Choice B reason: The first response is to assess the patient for injuries. Safety and immediate clinical evaluation take priority after a fall. The nurse must check for fractures, bleeding, neurological changes, or pain before moving the patient. This ensures that appropriate interventions are initiated promptly.

Choice C reason: Contacting the family is part of communication after the patient is stabilized and assessed. It is not the first priority because family notification does not address immediate patient safety.

Choice D reason: Completing an incident report is required for documentation and quality improvement, but it is done after the patient’s condition is stabilized and care needs are addressed.