A 22-year-old patient has an itchy rash on his left arm that has been diagnosed as contact dermatitis.
Which of the following patient statements indicates a need for more education?

Choice A rationale

Assessing the respiratory rate is a component of a full respiratory assessment but is not the most immediate priority. A life-threatening chest injury can cause a blocked or compromised airway, making respiratory rate an irrelevant measure if no air can get in or out. Ensuring a clear, patent airway is the absolute first step in the ABCs (airway, breathing, circulation) of emergency care, as without an open airway, no breathing can occur, regardless of the respiratory rate.

Choice B rationale

Administering opioid analgesics is important for pain management but is not a priority over life-sustaining interventions. Opioids can cause respiratory depression, which would worsen the patient's condition in the context of a life-threatening chest injury. The priority is to first secure the patient's airway and address immediate threats to life, such as establishing adequate oxygenation and ventilation, before addressing pain, which is secondary to survival.

Choice C rationale

Ensuring a patent airway is the most critical and immediate action according to the ABCs of trauma care. A life-threatening chest injury can compromise the airway through direct trauma, bleeding, or pneumothorax, leading to hypoxia and death within minutes. Establishing and maintaining a clear airway ensures the patient can be oxygenated and ventilated, a foundational step that must be secured before any other interventions can be effective in preserving life.

Choice D rationale

Starting two large bore IV lines is essential for fluid resuscitation and medication administration but is secondary to ensuring a patent airway. Without a secure airway, the patient will not survive long enough to benefit from IV fluids or medications. Airway management is the foundational step in emergency care, and it must be addressed before circulation can be effectively managed. The priority is always to ensure the patient can breathe first. ---.

Choice A rationale

A patient with diarrhea may have a communicable disease, such as C. difficile or Norovirus. The patient with Stevens-Johnson syndrome has compromised skin integrity, making them highly susceptible to opportunistic infections. Placing them with a patient who has a potential infection poses a significant risk of cross-contamination and sepsis, which is a life-threatening complication for this vulnerable patient.

Choice B rationale

A patient with methicillin-resistant Staphylococcus aureus (MRSA) has a colonization or infection with a resistant bacteria. Stevens-Johnson syndrome involves extensive epidermal detachment, creating large areas of open, denuded skin, similar to a burn injury. This makes the patient extremely vulnerable to infection from resistant organisms like MRSA, which could lead to severe systemic infection and sepsis.

Choice C rationale

A patient with atrial fibrillation is not contagious and does not pose an infectious risk. Atrial fibrillation is a cardiac arrhythmia caused by an electrical conduction abnormality in the heart, with no risk of transmission. This roommate choice is the safest because it minimizes the risk of infection for the patient with Stevens-Johnson syndrome, whose compromised skin barrier makes them highly susceptible.

Choice D rationale

A fever of unknown origin (FUO) suggests an underlying infectious process that has not yet been identified. This poses a high risk of cross-contamination to the patient with Stevens-Johnson syndrome. The patient with compromised skin integrity is at an extreme risk of contracting a new infection from an undiagnosed and potentially contagious pathogen, which could lead to a severe and rapid decline in their condition.