a nurse in the emergency department is prioritizing care for four clients which of the following clients should the nurse see first
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PN ATI Capstone Proctored Comprehensive Assessment Form B

1. A nurse in the emergency department is prioritizing care for four clients. Which of the following clients should the nurse see first?

Correct answer: D

Rationale: The client with slurred speech, disorientation, and a headache may be experiencing a stroke, a life-threatening condition that requires immediate attention. Identifying and managing a stroke promptly can reduce the risk of long-term disability or complications. The other options, although important, do not present immediate life-threatening conditions that require urgent intervention. A dislocated shoulder, severe joint pain in sickle cell disease, confusion with fever and foul-smelling urine, while concerning, can be addressed after attending to the client with potential stroke symptoms.

2. A healthcare professional is assessing a client for potential complications after surgery. Which of the following should the healthcare professional monitor for?

Correct answer: A

Rationale: Corrected Rationale: Decreased urine output can indicate renal complications or dehydration, which are common post-surgical complications. Monitoring urine output is crucial for detecting early signs of kidney dysfunction or fluid imbalances. Increased appetite, improved mobility, and normal temperature are not typical signs of immediate post-surgical complications and would not be the priority for monitoring in this case.

3. A healthcare professional is preparing to administer a dose of hydrocodone. Which of the following should the healthcare professional assess first?

Correct answer: A

Rationale: When administering hydrocodone, a healthcare professional should assess the respiratory rate first because hydrocodone is an opioid that can lead to respiratory depression. Monitoring the respiratory rate helps to detect any signs of respiratory distress or depression early on. Assessing blood pressure, pain level, or heart rate is also important but not the priority when administering hydrocodone, as the risk of respiratory depression is a more critical concern.

4. A nurse is teaching a client who has hypertension about dietary modifications to help control blood pressure. Which of the following food choices should the nurse recommend as the best choice for the client to include in their diet?

Correct answer: C

Rationale: A low sodium diet is recommended for a client who has hypertension. Therefore, the nurse should recommend 3 oz of chicken breast as the best choice for the client's diet because it contains 30 – 90 mg of sodium. Choice A, 1 packet of reconstituted dry onion soup, and Choice B, 3 oz of lean cured ham, are high in sodium content, which is not suitable for a client with hypertension. Choice D, 1/2 cup of canned baked beans, is also high in sodium, making it a less suitable choice compared to 3 oz of chicken breast.

5. A healthcare provider is reviewing the laboratory data of a client with diabetes mellitus. Which of the following laboratory tests is an indicator of long-term disease management?

Correct answer: B

Rationale: The correct answer is B: Glycosylated hemoglobin (HbA1c). The glycosylated hemoglobin test measures average blood glucose levels over the past 2-3 months, providing an indication of long-term glycemic control in clients with diabetes. Choice A, postprandial blood glucose, reflects blood sugar levels after a meal and does not provide a long-term view. Choice C, glucose tolerance test, evaluates the body's ability to process sugar but does not offer a continuous assessment like the HbA1c test. Choice D, fasting blood glucose, measures blood sugar levels after a period of fasting, which is more indicative of immediate glycemic status rather than long-term management.

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