Adult health / medical-surgical nursing · practice question
A 68-year-old client on a medical-surgical unit is being evaluated for partial bowel obstruction. Assessment data include blood glucose 420 mg/dL with acetone breath and Kussmaul respirations. Which action should the nurse take first?
Multiple choiceEasynclex-rn-bsnnclex-validatednclex-2026adult-health-med-surg
Answer and explanation
Correct answer
D. Assess airway, breathing, and circulation; address immediate safety risk; then notify the provider per protocol.
Why
NCLEX priority questions require stabilizing the client first using ABCs and focused assessment before comfort measures, documentation only, or delayed escalation.
Test yourself on Adult health / medical-surgical nursing
A free test with instant, explained results. No account needed.
More Adult health / medical-surgical nursing questions
- A 68-year-old client on a medical-surgical unit is being evaluated for uncontrolled hyperglycemia. The nurse reviews…
- A 68-year-old client on a medical-surgical unit is being evaluated for pancytopenia after chemotherapy. Assessment…
- A 45-year-old client in the emergency department is being evaluated for heart failure exacerbation. Assessment data…
- A 68-year-old client on a medical-surgical unit is being evaluated for uncontrolled hyperglycemia. Assessment data…
- After nursing care for rapidly worsening vital signs, the nurse evaluates the client response. Which action best…
- The RN is caring for a stable client who needs routine assistance related to rapidly worsening vital signs. Which task…