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

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=393675&lang=en  
> language: en  
> subject: Establishing Priorities  
> category: MOC

## Question

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

## Option

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**

**Correct answer: 4**

## 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.

## 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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