1.25/1.25 points (graded)

Which assessment data should the RN collect first from the client brought to the Emergency

Department with confusion and a decreased level of consciousness?

History of drug or alcohol abuse.

Current medications.

Family medical history.

Onset of symptoms correct

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2.0 M8E_N213

1.25/1.25 points (graded)

The RN uses the Glasgow Coma Scale (GCS) to assess a client with an acute brain injury and

notes a score of four (4). Which intervention is a priority for this client?

Maintain the airway. correct

Improve extremity range of motion.

Promote skin integrity.

Prevent injury.

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3.1 M8E_N213

1.25/1.25 points (graded)

An RN is caring for a client with Multiple Sclerosis, who is experiencing weakness in their

extremities. Which of the following would be an appropriate expected outcome for a client with

Impaired physical mobility? The client will:

Participate in strenuous exercise as tolerated.

Apply orthotics to reduce contractures