QLexNursing

Client 3 Is FIRST Priority

🟨Client 3 has pulmonary edema, which is a life-threatening complication of congestive heart failure requiring immediate assessment and intervention.

🟨 Pulmonary edema causes severely impaired gas exchange, leading to hypoxia, respiratory distress, frothy sputum, crackles, and potential respiratory failure.

🟨The chest X-ray confirming pulmonary edema indicates fluid accumulation in the lungs, which can rapidly worsen if not treated promptly.

🟨 This client is at the highest risk of acute decompensation, including possible airway compromise, arrhythmias, and cardiogenic shock.

🟨Because airway and breathing issues fall under ABCs (Airway, Breathing, Circulation), this client is the highest priority among all six clients.

Client 4 Is SECOND Priority

🟨Client 4 has a potassium of 3.4 mEq/L, which is hypokalemia, and they have a new prescription for furosemide, a potassium-wasting diuretic.

🟨Hypokalemia increases the risk of dangerous cardiac dysrhythmias, muscle weakness, and arrhythmias such as PVCs or ventricular tachycardia.

🟨Giving furosemide to a client with already low potassium could cause severe hypokalemia, potentially leading to cardiac arrest.

🟨This client must be assessed promptly so the nurse can hold the medication, notify the provider, and anticipate potassium replacement.

🟨 While this is a cardiovascular risk, it is not as immediately life-threatening as pulmonary edema, making this client second priority.

Incorrect options.

Client 1 – Right hip fracture

🟨 Although painful and requiring surgical evaluation, this is a stable orthopedic injury.

🟨 The client is not showing signs of shock, neurovascular compromise, or respiratory distress.

🟨 Orthopedic pain is significant but not an airway or circulation emergency.

🟨 This client should be assessed soon, but not before life-threatening conditions.

🟨 Thus, they are lower urgency compared to pulmonary edema or hypokalemia.

Client 2 – HDL 40 mg/dL (low HDL)

🟨Low HDL is a long-term cardiovascular risk, not an acute problem.

🟨The client is stable, with no urgent clinical complications.

🟨This finding does not require immediate nursing intervention.

🟨Teaching and lifestyle counseling can occur later in the shift.

🟨Therefore, this client is the lowest priority.

Client 5 – Prealbumin 12 mg/dL (malnutrition)

🟨A prealbumin of 12 mg/dL indicates poor nutrition but is not an emergency.

🟨Malnutrition affects wound healing, especially with a stage 2 pressure injury, but intervention is not time-critical.

🟨This client requires monitoring and dietary planning, not immediate rescue care.

🟨No airway, breathing, circulation, or acute neuro changes are present.

🟨Therefore, they do not take precedence over clients with emergent risks.

Client 6 – HbA1c 9% (poor diabetic control)

🟨An A1C of 9% means long-term poor glucose control, not an acute crisis.

🟨There is no hyperglycemia emergency (DKA or HHS) indicated in the scenario.

🟨Education and medication adjustment can safely occur later.

🟨This does not place the client at immediate risk of rapid deterioration.

🟨 Therefore, this client is also not an immediate priority.