The nurse has been assigned to care for four clients. Which client should the nurse plan to assess first?

Rationale: A. This client is at highest risk for an acute, potentially life-threatening complication. Coughing increases intra-abdominal pressure, which can precipitate esophageal variceal rupture and massive bleeding. Prompt assessment is essential to evaluate for signs of hemorrhage (vomiting blood, hypotension, tachycardia) and initiate immediate interventions. B. Although post-operative assessment is necessary, the client has been stable, making this a lower-priority assessment compared with a client at risk for sudden life-threatening bleeding. C. Pain management is important, but the client’s condition is not immediately life-threatening. Pain can be addressed after assessing clients with more acute complications. D. Pruritus in cirrhosis is uncomfortable but not life-threatening. This assessment can be prioritized after addressing clients at risk for acute hemorrhage or airway compromise.