In a hospital, there are 4 patients who require the attention of the nurse. Who of the following should the nurse attend first?

Appeared in: AIIMS Bhopal NO - 2018 (Shift-1st)

Explanation

The core principle of nursing prioritization is to address the most life-threatening condition first.
The ABC framework (Airway, Breathing, Circulation) dictates that any compromise to these functions is the highest priority.
A pneumothorax (collapsed lung) with shortness of breath is a direct and immediate threat to the patient's breathing.
This condition can rapidly deteriorate, leading to severe respiratory failure and is therefore a medical emergency requiring immediate intervention.

Option B: This patient is clinically stable and their care needs are non-urgent. Discharge procedures are administrative and can be performed after life-threatening conditions are managed.
Option C: While managing pain is an important nursing function, it is considered a psychosocial need and is a lower priority than an acute physiological threat to breathing or circulation.
Option D: This patient is stable, as they are asking to ambulate, which indicates they are not in acute respiratory distress. Their request is for a routine activity, not an urgent need.

Clinical Relevance

Nursing practice connection: Knowing Prioritization of Patient Care helps nurses interpret findings accurately and avoid errors in routine assessment, medication administration, and patient teaching.
Prioritization is a fundamental skill for nurses to ensure patient safety and manage workload effectively in any clinical setting.
Failure to correctly prioritize can lead to adverse patient outcomes, including death. Always assess for threats to ABCs first.
In the Indian healthcare context, where nurse-to-patient ratios can be high, rapid and accurate prioritization is even more critical for managing care on a busy ward.

How to Approach the Question

Identify the question type: This is a prioritization question asking you to determine which patient is the most critical.
Recall the primary framework for prioritization: Airway, Breathing, Circulation (ABCs).
Analyze each option through the lens of the ABCs.
Option A: Pneumothorax with shortness of breath is a 'Breathing' problem.
Option B: Waiting for discharge is not an ABC problem.
Option C: Post-op pain is a comfort/psychosocial issue, not an immediate ABC problem.

Concept Tested & Keywords

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E6 Nursing Fundamentals Potter Perry 12e Part 2 pp. 22-24, 72-74

Practise the full AIIMS Bhopal NO - 2018 (Shift-1st)

Attempt every question from this paper in a timed mock, then review the full solution for each one.