# A community health nurse is the first responder at a bus crash with 15 injured people. Emergency medical services are delayed, and supplies are limited. Which client should the nurse attend to first?

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=505776&lang=en  
> language: en  
> subject: Management of Care  
> category: MOC

## Question

A community health nurse is the first responder at a bus crash with 15 injured people. Emergency medical services are delayed, and supplies are limited. Which client should the nurse attend to first?

## Option

1. A 10-year-old child with a deformed right forearm, crying and holding the arm.
2. A 30-year-old adult with a penetrating chest wound, tachypnea, and leftward tracheal deviation. **✔ Correct answer**
3. A 40-year-old adult with a head laceration, alert, and walking around the scene.
4. A 60-year-old adult with burns to both lower legs, moaning in pain.

**Correct answer: 2**

## Explanation

The client with a penetrating chest wound, tachypnea, and tracheal deviation likely has a tension pneumothorax, which is an immediate life-threatening condition requiring urgent decompression. This client is classified as emergent (red tag) in mass-casualty triage and must be treated first to prevent death. The child with a deformed forearm has a non-life-threatening injury (yellow tag) and can wait. The adult with a head laceration who is alert and walking has a minor injury (green tag) and is the lowest priority. The adult with lower leg burns is in pain but has no immediate airway or breathing compromise (yellow tag), so care can be delayed.

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