While Performing a Skin Assessment for a Client, the Nurse

While performing a skin assessment for a client, the nurse notes that the client becomes pales and diaphoretic. The client's vital signs have remained stable since the beginning of the examination: blood pressure 138/76 mmHg, heart rate is 88 beats per minute, and respiratory rate is 18 breaths per minute. Which is the priority response by the nurse?

A) The nurse immediately raises the client's head of bed.
B) The nurse asks the client, "Are you feeling anxious during this assessment?"
C) The nurse immediately notifies the client's healthcare provider.
D) The nurse provides the client with ½ cup of orange juice.