An unconscious teenager is treated in the emergency department. The teenager's friends suspect a rape occurred at a party. Priority action by the nurse should focus on:
a. preserving rape evidence.
b. maintaining physiologic stability.
c. determining what drugs were ingested.
d. obtaining a description of the rape from a friend.
ANS: B
Because the patient is unconscious, the risk for airway obstruction is present. The nurse's priority will focus on maintaining physiologic stability. The distracters are of lower priority than preserving physiological functioning.
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