Difficulty: Medium
Average Score: 93%
Simulated
A nurse is triaging clients following a mass casualty event. Which of the following clients should the nurse assess first?
Correct answer
D
Rationale
The correct answer is D: A client who has severe respiratory stridor and a deviated trachea. This client should be assessed first because stridor indicates airway obstruction, which can rapidly progress to respiratory failure. A deviated trachea suggests a possible tension pneumothorax, a life-threatening condition requiring immediate intervention to prevent further deterioration. Assessing and managing the airway takes priority over other injuries.
Incorrect choices:
A: A small circular partial-thickness burn of the left calf is a lower priority as it does not pose an immediate threat to life compared to airway compromise.
B: A massive head injury with seizures is serious but managing the airway is the priority in this scenario.
C: A splinted open fracture of the left medial malleolus is important but does not pose an immediate threat to life compared to airway and breathing concerns.
Incorrect choices:
A: A small circular partial-thickness burn of the left calf is a lower priority as it does not pose an immediate threat to life compared to airway compromise.
B: A massive head injury with seizures is serious but managing the airway is the priority in this scenario.
C: A splinted open fracture of the left medial malleolus is important but does not pose an immediate threat to life compared to airway and breathing concerns.