During the primary assessment of a semiconscious 70-year-old female, you should:

• A. ensure a patent airway and support ventilation as needed.
• B. ask family members if the patient has a history of stroke.
• C. immediately determine the patient's blood glucose level.
• D. insert a nasopharyngeal airway and assist ventilations.

Answer: (A)

The main idea is that the first priority in a primary assessment is to secure the airway and ensure the patient is ventilating. A semiconscious patient is at high risk for airway obstruction from the tongue or secretions and for aspiration due to reduced protective reflexes, so you must act to keep the airway open and support breathing. This means positioning to open the airway, suctioning as needed, and providing oxygen or rescue breaths if the patient isn’t breathing adequately. Other tasks like asking about stroke history or checking blood glucose are important but come after you’ve addressed the immediate threat to life: airway and breathing. An airway adjunct like a nasopharyngeal airway isn’t the first move; it’s something you consider after you’ve secured the airway and determined ventilation status, and only if there are no contraindications.