The nurse receives report on four clients. Which client should the nurse assess first?

1 A client awaiting discharge teaching after an uncomplicated appendectomy.
2 A client with a low-grade fever 24 hours after surgery who is using an incentive spirometer.
3 A client with chronic back pain requesting medication due in 30 minutes.
4 A client with new facial droop and slurred speech that began 20 minutes ago. ✓ Correct answer

Explanation

New facial droop and slurred speech are acute stroke warning signs and require rapid assessment and activation of emergency stroke care. Time-sensitive neurologic changes take priority over stable discharge teaching, expected postoperative fever, or nonurgent chronic pain medication timing.

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In-depth explanation

Clinical Judgment
Use acute change, threat to brain perfusion, and time-sensitive treatment windows to rank priority.

Memory Tip
New neuro deficit is a now problem.

KR vs US
NCLEX priority items often reward rapid stroke recognition and escalation.

Clinical scenario

Clinical Practice Guide
Priority setting weighs airway, breathing, circulation, acute neurologic change, and time-sensitive interventions.

Caution
Do not choose the client who is loudest or easiest; choose the client with the greatest risk of rapid harm.

Key concepts

Stroke — An acute disruption of brain blood flow that can cause sudden weakness, facial droop, speech change, or visual symptoms.
Priority Setting — The nursing process of deciding which client need requires immediate assessment or intervention.
Neurologic Assessment — Focused evaluation of level of consciousness, speech, motor strength, pupils, and other nervous system findings.

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The nurse receives report on four clients. Which client should the nurse assess first?

In-depth explanation

Clinical scenario

Key concepts

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