Editing Management of Care – LPN Practice Questions (section)

==Question 8==
A licensed practical nurse begins the shift with four clients. Which client should the LPN see '''first'''?
# A client whose scheduled dressing change is due.
# A client who reports new shortness of breath and is using accessory muscles to breathe.
# A client who requests medication for chronic low back pain rated 6 on a 0 to 10 scale.
# A client who needs assistance to walk to the bathroom.

'''Answer:''' 2. The client who reports new shortness of breath and is using accessory muscles to breathe.

''Rationale:'' New dyspnea with accessory muscle use is a breathing problem and an acute, unexpected change, which outranks every other option under the ABC framework. The LPN should assess the client, raise the head of the bed, apply oxygen if ordered, and report to the registered nurse immediately. Option 1 is a scheduled task. Option 3 is chronic pain, which is real and must be treated but does not precede a respiratory change. Option 4 is an activity of daily living that can be delegated to assistive personnel.