Which client should the nurse assess first?

The priority in nursing assessment often hinges on the potential for immediate harm or urgent medical intervention needed. In this scenario, the client with a decreased level of consciousness and vomiting is the most critical case. A diminished level of consciousness may indicate potential neurological deficits, and vomiting can exacerbate these concerns by increasing the risk of aspiration, dehydration, or a worsened underlying condition.

Assessing this client first allows for timely identification of the underlying issue, whether it be due to a stroke, substance abuse, or other neurological problems. Addressing these symptoms swiftly is vital to prevent further complications and provide the necessary interventions to stabilize the patient.

In contrast, the other clients, while they need attention, do not present with immediate life-threatening concerns. The client recovering from surgery may require monitoring, but they are not actively deteriorating. The one preparing for discharge is typically stable, and the client with a headache, while possibly in discomfort, does not pose an acute risk that necessitates immediate assessment over the one with altered consciousness and vomiting.