A nurse in an emergency department is planning care for a client who has abdominal trauma from a motor-vehicle crash. Which of the following provider prescriptions should the nurse implement first?
Place a large-bore IV catheter in an upper extremity.
Administer packed RBCs.
Obtain a specimen for ABG analysis.
Insert an indwelling urinary catheter.
The Correct Answer is A
A. Place a large-bore IV catheter in an upper extremity: Establishing rapid IV access with a large-bore catheter is the priority in a client with abdominal trauma because it allows for immediate fluid resuscitation and administration of blood products if hemorrhage is present. Prompt vascular access is essential for stabilizing circulation and preventing shock.
B. Administer packed RBCs: Blood transfusion is critical for treating hypovolemia, but it cannot occur until IV access is established. Administering RBCs without a patent, large-bore line is unsafe and impractical in an emergency setting.
C. Obtain a specimen for ABG analysis: While ABG analysis provides valuable information on oxygenation and acid-base status, it is not the immediate priority. Ensuring vascular access and hemodynamic stability takes precedence in acute trauma care.
D. Insert an indwelling urinary catheter: Urinary catheterization is important for monitoring output and assessing renal perfusion, but it is secondary to establishing IV access and stabilizing the client’s circulatory status.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A. First trimester bleeding: Bleeding during the first trimester is more characteristic of conditions such as miscarriage or ectopic pregnancy. Abruptio placentae typically occurs in the third trimester and is not associated with early pregnancy bleeding.
B. Delayed menses: Delayed or missed menses is a sign of early pregnancy, not a complication of abruptio placentae, which occurs after the placenta has implanted and matured.
C. Nausea: Nausea is common in early pregnancy or with hyperemesis gravidarum but is not a hallmark symptom of abruptio placentae.
D. Severe abdominal pain: Sudden, severe, and continuous abdominal or lower back pain is a classic manifestation of abruptio placentae. It occurs due to premature separation of the placenta from the uterine wall, often accompanied by vaginal bleeding and uterine tenderness or rigidity.
Correct Answer is C
Explanation
A. "I can infuse the medication at a faster rate.": Infusing vancomycin faster than the recommended rate can cause adverse effects such as “red man syndrome,” hypotension, and cardiac arrhythmias. Rate adjustments must follow safe administration guidelines rather than client preference.
B. "I can adjust the time and schedule for when it's convenient for you.": Vancomycin dosing schedules are based on therapeutic drug levels and infection control, not convenience. Arbitrary adjustments could reduce efficacy or increase toxicity.
C. "I have up to 2 hours after the usual scheduled time to give you this medication.": Vancomycin can generally be administered within a 1–2 hour window of the scheduled time without compromising therapeutic effectiveness. This statement educates the client about safe timing while maintaining efficacy and adherence to clinical guidelines.
D. "I can start the medication 30 minutes earlier.": Administering vancomycin earlier than the recommended schedule may affect dosing intervals and drug serum levels. While minor adjustments may be permissible, starting early should follow provider orders and institutional protocols.
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