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?
Administer packed RBCS.
Obtain a specimen for ABG analysis.
Place a large-bore IV catheter in an upper extremity.
Insert an indwelling urinary catheter.
The Correct Answer is C
A. Administer packed RBCs. While blood transfusion may be urgently needed for hemorrhagic shock, it cannot be initiated until vascular access is established. It is important, but not the first step.
B. Obtain a specimen for ABG analysis. Arterial blood gases can provide valuable information about respiratory and metabolic status, but they are not the top priority in an unstable trauma patient.
C. Place a large-bore IV catheter in an upper extremity. Establishing IV access is the priority in trauma care, as it allows for rapid fluid resuscitation and medication administration. This intervention supports all subsequent emergency treatments.
D. Insert an indwelling urinary catheter. A catheter may be necessary for monitoring urine output as a sign of perfusion, but this is not the first action in a trauma situation where immediate stabilization is the priority.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A. "I will plan to spend time tanning between 10 a.m. and 2 p.m." UV radiation from the sun is strongest between 10 a.m. and 4 p.m., and sun exposure during this time significantly increases the risk of skin cancer. Outdoor activity should be minimized during peak hours.
B. "I will use an indoor tanning bed instead of going outside." Indoor tanning beds expose users to intense UV radiation, which also increases the risk of skin cancer. They are not a safer alternative to natural sunlight and should be avoided.
C. "I will use sunblock with an SPF of 10 when I am outdoors." SPF 10 provides minimal protection and is not adequate for skin cancer prevention. The recommended SPF is 30 or higher, applied generously and re-applied regularly.
D. "I will apply sunscreen before and after swimming." Sunscreen should be applied 15 to 30 minutes before sun exposure and re-applied every 2 hours, especially after swimming or sweating. This statement shows an understanding of proper sun protection practices.
Correct Answer is C
Explanation
A. Ketorolac. This is a nonsteroidal anti-inflammatory drug (NSAID) that can increase the risk of gastrointestinal bleeding, especially in clients with a history of peptic ulcer disease. It should be avoided in this population.
B. Aspirin. Aspirin is also an NSAID and can irritate the gastric lining, increasing the risk of ulceration and bleeding. It is contraindicated in clients with peptic ulcers.
C. Acetaminophen. Acetaminophen is the safest option for clients with peptic ulcer disease because it does not affect the gastric mucosa. It provides effective relief for mild to moderate pain, including headaches.
D. Ibuprofen. Like ketorolac and aspirin, ibuprofen is an NSAID and is not recommended for clients with peptic ulcers due to the increased risk of gastrointestinal irritation and bleeding.
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