A young adult is admitted to the emergency department after a motor vehicle crash. The client has severe pain in the right chest due to impact with the steering wheel. Which is the priority client goal?

Decrease chest pain

Reduce the client's anxiety

Maintain adequate circulating volume

Maintain adequate oxygenation

Answer and Explanation

The Correct Answer is D

A. Decrease chest pain is important but not the highest priority. Managing pain can help with breathing, but oxygenation is the primary concern.

B. Reduce the client's anxiety is secondary to physiological needs. Anxiety can worsen dyspnea, but addressing oxygenation first is more critical.

C. Maintain adequate circulating volume is a priority if there is hemorrhage, but the question does not indicate bleeding. Oxygenation takes precedence in this case.

D. Maintain adequate oxygenation is the priority. Chest trauma can lead to pneumothorax, pulmonary contusion, or other complications that can impair gas exchange. Ensuring adequate oxygenation prevents hypoxia and respiratory failure, which are life-threatening.

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Correct Answer is A

Explanation

A. Stop transfusion, run normal saline is correct because the client is likely experiencing an acute hemolytic transfusion reaction (AHTR), which is life-threatening. The priority is to stop the transfusion immediately and maintain IV access with normal saline to prevent further hemolysis.

B. Administer morphine IV is incorrect because pain management is important, but stopping the transfusion is the immediate priority.

C. Administer epinephrine IM is incorrect because epinephrine is used for anaphylaxis, not hemolytic reactions.

D. Continue to monitor the infusion is incorrect because the transfusion must be stopped immediately to prevent worsening hemolysis.

A. 20-gauge catheter in the the right wrist infusing IV antibiotics B. 20-gauge catheter in the the right forearm infusing 0.9% Normal Saline C. 22-gauge catheter in the left forearm infusing 0.45% Normal Saline D. 18-gauge infusing 20mg Potassium Chloride IV

Correct Answer is B

Explanation

A. 20-gauge catheter in the right wrist infusing IV antibiotics

Infusing antibiotics can cause incompatibilities.

B. 20-gauge catheter in the right forearm infusing 0.9% Normal Saline

A 20-gauge or larger catheter in a patent IV site with compatible fluid (NS) is required for PRBC transfusion.

C. 22-gauge catheter in the left forearm infusing 0.45% Normal Saline

A 22-gauge catheter is too small for safe transfusion.

D. 18-gauge infusing 20 mg Potassium Chloride IV

Potassium chloride infusion should not be interrupted, making this site unsuitable.

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A young adult is admitted to the emergency department after a motor vehicle crash. The client has severe pain in the right chest due to impact with the steering wheel. Which is the priority client goal?

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Naxlex Comprehensive Predictor Exams

The client admitted with sickle cell anemia crisis is being treated with a transfusion of 2 units of packed red blood cells (PRBC's) for a low hemoglobin. The cent demonstrating a new onset of chest pain. low back pain, tachycardia and anxiety. The nurse's immediate intervention is

Correct Answer is A

Explanation

The nurse is preparing to start a transfusion of packed red blood cells. Which IV site should the nurse use?

Correct Answer is B

Explanation

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