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.

Answer and Explanation

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.

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Correct Answer is ["A","C","D","E"]

Explanation

A. Potential complications. The provider is responsible for informing the client of possible risks and complications associated with the procedure. This ensures the client understands what to expect and can make an informed decision.
B. Cost of the procedure. While cost is an important consideration, it is not part of the informed consent process that the provider must explain. Financial discussions are typically handled by billing or administrative personnel.
C. Possible alternative treatments. Informed consent includes a discussion of reasonable alternatives so the client can weigh all available options. This allows for autonomous decision-making regarding their care.
D. Explanation of the procedure. The provider must describe the nature and details of the procedure, including what it involves and how it will be performed. This ensures the client understands what they are consenting to.
E. Expected outcome of the procedure. Clients should be informed of the anticipated results and benefits of the surgery. This helps set realistic expectations and supports informed decision-making.

A. "You have already consented to this treatment, so you must continue." B. "I will let your doctor know that you want to discontinue treatment. C. "You should discuss this with your family and see if they agree." D. "I know this treatment is difficult for you, but you will feel better."

Correct Answer is B

Explanation

A. "You have already consented to this treatment, so you must continue." This response disregards the client’s autonomy. Clients have the right to withdraw consent and stop treatment at any time, even after initially agreeing to it.
B. "I will let your doctor know that you want to discontinue treatment." This response respects the client’s right to make decisions about their care and ensures that the healthcare team is informed to support the client appropriately. It demonstrates advocacy and ethical practice.
C. "You should discuss this with your family and see if they agree." While family input can be helpful, the final decision rests with the client, not their family. This response may undermine the client’s autonomy.
D. "I know this treatment is difficult for you, but you will feel better." This is a minimizing statement that may come across as dismissive. It does not acknowledge the client’s feelings or support their decision-making process.

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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?

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