Which trauma patient should the nurse prioritize as needing emergent treatment FIRST, assuming no other injuries are present except the ones outlined below?

A patient with a blunt chest trauma without difficulty breathing

A patient with a sore neck who was immobilized in the field on a backboard with a cervical collar

A patient with a possible fractured tibia with adequate pedal pulses

A trauma patient with hypovolemic shock

Answer and Explanation

The Correct Answer is D

Rationale:
A. A patient with blunt chest trauma who is breathing adequately is stable at the moment. While ongoing assessment is necessary, there is no immediate life-threatening compromise in airway, breathing, or circulation.

B. A patient with a sore neck who is properly immobilized has a potential cervical spine injury. The collar and backboard provide stabilization, reducing immediate risk of spinal cord injury. Although careful monitoring is required, this patient is not in immediate life-threatening danger.

C. A patient with a possible fractured tibia and adequate pedal pulses has a limb injury that, while painful, is not life-threatening. Neurovascular assessment and fracture management are important but not emergent in comparison to shock.

D. A trauma patient with hypovolemic shock is the priority because shock represents inadequate perfusion of vital organs. If untreated, hypovolemic shock can rapidly lead to organ failure and death. Immediate interventions such as fluid resuscitation and monitoring of vital signs are essential to preserve life.

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Correct Answer is C

Explanation

Rationale:
A. Administer morphine sulfate 4 mg IV is incorrect as the first intervention because while pain management is important, severe hypotension takes priority. Administering opioids before stabilizing blood pressure could worsen hypotension and perfusion.

B. Give acetaminophen (Tylenol) 650 mg is incorrect because fever reduction is secondary to stabilizing circulation. Acetaminophen does not address the patient’s life-threatening hypotension.

C. Infuse normal saline bolus is correct because the patient is hypotensive (BP 82/40), indicating circulatory compromise, which requires immediate fluid resuscitation to restore perfusion to vital organs. In the context of possible DIC, hypotension may reflect sepsis or ongoing hemorrhage, making fluid resuscitation the first priority according to the ABCs and primary survey principles.

D. Draw complete blood count and coagulation studies is incorrect as the first intervention because while laboratory evaluation is important to confirm DIC and guide treatment, it does not immediately address life-threatening hypotension. Labs can be drawn after initial stabilization.

A. Slow the IV infusion rate B. Administer dopamine C. No interventions are needed at this time D. Increase the IV infusion rate

Correct Answer is D

Explanation

Rationale:
A. Slowing the IV infusion rate would be inappropriate in this situation. The patient’s low CVP, hypotension, flat jugular veins, and clear lung sounds all indicate hypovolemia rather than fluid overload. Reducing fluids would worsen tissue perfusion and shock.
B. Administering dopamine, a vasopressor, is not the first-line intervention in this case. Vasopressors are typically considered after adequate fluid resuscitation has been attempted. Because this patient shows clear signs of volume depletion, correcting hypovolemia with fluids is the priority before initiating medications to support blood pressure.
C. No intervention is not appropriate. The patient is hypotensive (90/50 mmHg) with a low CVP (normal is approximately 2–6 mmHg), indicating inadequate circulating volume. Without intervention, the patient is at risk for worsening shock and organ hypoperfusion.
D. Increasing the IV infusion rate is the most appropriate action. Hemorrhagic pancreatitis can cause significant third-spacing and fluid loss, leading to hypovolemic shock. A low CVP, hypotension, flat neck veins, and clear lung sounds all support the need for aggressive fluid resuscitation to restore intravascular volume and improve perfusion.

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Which trauma patient should the nurse prioritize as needing emergent treatment FIRST, assuming no other injuries are present except the ones outlined below?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A patient with possible disseminated intravascular coagulation arrives in the emergency department with a blood pressure of 82/40, temperature 102° F (38.9° C), and severe back pain. Which physician order will the nurse implement first?

Correct Answer is C

Explanation

The healthcare provider is caring for a patient with a diagnosis of hemorrhagic pancreatitis. The patient's central venous pressure (CVP) reading is 2, blood pressure is 90/50 mmHg, lung sounds are clear, and jugular veins are flat. Which of these actions is most appropriate for the nurse to take?

Correct Answer is D

Explanation

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A patient is experiencing respiratory insufficiency and cannot maintain spontaneous respirations. The nurse suspects that the physician will perform which of the following actions?

A critical care nurse is planning assessments in the knowledge that patients in shock are vulnerable to developing fluid replacement complications. For what signs and symptoms should the nurse monitor the patient? Select all that apply.

A patient is admitted to the ED after being involved in a motor vehicle crash. The patient has multiple injuries. After establishing an airway and adequate ventilation, the ED team should prioritize what aspect of care?

A patient who has been involved in a motor-vehicle crash is admitted to the ED with cool, clammy skin, tachycardia, and hypotension. All of these orders are written. Which one will the nurse act on first?

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