A patient with a suspected gastrointestinal bleed is admitted to the emergency department. The patient presents with hypotension, tachycardia, and black tarry stools, which initial intervention should the nurse prioritize?

Rationale: A. Incorrect because while an NG tube can help determine the source of upper gastrointestinal bleeding, it is not the priority intervention. The patient is showing signs of hemodynamic instability (hypotension, tachycardia), which must be addressed first. B. Correct because the patient exhibits signs of hypovolemic shock due to blood loss (hypotension, tachycardia). Restoring circulating volume with IV fluids is the priority to maintain tissue perfusion and prevent organ failure. According to the ABCs of emergency care, stabilizing circulation takes precedence over diagnostic procedures or medications. C. Incorrect because PPIs help reduce gastric acid and stabilize clot formation but are not emergent interventions for life-threatening hypovolemia. Acid suppression is secondary to hemodynamic stabilization. D. Incorrect because while endoscopy is important for diagnosis and treatment of a GI bleed, the patient must first be stabilized. Performing an invasive procedure on a hemodynamically unstable patient increases risk of complications.