NCLEX-PN

Category - Physiological Adaptation

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A nurse finds an adult client on the floor who is not responsive to stimulus. The client is not breathing, but has a pulse. The nurse gives 2 rescue breaths without success. The client continues to have a pulse. Which of the following is the next action of the nurse?

Begin chest compressions
Continue rescue breathing
Attempt to bring the client to consciousness
Assess the client’s circulation

Explanation

Answer: B - If 2 rescue breaths are given but the client is not breathing and there is still a pulse, the nurse should continue rescue breathing. She should also call for help. The other options are not appropriate.

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