What should the nurse do first for a client who is post-operative and experiencing confusion?

Correct Answer: B

Rationale: The correct answer is B: Place in a safe environment. This is the first priority to ensure the safety of the confused post-operative client. Placing the client in a safe environment prevents harm from falls or accidents. Reorienting the client (choice A) can come after ensuring safety. Administering pain relief (choices C and D) should be done based on assessment but is not the first priority when the client is confused.

Correct Answer: A

Rationale: The correct answer is A because health assessment helps establish a baseline database for comparison in future assessments, allowing for tracking of changes in health status over time. It provides essential information for identifying health issues and developing appropriate interventions. Choice B is incorrect as establishing rapport is a benefit but not the primary purpose. Choice C is incorrect as health assessment is typically conducted by primary healthcare providers, not specialists. Choice D is incorrect as quantifying pain is just one aspect of health assessment, not its primary purpose.

Correct Answer: D

Rationale: A focused assessment is more in-depth on specific issues, providing detailed information on a particular problem or concern. This allows for targeted interventions and treatment strategies. In contrast, a comprehensive assessment covers the body head to toe and involves all body systems, which may not be necessary when focusing on a specific issue. Occurring only in the clinic is a limitation to choice B, as assessments can be conducted in various settings. Involving all body systems, as stated in choice C, is not the primary focus of a focused assessment.

Correct Answer: D

Rationale: The correct answer is D: Create home care safety. Nursing activities that promote health and prevent disease focus on educating individuals on maintaining their health and preventing diseases, rather than specifically creating home care safety. The other choices (A, B, C) are correct as they accurately reflect the goals of nursing activities - reducing disease risk, maintaining optimal functioning, and reinforcing good habits to promote overall health and well-being. Choice D is incorrect because while ensuring home care safety is important, it is not the primary focus of nursing activities aimed at health promotion and disease prevention.

Correct Answer: D

Rationale: In emergency situations, time is crucial. Emergency assessment is the most appropriate as it focuses on quickly identifying and addressing life-threatening issues. It involves a rapid but systematic evaluation of the patient's airway, breathing, circulation, and disability. Head-to-toe assessment (A) and comprehensive assessment (C) are too time-consuming in emergencies, whereas focused assessment (B) may not cover all critical aspects.