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

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=394076&lang=en  
> language: en  
> subject: Establishing Priorities  
> category: MOC

## Question

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

## Option

1. A client with chest pressure, diaphoresis, and nausea **✔ Correct answer**
2. A client with chronic arthritis requesting help with a meal tray
3. A client scheduled for discharge who needs prescription teaching
4. A client with a history of insomnia who slept 4 hours last night

**Correct answer: 1**

## Explanation

Chest pressure with diaphoresis and nausea suggests possible acute coronary syndrome and requires immediate assessment. Meal assistance, insomnia, and discharge teaching are important but less urgent. Use ABCs, acute change, and potential instability to prioritize.

## In-depth explanation

Clinical Judgment
Prioritization favors acute, potentially life-threatening changes over routine needs.

Memory Tip
Chest pressure plus sweating equals assess first.

## Clinical scenario

Clinical Practice Guide
Acute coronary symptoms may include chest discomfort, sweating, nausea, shortness of breath, and pain radiating to the arm, jaw, or back.

Caution
Do not wait for classic crushing chest pain before assessing possible cardiac ischemia.

## Key concepts

- **Triage** — Sorting clients by urgency and risk to determine care priority.
- **Diaphoresis** — Profuse sweating that can occur with pain, shock, or cardiac ischemia.
- **Acute Coronary Syndrome** — A spectrum of conditions caused by sudden reduced blood flow to the heart.

## Related questions

- [The nurse receives report on four clients. Which client should the nurse assess first?](https://mymerci.kr/pages/nclex_q.php?qn_id=393675&lang=en)
- [Four hours after open reduction and internal fixation of a fractured tibia, a client repor…](https://mymerci.kr/pages/nclex_q.php?qn_id=394047&lang=en)
- [During a mass casualty incident, which client should be assigned a delayed priority rather…](https://mymerci.kr/pages/nclex_q.php?qn_id=394136&lang=en)
- [During disaster triage, a client is not breathing after the airway is opened and repositio…](https://mymerci.kr/pages/nclex_q.php?qn_id=394166&lang=en)
- [Four clients arrive at an urgent care clinic. Which client should the nurse assess first?](https://mymerci.kr/pages/nclex_q.php?qn_id=396577&lang=en)
- [Several clients arrive after a building collapse. Which client should the triage nurse cla…](https://mymerci.kr/pages/nclex_q.php?qn_id=397127&lang=en)
- [The nurse has just received report on 4 clients. Which client should the nurse assess firs…](https://mymerci.kr/pages/nclex_q.php?qn_id=522686&lang=en)

## Read in another language

- [en](https://mymerci.kr/pages/nclex_q.php?qn_id=394076&lang=en)
- [ko](https://mymerci.kr/pages/nclex_q.php?qn_id=394076&lang=ko)
- [ja](https://mymerci.kr/pages/nclex_q.php?qn_id=394076&lang=ja)
- [zh-TW](https://mymerci.kr/pages/nclex_q.php?qn_id=394076&lang=zh-tw)
- [vi](https://mymerci.kr/pages/nclex_q.php?qn_id=394076&lang=vi)

---

More free questions: [NCLEX-RN Practice](https://mymerci.kr/pages/nclex_bank.php?lang=en)

_For study reference only. Always follow current clinical guidelines and your institution’s protocols._