Health assessment · practice question

A 49-year-old client in the emergency department is being evaluated for musculoskeletal assessment during hospitalization. Assessment data include the client tries to get out of bed unassisted and becomes unsteady. Which finding requires the nurse to intervene immediately?

Multiple choiceHardnclex-rn-bsnnclex-validatednclex-2026health-assessment

Routine data unchanged from the prior assessment.The new finding that tries to get out of bed unassisted and becomes unsteady.A stable, long-standing finding that matches the expected care plan.A comfort request with unchanged vital signs and no new symptoms.

Answer and explanation

Correct answer

B. The new finding that tries to get out of bed unassisted and becomes unsteady.

Why

Follow-up items test whether the nurse recognizes cues that are new, acute, or inconsistent with stability and need prompt nursing action.

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A 49-year-old client in the emergency department is being evaluated for musculoskeletal assessment during hospitalization. Assessment data include the client tries to get out of bed unassisted and becomes unsteady. Which finding requires the nurse to intervene immediately?

Correct answer

Why

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