Management of Care

Four clients at shift start: who do you see first?

Original RemoteNurse question · Last reviewed 2026-10-14

At the start of a shift, a nurse on a surgical unit receives report on four clients. Which client should the nurse see first?

AA client with type 2 diabetes whose fasting fingerstick glucose is 182 mg/dL.
BA client with pneumonia who rates pain at 5 out of 10 when coughing and asks for the prescribed pain medicine.
CA client one day after hip replacement who is newly restless, breathing 28 times a minute, with an oxygen saturation of 89% on room air.
DA client going home this morning whose ride is waiting and who still needs teaching about wound care.

Show the answer and rationale

Correct answer: C

A. Incorrect. The glucose is high and needs follow-up, but it is not an immediate threat to breathing or circulation.
B. Incorrect. The pain should be treated soon, but the client is stable and the pain fits the known diagnosis.
C. Correct. New restlessness, fast breathing and low oxygen saturation point to a breathing problem, such as a blood clot in the lung, that can worsen within minutes. The 2026 test plan asks nurses to prioritize care for several clients by acuity, and this client is the least stable.
D. Incorrect. Discharge teaching matters, but it can wait until the unstable client is safe.

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