The registered nurse working in a COVID-19 triage unit reads vital signs taken by the patient care technician (PCT). Which patient should the nurse assess first?

Mr. Grey: T 37.3 °C P 96 R 18 BP 138/90 02 Sat 97%

Mr. Silver: T 37.4 °C P 108 R 14 BP 102/74 02 Sat 95%

Mr. Green: T 36.8 °C P 96 R 28 BP 118/68 02 Sat 92%

Mr. Brown: T 38 °C P 100 R 16 BP 120/78 02 Sat 99%

Answer and Explanation

The Correct Answer is C

COVID-19 triage prioritization relies on identification of respiratory compromise, hypoxemia, and increased work of breathing caused by viral pneumonia leading to impaired alveolar gas exchange, ventilation-perfusion mismatch, and acute hypoxic respiratory failure requiring immediate escalation of care.

Rationale:

A. Stable oxygen saturation of 97% indicates adequate gas exchange with no hypoxemia present. Respiratory rate is within normal limits suggesting no increased work of breathing. Hemodynamic parameters are stable without evidence of shock or deterioration. This patient does not require immediate priority assessment.

B. Tachycardia at 108 beats per minute may indicate early physiological stress or mild dehydration. Oxygen saturation remains acceptable at 95% without significant hypoxemia. Respiratory rate is normal, suggesting no acute respiratory compromise. This patient is not the highest priority.

C. Tachypnea at 28 breaths per minute indicates increased work of breathing and respiratory distress. Oxygen saturation of 92% reflects hypoxemia consistent with impaired alveolar oxygen exchange. This combination suggests potential acute respiratory deterioration requiring immediate assessment and intervention as highest priority.

D. Fever of 38 °C indicates infectious or inflammatory response consistent with viral illness. Oxygen saturation is 99%, showing adequate oxygenation at present. Respiratory rate and hemodynamics are stable without distress. This patient is clinically stable compared to others and not urgent.

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

Explanation

Pediatric unilateral hearing reduction commonly results from external auditory canal obstruction leading to impaired sound wave transmission to the tympanic membrane, producing conductive hearing loss due to mechanical blockage rather than cochlear or neural dysfunction processes.

Rationale:

A. Cerumen impaction involves accumulation of hardened earwax obstructing the external auditory canal. It can reduce hearing but does not specifically describe a visible bright green object. This condition is common but does not confirm foreign material presence. Therefore it is not the best match here.

B. Presbycusis is age-related degenerative hearing loss affecting elderly patients due to cochlear hair cell degeneration. It does not occur in kindergarten-aged children. It is a bilateral progressive sensorineural process unrelated to acute unilateral obstruction or visible foreign object in ear canal.

C. Sensorineural hearing loss results from cochlear or vestibulocochlear nerve damage affecting sound processing. It is not caused by visible external objects in the ear canal. There is no mechanical obstruction visible on inspection. Therefore it does not match the clinical finding described.

D. Conductive hearing loss occurs when sound transmission is blocked in external or middle ear structures. A visible foreign object obstructing the canal directly prevents sound conduction. This produces unilateral hearing loss consistent with reported symptoms in pediatric patients.

E. Foreign body obstruction is presence of external object in ear canal causing mechanical blockage. Bright green object strongly indicates inserted material such as toy fragment. This leads to acute unilateral hearing loss and is common in children due to exploratory behavior.

A. Sudden vision loss B. More common in young people C. Excessive exposure to UV light is a risk factor D. Cloudiness in the lens of the eye

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

Explanation

Cataracts involve progressive opacification of the crystalline lens, often stemming from oxidative stress and protein aggregation. This degenerative process causes light scattering, leading to painless visual impairment, decreased contrast sensitivity, and myopic shifts in refractive error.

Rationale:

A. Cataracts are characterized by a gradual, progressive decline in visual acuity rather than an acute event. Sudden vision loss is more indicative of retinal detachment or vascular occlusions. This condition typically manifests over months or years as protein denaturation increases.

B. This ocular pathology is primarily an age-related condition resulting from cumulative environmental exposure and metabolic changes. While congenital forms exist, the vast majority of cases occur in the geriatric population due to lenticular fiber compaction and hardening.

C. Chronic, unprotected exposure to ultraviolet radiation induces photochemical damage and free radical production within the lens. These stressors accelerate the cross-linking of crystallin proteins, making UV protection a critical preventative measure for ocular health and longevity.

D. The primary pathophysiology involves the loss of lens transparency, which appears as a visible milky opacity upon examination. This physical change disrupts the path of light to the retina, resulting in the classic symptom of blurred vision and glare.

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The registered nurse working in a COVID-19 triage unit reads vital signs taken by the patient care technician (PCT). Which patient should the nurse assess first?

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Explanation

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