NCLEX-RN
NCLEX RN Prioritization Questions Questions
Extract:
Question 1 of 5
A client is found unresponsive in his room by a nurse. The client is not breathing and does not have a pulse. After calling for help, what is the next action the nurse should take?
Correct Answer: C
Rationale: After finding an unresponsive client who is not breathing and has no pulse, the nurse's immediate action should be to call for help and start chest compressions. Chest compressions should be initiated at a rate of at least 100 per minute and a depth of at least 2 inches.
Choice A, administering ventilations, is not the initial step as compressions take priority.
Choice B, performing a head-tilt, chin lift, is also not the first step; chest compressions are crucial before airway management.
Choice D, performing a jaw thrust, is typically used in cases of suspected cervical spine injury and is not the immediate action in this scenario.
Question 2 of 5
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Question 3 of 5
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Question 4 of 5
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Question 5 of 5
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