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A nurse is the triage officer in the emergency department when four clients arrive following a factory explosion. Which of the following clients should the nurse care for first?

A conscious adult client who reports shortness of breath, has a respiratory rate of 24/min, and capillary refill of <2 seconds

A conscious adult client who has a dislocated right shoulder, respiratory rate of 18/min, and capillary refill of <2 seconds

An unconscious adult client who has a sucking chest wound, respirations of 38/min, and capillary refill of <2 seconds

An unconscious adult client who has no respirations, capillary refill is 2 seconds and paramedics have already tried to reposition airway without results

Answer and Explanation

The Correct Answer is C

A. This client has respiratory distress but is conscious and stable, requiring urgent but not immediate attention compared to other critical conditions.
B. This client has a dislocated shoulder, which is painful and needs attention but is not life-threatening compared to other conditions.
C. This client is unconscious with a sucking chest wound and high respiratory rate, indicating severe respiratory compromise and needing immediate intervention to prevent further deterioration.
D. This client is also unconscious with no respirations despite attempted airway management, indicating a need for immediate resuscitative efforts, potentially including CPR.

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Correct Answer is C

Explanation

A. WBCs (White Blood Cells) may be decreased in multiple myeloma due to bone marrow suppression.
B. ANC (Absolute Neutrophil Count) can be decreased due to bone marrow suppression from the disease or treatment.
C. Calcium levels are often elevated in multiple myeloma due to bone breakdown and release of calcium from bone.
D. Platelets may be decreased due to bone marrow suppression as well.

A. A patient with an anaphylactic reaction B. A patient who has viral pneumonia C. A patient with graft-versus-host disease D. A patient with second degree burns

Correct Answer is B

Explanation

A. A patient with anaphylactic reaction may have unpredictable clinical course and require immediate interventions, which could affect the stability of the roommate.
B. A patient with viral pneumonia poses a lower risk of infection transmission to an immunocompromised patient with acute organ rejection compared to other options.
C. Graft-versus-host disease indicates an immunocompromised state and poses infection risks, similar to acute rejection patients.
D. Second degree burns also pose infection risks and would not be suitable for a roommate of a patient with acute organ rejection.

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A nurse is the triage officer in the emergency department when four clients arrive following a factory explosion. Which of the following clients should the nurse care for first?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is reviewing the laboratory results of a client who was admitted with a history of multiple myeloma. The nurse should expect to find an increase in which of the following laboratory values?

Correct Answer is C

Explanation

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Correct Answer is B

Explanation

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