A nurse is planning care for four clients who were classified using a disaster triage tag system following a mass casualty event. Which of the following clients should the nurse identify as the priority?
A client who has a green tag
A client who has a yellow tag
A client who has a red tag
A client who has a black tag
The Correct Answer is C
Rationale:
A. A green tag indicates minor injuries; these clients can wait for treatment and are the lowest priority.
B. A yellow tag indicates serious but non-life-threatening injuries; these clients require care soon but are not the highest priority.
C. A red tag indicates life-threatening injuries that require immediate intervention to save the client’s life, making this the highest priority.
D. A black tag indicates deceased or expectant clients whose injuries are so severe that survival is unlikely, and they are the lowest priority for immediate care.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Rationale:
A. Documenting the pain is important but does not address the client’s immediate need for pain relief.
B. Waiting to re-evaluate in 1 hour delays intervention and does not prioritize the client’s current high pain level.
C. Asking the client what has helped relieve their pain in the past allows the nurse to assess effective interventions and tailor immediate pain management, making this the first action.
D. Obtaining a prescription may be necessary, but the nurse should first assess the client’s response to previous interventions and preferences before taking further steps.
Correct Answer is C
Explanation
Rationale:
A. Teaching a new mother how to change a diaper involves client education, which is the nurse’s responsibility, not the AP’s.
B. Inspecting the skin of a newborn receiving phototherapy requires assessment, which cannot be delegated to an AP.
C. Obtaining the weight of a newborn is a routine, stable task that does not require nursing judgment, making it appropriate to delegate to an AP.
D. Answering parents’ questions about newborn circumcision requires teaching and reinforcing medical information, which is the nurse’s role.
Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.
Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today
Report Wrong Answer on the Current Question
Do you disagree with the answer? If yes, what is your expected answer? Explain.
Kindly be descriptive with the issue you are facing.