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    Ati med surg (cardiovascular) freshno college proctored exam

    After receiving change-of-shift report on four patients admitted to a heart failure unit, which patient should the nurse assess first?

    Explanation & Rationale

    Rationale: A. This patient shows signs of mild pulmonary congestion, but oxygen saturation is within an acceptable range and the patient is currently stable. B. While this patient is on a vasodilator and has borderline low blood pressure, they are hemodynamically stable at this moment and not showing signs of acute deterioration. C. This patient exhibits signs of poor perfusion and possible cardiogenic shock, which is life-threatening. These symptoms indicate an urgent priority for assessment and intervention. D. This is a common side effect of ACE inhibitors and is non-emergent; the patient is stable and does not require immediate assessment

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