Difficulty: Medium
Average Score: 71%
Simulated
The nurse is caring for assigned clients. The nurse should initially follow up on the client who
Correct answer
B
Rationale
A GCS drop from 13 to 11 post-craniotomy (B) indicates neurological deterioration, possibly from hematoma, requiring immediate follow-up. Bruises with skull fracture (A), ALS DNR request (C), and GBS weakness (D) are less urgent, though GBS needs monitoring.