Strategy Session: Client Need 1

Management of Care Subcategory

Question Type: Establishing Priority
Strategy Used: Answer Elimination

Consider this example:
A home care nurse is planning her visits for the day. Which of the following patients should the nurse visit first?

(1)		A 62-year old man two days after an inguinal hernia repair.

(2)		A 40-year old woman with type 1 diabetes mellitus (IDDM) with a foot ulcer.

(3)		A 76-year old man with chronic obstructive pulmonary disease (COPD).

(4)		A 50-year old woman three days after a right mastectomy.

Applying the strategy: The difficulty with priority questions is that all of the answer choices seem correct. First, reword the question in your own words. Which patient takes highest priority? Next, eliminate answers using the rules of Management. Answer choice 1: There is nothing that leads you to believe that the patient is unstable. Usually, recovery from hernia repairs are uneventful. Eliminate this answer. Answer choice 2: Impaired circulation is a complication of diabetes, and this client's situation is potentially unstable. Leave this in for consideration. Answer choice 3: While this client has a chronic condition that requires close monitoring by the nurse, there is no indication of an acute situation. Eliminate this answer. Answer choice 4: This is a relatively new postop client that has the potential for major complications. This patient should be assessed by the nurse. Leave this in for consideration. You are now choosing from answers (2) and (4). Which client do you consider least stable? The correct answer is (4). Remember, the only way to answer priority questions correctly is to eliminate answer choices. It is too difficult to pick the correct answer from four answer choices.

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