In the assessment of a client with chest injury, which action best reflects the breathing assessment within the primary survey?

• A. Palpate for edema
• B. Auscultate for bowel sounds
• C. Examine the neck for stiffness
• D. Observe the rate, depth, and effort of breathing

Answer: (D)

Breathing assessment in the primary survey is about quickly judging ventilation by watching the chest and noting the rate, depth, and effort of breathing. This immediate observation tells you if ventilation is adequate and whether there are signs of distress or airway/ chest problems that require prompt intervention, such as chest injuries or obstruction. Edema palpation relates to circulation and perfusion, not ventilation. Listening for bowel sounds is unrelated to breathing in a chest injury, and examining the neck for stiffness is a neurological/ cervical-spine concern. Focusing on rate, depth, and effort provides the clearest, fastest snapshot of how well the client is ventilation, guiding urgent actions if needed.