護理師正在照護一組病人，應優先評估哪一位？
A nurse is caring for a group of clients. Which client should the nurse see first?
- AA client post-op following a hip arthroplasty reporting pain level 6 out of 10接受髖關節置換術後報告疼痛程度為 10 分中的 6 分的病人
- BA client with COPD reporting a sudden increase in sputum production✓ 正解慢性阻塞性肺病（COPD）病人報告痰液產生量突然增加
- CA client with type 1 diabetes reporting a blood glucose of 70 mg/dL第一型糖尿病病人報告血糖為 70 mg/dL 的病人
- DA client with heart failure complaining of 1+ pitting edema in the ankles心衰竭病人抱怨腳踝有 1+ 凹陷性水腫的病人
依 ABC（Airway, Breathing, Circulation）優先原則，呼吸相關問題優於代謝/循環/疼痛。D. COPD 病人「痰量突然增加」可能表示急性感染或惡化，會威脅呼吸道與通氣，需優先評估。其他選項：C. 血糖 70 mg/dL 為正常下限（多數教科書 70-99 為正常），未提及低血糖症狀，不屬於急；B. 1+ 踝部凹陷性水腫為心衰竭穩定徵象；C. 髖關節置換術後疼痛 6/10 需處理但非威脅生命。
According to the ABC (Airway, Breathing, Circulation) priority framework, respiratory issues take precedence over metabolic, circulatory, or pain-related concerns. D. A sudden increase in sputum production in a COPD client may indicate acute infection or exacerbation, threatening the airway and ventilation, and therefore must be assessed first. Other options: A. A blood glucose of 70 mg/dL is at the lower limit of normal (most textbooks consider 70-99 normal); without symptoms of hypoglycemia, this is not urgent; B. 1+ pitting ankle edema is a stable finding in heart failure; C. Postoperative pain of 6/10 after hip arthroplasty requires management but does not threaten life.
美台護理臨床皆採用優先級排序（Triage），但在分秒必爭的照顧下，對於低血糖的處理 SOP 均需立即介入。