On a day when the temperature is expected to drop below freezing during the night, the nurse is asked to determine which homeless adult is most in need of the limited shelter spaces available. Which individual should be prioritized for admission?
An older person who is malnourished.
A young person with diabetes mellitus.
An adult who was hit by a car 3 weeks ago.
A middle-aged person who has hypertension.
The Correct Answer is A
Choice A reason: Older adults who are malnourished are at significantly higher risk of hypothermia, infection, and poor wound healing. Malnutrition compromises thermoregulation and immune function, making cold exposure potentially fatal. Age-related physiological decline further exacerbates vulnerability to environmental stressors. Prioritizing this individual aligns with triage principles that emphasize immediate risk to life and physiological instability.
Choice B reason: While diabetes mellitus poses risks such as impaired circulation and potential for hypoglycemia, a young person with diabetes is likely to have better physiological reserves and self-management capacity compared to an older malnourished adult. Unless the diabetes is uncontrolled or complicated by comorbidities, it does not present the most immediate threat in freezing conditions.
Choice C reason: Being hit by a car three weeks ago may suggest lingering injuries, but without acute symptoms such as open wounds, fractures, or neurological deficits, this person is less likely to be in immediate danger. The absence of current trauma or infection reduces the urgency for shelter prioritization.
Choice D reason: Hypertension is a chronic condition that, while serious, does not inherently increase risk of death from cold exposure in the short term. Unless accompanied by complications such as heart failure or stroke, it does not warrant prioritization over acute physiological compromise like malnutrition in an elderly person.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A reason: While understanding the living conditions may help assess crowding and potential environmental risks, it does not directly address the acute symptoms the client is experiencing. It is a secondary concern compared to identifying a toxic exposure.
Choice B reason: Work hours and rest breaks are relevant for assessing heat exhaustion or fatigue, but they do not explain the constellation of symptoms including abdominal cramps and respiratory difficulty. These symptoms suggest a toxicological cause.
Choice C reason: Lead exposure can cause neurological and gastrointestinal symptoms, but it typically presents with chronic issues rather than acute respiratory distress. The symptoms described are more consistent with pesticide toxicity, which is common among agricultural workers.
Choice D reason: Pesticide exposure is a high-priority concern in migrant farm workers due to frequent contact with chemicals. The symptoms—dizziness, headaches, abdominal cramps, and difficulty breathing—are hallmark signs of organophosphate or carbamate poisoning. Immediate assessment and intervention are critical.
Correct Answer is D
Explanation
Choice A reason: Scheduled immunizations are administered using sterile technique and do not transmit disease. Vaccines are designed to prevent illness, not cause it, and are not a source of vertical transmission.
Choice B reason: Spoiled baby food may cause foodborne illness, but this is considered horizontal transmission. Vertical transmission refers to disease passed from mother to child during pregnancy, childbirth, or breastfeeding.
Choice C reason: Mosquito bites are a form of horizontal transmission and are not relevant to vertical transmission. Diseases like malaria or Zika may be transmitted this way, but not from mother to child directly.
Choice D reason: Breastfeeding is a known route of vertical transmission for certain infections such as HIV and cytomegalovirus. The nurse should investigate maternal health status and potential infectious exposures to determine the source of transmission.
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