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A blood glucose level of 300 mg/dL in a client with a heel ulcer is concerning but not immediately life-threatening. It requires medical management, not emergency intervention.

Blood on a pressure dressing after cardiac catheterization suggests oozing or minor bleeding, but unless it’s active, pulsatile, or expanding, it does not yet meet criteria for a rapid response call.

Dark red toes and absent pedal pulse indicate possible critical limb ischemia but do not immediately threaten life. This requires urgent vascular evaluation, but not a rapid response unless systemic compromise occurs.

Modified jaw thrust: This technique opens the airway by displacing the jaw forward without moving the neck and is for patients suspected to have cervical spine injury.

Hyperextension of the head: This position may further injure the cervical spine and does not follow trauma airway protocol.

Flexion of the head: This worsens airway obstruction by pushing the chin toward the chest and narrows the upper airway, making it inappropriate in any airway emergency.

Dobutamine: Used in heart failure and cardiogenic shock to improve myocardial contractility, but not for cardiac arrest situations.

Dopamine: Used for symptomatic bradycardia or shock unresponsive to fluids, but not the first choice during active cardiac arrest.

Atropine: Used specifically for symptomatic bradycardia, not for pulseless rhythms or full cardiac arrest.

Obtain a detailed medical history: While important, this is not the immediate priority when the client shows signs of acute physiological compromise.

Determine the kind of insurance: Administrative concerns do not take precedence over emergency care. Treatment should never be delayed for financial or coverage issues.

Start supplemental oxygen and have the ED physician see him: While oxygen may be supportive, initiating care without first assessing vitals and core temperature misses the most critical diagnostic step in this situation.

A mass casualty incident, such as a chemical explosion involving a large number of victims, requires immediate implementation of the hospital’s emergency response plan to coordinate triage, staffing, communication, and resource management.
Rationale for Correct Answer:

A mass casualty incident, such as a chemical explosion involving a large number of victims, requires immediate implementation of the hospital’s emergency response plan to coordinate triage, staffing, communication, and resource management.
Rationale for Correct Answer:

A mass casualty incident, such as a chemical explosion involving a large number of victims, requires immediate implementation of the hospital’s emergency response plan to coordinate triage, staffing, communication, and resource management.
Rationale for Correct Answer:

Important facts may be forgotten when needed later for legal actions: While legal documentation is important, the priority in a secondary survey is clinical decision-making based on the patient’s condition, not legal preparation.

Alcohol use associated with many accidents can affect treatment of injuries: Though true, alcohol screening is part of routine trauma assessment and labs, but it is not the primary reason for asking about the incident itself.

Many types of accidents or trauma must be reported to government agencies: This is a regulatory requirement, not a priority during clinical assessment in the secondary survey phase.

Anatomy of injuries, mucous membranes, peripheral edema, leukocytosis, eczema location: This is not a standard or clinically useful framework for trauma assessment.

Approximate weight, motor function, palpable swelling, labored breathing, edema severity: These are not part of the AMPLE components and do not reflect a structured emergency history.

Abdominal sounds, memory loss, people exposed to, last medication, earliest availability of past medical records: These elements are not relevant to the AMPLE acronym and do not follow established emergency protocols.

Whether the resources of the ED are adequate: This is part of administrative triage planning, not the clinical assessment performed during the primary survey.

The acuity of the patient’s condition to determine priority of care: This refers to triage, which typically occurs before or alongside the primary survey but is not the same as the clinical ABCDE assessment.

Whether the patient is responsive enough to provide information: This might influence the history-taking process but is not a component of the primary survey, which focuses on physical and physiological assessment.

Check a central pulse: While circulation assessment is important, it is not the priority when breathing is compromised.

Stabilize the cervical spine: This is performed at the start of the primary survey, typically simultaneously with airway management, but it is not the next immediate action after identifying compromised breathing.

Apply direct pressure to the wound: This addresses external bleeding under the circulation step (C), which is secondary to airway and breathing in the ABCDE hierarchy.

A 6-year-old child with a temperature of 10C.2°F (39.6°C): While concerning, a high fever alone without signs of respiratory distress, seizure, or altered consciousness is not an immediate life-threatening emergency and can be triaged after stabilizing airway/breathing concerns.

 Risk of dehydration is high in infants, but unless the infant shows signs of shock, altered mental status, or severe electrolyte disturbance, this is not as emergent as active respiratory compromise.

 This is a painful but non-emergent condition without signs of neurologic deficit, infection, or trauma-related spinal injury.

Correction of acidosis: Acidosis (metabolic and/or respiratory) is a consequence of hypoxia and can be resolved by restoring oxygenation and perfusion. It is important, but not the first priority.

Maintenance of fluid balance: Fluid shifts and aspiration can cause pulmonary edema, but this is addressed after securing the airway and correcting hypoxia.

Prevention of cerebral edema: While cerebral edema is a potential complication due to prolonged hypoxia, the immediate threat is oxygen deprivation, which must be corrected first to prevent cerebral hypoxia and subsequent edema.