A nurse is participating in a staff discussion about disaster triage. The nurse should include which of the following clients as an example emergent (red tag) category?

A client who has a punctured femoral artery

A client who has an open fracture

A client who exhibits manifestations of multiple organ failure

A client who has several closed fractures with bruising

Answer and Explanation

The Correct Answer is A

A.   Emergent (red tag) category includes patients with life-threatening injuries requiring immediate attention, such as a punctured femoral artery.
B.   An open fracture may be urgent but not emergent unless associated with severe bleeding or other life-threatening complications.
C.   Manifestations of multiple organ failure are severe but may fall into the expectant (black tag) category.
D.   Closed fractures with bruising may be urgent but not emergent unless there are associated life-threatening complications.

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Correct Answer is C

Explanation

A. Vomiting is not a specific manifestation of sepsis.
B. Hypertension is not a typical finding in sepsis; hypotension is more common.
C. Altered mental status, such as confusion or lethargy, can be a sign of sepsis- induced organ dysfunction.
D. While an elevated white blood cell (WBC) count is often seen in infection, it alone does not indicate sepsis. The key in sepsis is the body's dysregulated response to infection leading to organ dysfunction.

A. A single dose of diazepam is unlikely to cause side effects. B. Diazepam can cause drowsiness. C. Avoid foods that contain tyramine. D. Grapefruit juice inactivates this medication.

Correct Answer is B

Explanation

A. Diazepam can cause side effects, especially drowsiness, even with a single dose.
B. One of the common side effects of diazepam is drowsiness, and the client should be advised not to operate heavy machinery or engage in activities requiring alertness until the effects are known.
C. Avoiding foods that contain tyramine is more relevant for certain antidepressant medications, not diazepam.
D. Grapefruit juice is known to interact with certain medications, but it does not inactivate diazepam.

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A nurse is participating in a staff discussion about disaster triage. The nurse should include which of the following clients as an example emergent (red tag) category?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is collecting data on a client who has an infection. Which of the following findings is a manifestation of sepsis?

Correct Answer is C

Explanation

A nurse is reinforcing teaching with a client who takes diazepam. Which of the following information should the nurse the nurse include?

Correct Answer is B

Explanation

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