The nurse working in the emergency department is triaging a 65-year-old female client from a mass casualty motor vehicle crash. The client arrives ambulatory by ambulance and is complaining of a headache and neck pain. She is awake, alert, and oriented, and follows commands appropriately. What START triage level would be assigned to this client?

Choice A reason: This statement is incorrect because a mass casualty event refers to an incident that results in a large number of casualties, overwhelming the local healthcare system. A fight between visitors in the emergency department, although potentially serious, would not constitute a mass casualty event.

Choice B reason: This statement is incorrect because mass casualty events typically require a significant increase in the number of staff to manage the influx of patients and provide adequate care. Staffing levels are often augmented to ensure that the medical response can meet the demands of the situation.

Choice C reason: This statement is incorrect because mass casualty events are not limited to occurring within healthcare facilities. They can happen anywhere, such as at public events, natural disasters, or terrorist attacks, and involve a large number of casualties that overwhelm local medical resources.

Choice D reason: This statement is correct and does not indicate a need for further teaching. A mass casualty event is indeed characterized by overwhelming local medical capabilities, necessitating additional resources and support.

Choice E reason: This statement is correct and does not indicate a need for further teaching. Mass casualty events often require collaboration among multiple local agencies, such as emergency services, law enforcement, and healthcare providers, to effectively manage the situation.

Choice A reason: A heart rate of 104 bpm can be expected in a client with pneumonia and after suctioning. Tachycardia (elevated heart rate) can occur as a response to infection, stress, or the suctioning procedure itself. While it should be monitored, it is not the most critical finding.

Choice B reason: A tympanic temperature of 102.6°F (39.2°C) is unexpected and indicates a significant fever, which may suggest a worsening infection or sepsis. This finding requires immediate attention as it could indicate that the current treatment for pneumonia is not effective, and the client's condition may be deteriorating.

Choice C reason: A blood pressure of 158/90 mmHg, though elevated, may be less critical in the context of this client's condition. Hypertension can occur due to various factors, including stress and illness, and should be monitored but is not the most urgent priority compared to a high fever.

Choice D reason: A respiratory rate of 24 breaths/min is slightly elevated but can be expected in a client with pneumonia and after suctioning. This rate indicates mild tachypnea, which should be monitored but is not as immediately concerning as a high fever.