The nurse in the emergency department is performing a primary assessment on a patient who has sustained significant burn injuries. Which of the following physical assessments does the nurse include in the primary survey?

The nurse is assigned to a patient with malignant hypertension. The patient acutely develops mid-sternal “tearing” chest pain that radiates to the back. Which of the following additional clinical signs is most likely to be present in this patient?

The nurse finds a 70-year-old client admitted with heart failure, unresponsive with agonal gasping respirations. Which action does the nurse take first?