Priority Setting Frameworks Advanced Test Questions and Answers | Latest Version | 2025/2026 | Correct & Verified

Priority Setting Frameworks Advanced Test Questions and Answers | Latest Version | 2025/2026 | Correct & Verified A client who just returned from surgery reports sudden shortness of breath. What is the nurse’s immediate action? Assess the client's airway and breathing A client who is post-op day 2 asks for assistance to the bathroom. At the same time, another client reports chest pain. Who should the nurse respond to first? The client reporting chest pain What is the nurse's first action when a confused client begins removing their oxygen cannula? Reorient the client and reapply the oxygen safely A client with new abdominal pain and a hard, distended belly is calling for help. What should the nurse do first? Perform a focused abdominal assessment 2 What is the priority when a client’s pulse oximeter shows 80% and they appear cyanotic? Apply oxygen and assess respiratory effort A client begins to vomit blood. What should the nurse do first? Turn the client to the side and notify the provider What should the nurse do when a diabetic client says, “I feel dizzy and shaky”? Check blood glucose immediately The nurse sees a fire in a client’s room. What is the first priority action? Remove the client from the room If a client is confused and tries to get out of bed alone, what is the nurse’s priority action? Stay with the client and prevent a fall A client is 1 hour post-op and has not voided. Another client is complaining of chronic back pain. Who takes priority? The post-op client who has not voided 3 What is the first action when a client reports a severe headache after spinal anesthesia? Report the headache to the provider and assess vitals A client who had abdominal surgery now shows tachycardia and low blood pressure. What is the nurse’s priority? Assess for signs of internal bleeding When a client with a chest tube suddenly reports difficulty breathing, what is the first thing the nurse should check? Check the chest tube connection and drainage system A client who is 12 hours post-op has not passed urine and is becoming restless. What is the nurse’s priority? Assess bladder distention and output What is the nurse’s first action if a newborn in the nursery turns blue and limp? Stimulate and initiate neonatal resuscitation protocols 4 If a client starts to seize during ambulation, what is the nurse’s immediate response? Ease the client to the floor and protect the head A nurse finds a client with a tracheostomy coughing and gasping. What should the nurse do first? Suction the tracheostomy immediately