A nurse is assisting with triaging clients in a mass casualty situation. The nurse should recommend that which of the following clients receive care first?
A client who has a head injury and whose pupils are fixed and dilated
A client who has a dislocated shoulder and reports a pain level of 8 on a scale from 0 to 10
A client who has a 20.3-cm (8-in) scalp laceration with intermittent bleeding
A client who has diminished breath sounds and paradoxical chest movement
The Correct Answer is D
The nurse should recommend that the client who has diminished breath sounds and paradoxical chest movement receive care first. This client is likely experiencing a tension pneumothorax, which is a life-threatening condition that requires immediate intervention.
Option a is incorrect because a client who has a head injury and whose pupils are fixed and dilated may have experienced brain death and may not be able to be resuscitated.
Option b is incorrect because a dislocated shoulder, while painful, is not immediately life-threatening. Option c is incorrect because a scalp laceration with intermittent bleeding can be managed with pressure and is not immediately life-threatening.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Neisseria gonorrhoeae is the bacterium responsible for the sexually transmitted infection known as gonorrhea. Gonorrhea is a reportable communicable disease, meaning healthcare providers are required to report cases to the appropriate public health authorities. This allows for tracking and monitoring of the disease, implementation of appropriate public health measures, and prevention of further spread of the infection.
Sarcoptes scabiei: This refers to scabies, a parasitic infestation caused by mites. While scabies can be contagious, it is not typically a reportable disease to the state health department.
Impetigo contagiosa: Impetigo is a bacterial skin infection that can be caused by various bacteria, including Staphylococcus aureus and Streptococcus pyogenes. Although it is contagious, it is not typically a reportable disease to the state health department.
Human papillomavirus (HPV): HPV is a viral infection transmitted through sexual contact. While it is a significant public health concern due to its association with cervical cancer and other conditions, it is not usually a reportable disease to the state health department. However, certain states may have specific reporting requirements for HPV-related diseases or conditions, such as cervical cancer. It is important to be familiar with the specific reporting guidelines of the state in question.
Correct Answer is A
Explanation
The action by the AP that indicates an understanding of the procedure is elevating the client's legs before applying the stockings. Elevating the legs can help reduce swelling and make it easier to apply the stockings.
Option b is incorrect because instructing the client to dorsiflex their feet while applying the stockings may not be necessary.
Option c is incorrect because massaging the client's legs before applying the stockings may not be necessary or appropriate.
Option d is incorrect because folding the top of the stockings over after applying them may not be necessary or appropriate.
Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.
Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today
Report Wrong Answer on the Current Question
Do you disagree with the answer? If yes, what is your expected answer? Explain.
Kindly be descriptive with the issue you are facing.