外科病房護理師評估湧入的創傷出血病患。哪一位病患要求最第一位的快速臨床介入？
A surgical unit nurse evaluates a sudden influx of heavily bleeding trauma clients. Which client demands the very first rapid clinical intervention?
- AA client displaying an extensive mid-shaft femur fracture with a newly observed rigid, board-like abdomen.✓ 正解一位顯示出廣泛性股骨中段骨折且新近觀察到腹部僵硬如木板狀的客戶。
- BA client possessing a gaping jagged forearm laceration packed securely with sterile gauze.一位擁有 gaping jagged forearm laceration 且已用無菌紗布安全填塞的客戶。
- CA client presenting with a simple closed right tibial fracture crying aggressively for pain relief.一位呈現單純性右脛骨閉鎖性骨折且因疼痛而激烈哭喊的客戶。
- DA client 1 hour post-closed-reduction of a dislocated shoulder who complains of localized tingling in the fingers.一位在肩關節脫臼閉合復位後1小時抱怨手指局部刺痛感的客戶。
本題考驗護理師在多重創傷病患湧入時，判斷緊急優先順序的能力。核心概念是識別危及生命的內出血徵兆。在創傷情境中，內出血可能迅速導致低血容積性休克（hypovolemic shock），進而危及生命。腹部僵硬如木板（rigid, board-like abdomen）是腹膜炎（peritonitis）或腹腔內大量出血的典型徵兆，這表示腹腔內有嚴重病變，需要立即的醫療介入。此狀況下，病患的生命徵象可能快速惡化，因此優先順序最高，必須立即評估並準備手術。
A rigid, board-like abdomen suggests catastrophic intra-abdominal hemorrhage or peritonitis, indicating immediate life-threatening instability requiring urgent surgical intervention. While other options involve injuries, they represent controlled external bleeding, manageable pain, or non-systemic neurological symptoms that do not pose the same immediate risk of hypovolemic shock.
肚子硬如洗衣板/木板是內出血經典考點，一看到就是第一順位。