A first-response team is working at the location of a bombing incident. A nurse triaging a group of clients should give treatment priority to which of the following clients?
A client who has a rigid abdomen with manifestations of shock
A client who has a femur fracture with a 2+ pedal pulse
A client who has superficial partial-thickness burn injuries over 5% of his body
A client who is ambulatory and exhibits manic behavior
The Correct Answer is A
The correct answer is choice A. A client who has a rigid abdomen with manifestations of shock should receive treatment priority in this situation. In a bombing incident, clients with life-threatening injuries, such as those with uncontrolled bleeding, airway compromise, or shock, should receive immediate attention. A rigid abdomen may indicate internal bleeding, which is a medical emergency requiring prompt intervention. Manifestations of shock, such as tachycardia, hypotension, and altered level of consciousness, indicate poor tissue perfusion and require immediate intervention. The other clients described in the question have less severe injuries and can wait for treatment while more critical injuries are addressed first. A femur fracture with a 2+ pedal pulse indicates adequate circulation to the extremity, superficial partial-thickness burn injuries over 5% of the body are not life-threatening, and an ambulatory client with manic behavior does not have immediate medical needs.
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Related Questions
Correct Answer is C
Explanation
A.While social withdrawal is a concerning sign of grief, it does not necessarily indicate an immediate risk of self-harm. The nurse should continue to monitor and encourage engagement.
B.Anger is a normal stage of grief. Unless the client expresses intent to harm themselves or others, anger alone does not require immediate intervention.
C.This statement may indicate suicidal ideation. When a grieving client expresses that "everything is going to be fine soon," it can be a red flag for suicidal intent, especially if they have recently experienced a significant loss. Some individuals contemplating suicide may appear calm or overly optimistic once they have decided on a plan.
D.Refusal to communicate is concerning but not necessarily an immediate crisis. The nurse should build rapport and offer ongoing support.
Correct Answer is C
Explanation
A.Migrant workersmay face barriers such as irregular work hours, lack of transportation, or limited access to healthcare facilities. A community health nurse helps people in a local community however, they do not provide health services in private places like work sites.
B.Many migrant workers may have limited financial resources and may struggle with the cost of fee-for-service healthcare. This approach could create financial barriers and limit access to necessary health services for this population.
C.Community centers provide a central location where migrant workers and their families can access health screenings and other services. This approach is beneficial and accessible.
D.Requiring a work visa can exclude undocumented workers or those without proper documentation from receiving care. This requirement could prevent a significant portion of the migrant population from accessing necessary health services and does not align with the goal of providing inclusive and equitable healthcare.
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