Difficulty: Medium
Average Score: 64%
Simulated
The nurse identifies several nursing problems for a client who is incontinent and immobile after a stroke and is now experiencing diarrhea. The client resides at home and the spouse is the primary caregiver. While planning care, the nurse should determine which problem has the highest priority?
Correct answer
B
Rationale
According to Maslow's Hierarchy of Needs, physiological needs are the priority. Diarrhea can lead to significant fluid and electrolyte loss, resulting in dehydration (fluid volume deficit), which can be life-threatening. Impaired mobility and caregiver strain are important but are higher-level needs. Bowel incontinence is the problem, but the complication of fluid loss is the priority.