1. A nurse is caring for four patients in a medical-surgical unit. The

patients have the following conditions: a) a post-operative patient who had

a cholecystectomy yesterday and has a low-grade fever, b) a patient with

chronic obstructive pulmonary disease (COPD) who is experiencing

dyspnea and wheezes, c) a patient with diabetes mellitus who has a blood

glucose level of 250 mg/dL and is scheduled for insulin administration,

and d) a patient with hypertension who has a blood pressure of 160/90

mmHg and is due for an antihypertensive medication. Which patient

should the nurse attend to first?

a) The post-operative patient

b) The patient with COPD

c) The patient with diabetes

d) The patient with hypertension

*Answer: b) The patient with COPD*

Rationale: The patient with COPD has the most urgent problem that

requires immediate intervention. Dyspnea and wheezes indicate

respiratory distress that can lead to hypoxia and respiratory failure. The

other patients have less acute problems that can be managed later.

2. A nurse is working in an emergency department and receives four

patients at the same time. The patients have the following conditions: a) a

25-year-old male who was involved in a motor vehicle accident and has an

open fracture of the left femur, b) a 50-year-old female who has chest pain

radiating to the left arm and jaw, c) a 35-year-old male who has abdominal

pain, nausea, and vomiting, and d) a 40-year-old female who has a severe

headache, blurred vision, and slurred speech. Using the ABCDE (airway,

breathing, circulation, disability, exposure) principle, which patient should

the nurse prioritize?

a) The 25-year-old male

b) The 50-year-old female

c) The 35-year-old male

d) The 40-year-old female

*Answer: b) The 50-year-old female*

Rationale: The 50-year-old female has the most life-threatening condition

that could indicate a myocardial infarction (heart attack). Chest pain

radiating to the left arm and jaw is a classic sign of cardiac ischemia. The