A home health nurse is making preparations for morning visits. Which one of the following clients should the nurse visit first? A. A client with brain attack (stroke) with tube feedings B. A client with congestive heart failure complaining of nighttime dyspnea C. A client with a thoracotomy 6 months ago D. A client with Parkinson's disease

We have four clients with different medical conditions and factors to consider: A. A client with stroke (brain attack) and tube feedings B. A client with congestive heart failure (CHF) complaining of nighttime dyspnea (shortness of breath at night) C. A client with a thoracotomy (a surgical incision into the chest wall) 6 months ago D. A client with Parkinson's disease

Now, let's individually assess the urgency of each client: A. The client with a stroke is likely at high risk of complications and needs proper nourishment through tube feedings. Regular monitoring of their condition is crucial, but their situation may not require immediate attention if they're stable. B. The client with CHF experiencing nighttime dyspnea is potentially in a more urgent situation. Dyspnea can be a sign of exacerbation or worsening of their CHF, which may require prompt intervention. C. The client with a thoracotomy 6 months ago is not an urgent case, as the surgery was some time ago and is not an active issue. D. A client with Parkinson's disease typically experiences a slow progression of their condition. While they may require ongoing support, their situation is usually not urgent unless they have an acute exacerbation of symptoms.

Based on the assessment of each client's urgency, we will prioritize them in the following order: 1. Client B (CHF client with nighttime dyspnea) - highest urgency due to the possibility of their condition worsening and needing prompt intervention. 2. Client A (client with stroke and tube feedings) - Next in priority as their condition requires regular monitoring and care. 3. Client D (client with Parkinson's disease) - Lower priority as their condition is typically slowly progressing. 4. Client C (client with a thoracotomy 6 months ago) - Lowest priority as this is not an active issue. The home health nurse should visit the CHF client with nighttime dyspnea (Client B) first, as the exacerbation of their condition may require immediate attention.