A nurse is working in the ER when a patient is brought in by ambulance after a motor vehicle accident. The patient has a neck brace in place and has blood on the face and down the torso. The patient is breathing and has a pulse that is rapid but palpable. The nurse knows the next intervention should be which of the following? 

Explanation

• In trauma patients, the first action is to secure the neck to prevent any injury to the cervical spine.

• If the patient is breathing, the level of consciousness should be determined next by asking simple questions such as name and birthday while checking the pupils for responsiveness.

• IV access should already be established if the patient is brought in by ambulance. If no IV is in place, at this point the nurse should insert one.

• Vital signs should be obtained after the patient is situated and assessment has begun.

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