A nurse has been assigned to an internal disaster drill team and is triaging clients. Which of the following clients should the nurse classify with a green tag?

A client who has an open compound fracture of the humerus

A client who has multiple facial lacerations

A client who has a puncture wound in the right lower lung

A client who has full-thickness burns over the lower extremities

Answer and Explanation

The Correct Answer is B

Rationale:

A. A client who has an open compound fracture of the humerus: This injury requires surgical intervention and has a moderate to high risk of complications. It is typically classified as yellow, indicating delayed care is acceptable but not minor.

B. A client who has multiple facial lacerations: These are superficial injuries that can be treated with simple wound care and suturing. The client is likely stable and ambulatory, fitting the criteria for a green tag, which denotes minor injuries requiring minimal care.

C. A client who has a puncture wound in the right lower lung: This suggests potential internal injury and respiratory compromise. Such a case is urgent and unstable, requiring immediate intervention, and would be tagged red for immediate treatment.

D. A client who has full-thickness burns over the lower extremities: Full-thickness burns covering a large area are life-threatening and resource-intensive to manage. Depending on the extent, this may fall under red or black, depending on survivability and available resources.

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Correct Answer is C

Explanation

Rationale:

A. "I should take this medication on an empty stomach.": Amitriptyline does not require administration on an empty stomach. It can be taken with or without food, although taking it with food may help reduce gastrointestinal discomfort in some individuals.

B. "I can continue to take St. John's wort while taking this medication.": St. John's wort can increase the risk of serotonin syndrome and reduce the effectiveness of amitriptyline due to drug interactions. Clients should avoid combining herbal supplements with antidepressants.

C. "I know it will be a couple of weeks before the medication helps me feel better.": Tricyclic antidepressants like amitriptyline take 2 to 4 weeks to show noticeable improvement in mood. Recognizing the delayed onset helps set realistic expectations and supports adherence.

D. "I expect this medication to raise my blood pressure.": Amitriptyline more commonly causes orthostatic hypotension, especially when therapy is initiated. Clients should be taught to change positions slowly to reduce the risk of dizziness and falls.

A. “You can obtain a personal response system that will be activated if you fall." B. “You need to move to a skilled nursing facility where they can prevent fall” C. "You can have an unlicensed assistive personnel (UAP) come to your house daily to stay with you." D. "You should contact a family member once a week to keep in touch."

Correct Answer is A

Explanation

Rationale:

A. “You can obtain a personal response system that will be activated if you fall.": Personal emergency response systems (PERS) allow individuals who live alone to call for help immediately in case of a fall or emergency.

B. “You need to move to a skilled nursing facility where they can prevent falls.": Moving to a skilled nursing facility is a major step and is not necessary solely due to fear of falling. It may also provoke anxiety or feelings of loss of autonomy, especially if less invasive alternatives are available.

C. "You can have an unlicensed assistive personnel (UAP) come to your house daily to stay with you.": Daily UAP support may not be realistic or necessary for someone who is still generally independent. This level of care may be excessive unless the client has significant mobility or cognitive impairments.

D. "You should contact a family member once a week to keep in touch.": While weekly contact with family can offer emotional support, it does not provide real-time assistance in the event of a fall. It’s not a sufficient solution for immediate safety concerns.

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A nurse has been assigned to an internal disaster drill team and is triaging clients. Which of the following clients should the nurse classify with a green tag?

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