Anatomy & Physiology I/II · practice question

A 68-year-old client on a medical-surgical unit is being evaluated for nursing care related to gastrointestinal digestion and absorption. Assessment data include vital signs change from earlier: blood pressure 94/60 mm Hg and heart rate 112/min. Which action should the nurse take first?

Multiple choiceMediumnclex-rn-bsnnclex-validatednclex-2026anatomy-physiology

Assess airway, breathing, and circulation; address immediate safety risk; then notify the provider per protocol.Complete all remaining scheduled tasks before reassessing the client.Offer a warm blanket and reschedule assessment until after lunch.Apply restraints without assessing less restrictive safety options first.

Answer and explanation

Correct answer

A. 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.

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A 68-year-old client on a medical-surgical unit is being evaluated for nursing care related to gastrointestinal digestion and absorption. Assessment data include vital signs change from earlier: blood pressure 94/60 mm Hg and heart rate 112/min. Which action should the nurse take first?

Correct answer

Why

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