A nurse is assessing a client with acute pancreatitis who reports increased shortness of breath and has an oxygen saturation level of 88%. What should the nurse assess first?

Rationale: A. Neurological status is important to assess, as hypoxemia can lead to confusion or altered mental status. However, this is a secondary assessment after identifying and addressing the primary cause of hypoxemia. It is not the first action. B. Lung sounds should be assessed first because the client is experiencing shortness of breath with a low oxygen saturation (88%, below the normal 95–100%). In acute pancreatitis, respiratory complications such as pleural effusion or acute respiratory distress syndrome (ARDS) can develop. Assessing lung sounds immediately helps determine the cause of hypoxemia, guides oxygen therapy, and identifies the need for urgent interventions like supplemental oxygen or respiratory support. C. Abdominal girth and tenderness are relevant for monitoring pancreatitis progression and ascites, but these assessments do not directly address the acute respiratory compromise. They are not the first priority in a client with hypoxemia. D. Vital signs for hypotension and tachycardia are important because circulatory instability can worsen oxygen delivery. While vital signs should be checked promptly, auscultating lung sounds provides more specific information about respiratory compromise, which is the immediate priority in a client with low oxygen saturation.