prioritization

[cardiaccancer29]

who will you prioritize in the ER? with rationale

a. patient with asthma and DHF

b. patient with preterm labor

c. patient with head wound with excessive bleeding unconscious

thanks!

[jjjoy, LPN]

one of my friends said that it is C its ok with me but i can't accept his rationale, that if we are going to perform CPR we ask the patient, first if he is ok and that is his reason for answering letter C, he said since the patient is unconscious with excessive bleeding,

Ugh, that's why I hate vaguely written NCLEX-style "no-'right'-just-'best'" answer questions. It seems all too easy for someone to choose the correct answer using faulty logic or inaccurate knowledge and all too easy to choose a "good-but-not-best' answer based on good logic, solid knowledge but 'reading too much' into a question.

Seriously, if you were *looking* at a patient with known asthma, you'd immediately be able to see whether or not they were having difficulty breathing - so why not state their breathing is good in the question if that's the case?! Since it would appear that the nurse in question hasn't yet assessed the patients herself, how does the nurse in this scenario even know that the patient has asthma? Did a colleagues tell her "pt has asthma" without any further description and the nurse in question didn't ask for more info? And who assessed that the other patient was "unconscious" with "excessive bleeding"? Can we trust this person's assessment? After all, pt A info appears to be rather incomplete.

That may be 'reading too much into the question' but don't we want students to be thinking that in depth as opposed to "it says 'asthma' not 'breathing difficulty' so best answer is 'C'"?

And what IS "DHF" referring to?

[RaziRN]

I think DHF is decompensated heart failure? I could be wrong but that's my best guess.

OP, what was the right answer?

I'm curious to know as I'm a new grad and think it's important to work on prioritization even though I'm not in the ER setting.

I wouldv'e gone with C becauase pt, is bleeding and unconscious. Do they have a pulse and an adequate airway? Pt. in A has asthma but that doesn't mean he's having an exacerbation at the moment.

I'm SO glad that I've passed the NCLEX already!