Difficulty: Medium
Average Score: 83%
Simulated
Passage / Scenario
A postoperative client refuses to use an incentive spirometer following major abdominal surgery.What is the nurse's priority action?
Correct answer
A
Rationale
The correct answer is A: Determine the reasons why the client is refusing to use the incentive spirometer. This is the priority action because understanding the client's refusal will help address any underlying issues hindering compliance with treatment, ensuring optimal care. Documenting the refusal (B) is important but not as immediate as understanding the root cause. Administering pain medication (C) may be necessary but addressing the refusal first is crucial. The other choices are not relevant to the immediate priority of addressing the client's refusal.