A child is brought into the emergency department. After assessing a child's airway, breathing and circulation (ABCs), which of the following would the nurse do next?

Choice A rationale Obtaining a full set of vital signs is a crucial part of the secondary assessment, but it follows the primary assessment (ABCs) and the initial rapid assessment of neurological status (AVPU or level of consciousness). The priority immediately after ensuring ABCs is to determine the child's immediate neurological status and responsiveness, which guides subsequent interventions for stabilizing the child. Choice B rationale While pain management is extremely important and should be addressed promptly, it is not the immediate priority following the primary ABC assessment. Assessing the level of consciousness (D in the 'ABCDE' trauma/emergency assessment) is the next vital step, as changes in neurological status can indicate immediate life threats like intracranial pressure or hypoxia. Choice C rationale Removing the child's clothing (Exposure in the 'ABCDE' approach) is performed to conduct a full physical examination and check for injuries, but it must be done after the immediate life threats (ABCs and initial Disability/LOC) are addressed. This step is also crucial for preventing hypothermia, making temperature regulation important after exposure, but not the first step after ABCs. Choice D rationale Assessing the level of consciousness (LOC) is the essential next step after the primary survey (Airway, Breathing, Circulation) in pediatric emergency care, corresponding to the 'D' (Disability) in the ABCDE approach. A rapid assessment, often using the AVPU scale (Alert, Voice, Pain, Unresponsive), provides an immediate gauge of the child's neurological function and helps detect life-threatening issues like hypoxia or severe hypoglycemia.