An emergency department nurse triages a group of clients who were injured in a school bus crash. Which of the following clients should the nurse have the provider evaluate first?

A client who has a forehead wound that is bleeding copiously

A client who has a compound fracture of the femur and is crying in pain

A client who was unconscious at the scene and now reports diplopia and nausea

A client who has several missing teeth and a swollen, ecchymotic upper lip

Answer and Explanation

The Correct Answer is C

A. A client who has a forehead wound that is bleeding copiously. Although bleeding may appear dramatic, most scalp wounds bleed heavily and can be controlled with pressure. This is not immediately life-threatening if the client is stable.
B. A client who has a compound fracture of the femur and is crying in pain. This is a serious injury with risk for blood loss and infection, but the client is alert and stable enough to express pain, suggesting less immediate neurologic risk than other clients.
C. A client who was unconscious at the scene and now reports diplopia and nausea. This client likely has a head injury with signs of increased intracranial pressure or concussion (diplopia = double vision, nausea, and prior loss of consciousness). These are neurological red flags and require immediate evaluation to prevent deterioration.
D. A client who has several missing teeth and a swollen, ecchymotic upper lip. While painful and concerning, oral trauma without airway compromise is less urgent than potential brain injury.

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Correct Answer is B

Explanation

A. Rotate staff members caring for the client. Clients with paranoid personality disorder often struggle with mistrust and feel suspicious of others. Consistency in staffing is important to build rapport and reduce anxiety, so rotating staff can worsen paranoia.
B. Speak in a neutral tone when addressing the client. This is appropriate because a calm, neutral, and non-threatening tone helps reduce perceived threats or suspicion. It promotes a sense of safety and control, which is important for therapeutic communication with paranoid individuals.
C. Limit the client's opportunities to socialize with others. While clients with paranoid personality disorder may prefer limited interaction, completely restricting socialization can increase isolation and reinforce delusional thinking. Structured, safe interactions are often encouraged.
D. Mix the medication with the client's food items. Administering medication without the client’s knowledge is deceptive and unethical, especially in someone already prone to distrust. Open and honest communication about treatment is crucial for promoting cooperation and trust.

A. Medicaid B. Medicare Part A C. Respite care D. Food stamps E. Adult day care

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

Explanation

A. Medicaid. Medicaid provides health coverage for low-income individuals, including young adults who meet poverty guidelines. It can cover home health services and IV therapy, making it an appropriate resource for this client.
B. Medicare Part A. Medicare Part A generally covers hospital care and limited home health services, but it is primarily for individuals aged 65 and older or those with certain disabilities. It is not typically available to young adults without qualifying conditions.
C. Respite care. Respite care provides temporary relief to caregivers, not direct services for clients requiring IV therapy. It is more relevant for individuals with long-term caregiving needs, not this scenario.
D. Food stamps. Also known as the Supplemental Nutrition Assistance Program (SNAP), food stamps assist low-income individuals in accessing food. It’s a valuable support service for someone living below the poverty line.
E. Adult day care. This is intended for older adults or individuals with disabilities who need supervision during the day. It is not applicable for a young adult requiring home IV therapy.

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An emergency department nurse triages a group of clients who were injured in a school bus crash. Which of the following clients should the nurse have the provider evaluate first?

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Naxlex Comprehensive Predictor Exams

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Correct Answer is B

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

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