Which client should the nurse assess first during the day shift report?

The best choice for the nurse to assess first during the day shift report centers on the clinical significance of the client's current condition and treatment needs. The 60-year-old client with leukemia receiving chemotherapy for the first time requires immediate attention because the introduction of chemotherapy can lead to significant complications, including severe side effects such as nausea, vomiting, febrile neutropenia, and potential metabolic imbalances. These effects can arise rapidly and may necessitate urgent nursing interventions and close monitoring to ensure the client's safety and manage any emergent symptoms.

In contrast, while the other clients present certain health issues requiring care, they are not as time-sensitive or critical in the context of new treatments being introduced. The client with metastatic cancer and confusion may indeed be experiencing a serious condition, but the focus on chemotherapy for a first-time treatment requires immediate evaluation to address potential acute side effects. The client scheduled for a CT scan and the one admitted with pneumonia both have significant health challenges, but they are not as urgent as managing the initial reactions and side effects of chemotherapy for the leukemia patient.