Emergency and Disaster Nursing

A patient who experienced blunt abdominal trauma during a motor vehicle collision reports increasing abdominal pain. For which procedure would thenurse expect to prepare thepatient? a. Peritoneal lavage b. Abdominal ultrasonography c. Nasogastric (NG) tube placement d. Magnetic resonance imaging (MRI)

B

A patient who is unconscious after a fall from a ladder is transported to theemergency department by emergency medical personnel. Which action would thenurse complete during theprimary survey of thepatient? a. Obtain a complete set of vital signs. b. Check a Glasgow Coma Scale score. c. Attach an electrocardiogram monitor. d. Ask about chronic medical conditions.

B

A triage nurse in a busy emergency department (ED) assesses a patient who reports 7/10 abdominal pain and states, ―I had a temperature of 103.9F (39.9C) at home.‖ Which action would thenurse take first? a. Administer acetaminophen (Tylenol). b. Assess thepatient's current vital signs. c. Ask thepatient to provide a clean-catch urine for urinalysis. d. Tell thepatient that it may be 2 hours before seeing a health care provider.

B

Gastric lavage and administration of activated charcoal are prescribed for an unconscious patient who has been admitted to theemergency department (ED) after ingesting 30 lorazepam (Ativan) tablets. Which prescribed action would thenurse plan to take first? a. Insert a large-bore orogastric tube. b. Assist with endotracheal intubation. c. Prepare a 60-mL syringe with saline. d. Give first dose of activated charcoal.

B

The following interventions are part of theemergency department (ED) protocol for a patient who has been admitted with multiple bee stings to thehands. Which action would thenurse take first? a. Apply ice packs to both hands. b. Attempt to remove thepatient's rings. c. Apply calamine lotion to itching areas. d. Give prescribed diphenhydramine (Benadryl).

B

The nurse is doing theprimary survey of an adult who was in a motor vehicle collision. After thenurse determines that thepatient has an unobstructed airway, which action would thenurse take next? a. Palpate extremities for bilateral pulses. b. Observe thepatient's respiratory effort. c. Check thepatient's level of consciousness. d. Examine thepatient for external bleeding.

B

A patient arrives in theemergency department (ED) after topical exposure to powdered lime at work. Which action would thenurse take first? a. Obtain thepatient's vital signs. b. Obtain a baseline complete blood count. c. Brush visible powder from theskin and clothing. d. Decontaminate thepatient by showering with water.

C

A patient who had a cardiac arrest has been resuscitated and therapeutic hypothermia is prescribed. Which action will thenurse include in theplan of care? a. Hold theprescribed sedative drugs. b. Check mental status every 15 minutes. c. Initiate protocol for temperature management. d. Rewarm if temperature is below 91F (32.8C).

C

A patient who has deep human bite wounds on theleft hand is being treated in theurgent care center. Which action will thenurse plan to take? a. Prepare to administer rabies immune globulin. b. Assist thehealth care provider with suturing thewounds. c. Teach thepatient about theuse of prophylactic antibiotics. d. Keep thewounds dry until thehealth care provider can assess them.

C

A patient with hypotension and an elevated temperature after working outside on a hot day is treated in theemergency department (ED). Which patient statement indicates to thenurse that discharge teaching has been effective? a. ―I'll take salt tablets when I work outdoors in thesummer.‖ b. ―I should take acetaminophen (Tylenol) if I start to feel too warm.‖ c. ―I need to drink extra fluids when working outside in hot weather.‖ d. ―I'll move to a cool environment if I notice that I'm feeling confused.‖

C

Family members are in the patient's room when the patient has a cardiac arrest and the staff start resuscitation measures. Which action would the nurse take first? a. Keep the family in the room and assign a staff member to explain the care given and answer questions. b. Ask the family to wait outside the patient's room with a staff member to provide emotional support. c. Ask thefamily members whether they would prefer to remain in thepatient's room or wait outside theroom. d. Tell the family members that patients are comforted by having family members present during resuscitation efforts.

C

The emergency department (ED) triage nurse is assessing four victims involved in a motor vehicle collision. Which patient requires themost immediate treatment? a. A patient with no pedal pulses b. A patient with an open femur fracture c. A patient with paradoxical chest motion d. A patient with bleeding facial lacerations

C

A 19-yr-old patient presents to theemergency department (ED) with multiple lacerations and tissue avulsion of theleft hand. thepatient denies having any previous vaccinations. What would thenurse anticipate administering? a. Tetanus immunoglobulin (TIG) only b. TIG and tetanus-diphtheria toxoid (Td) c. Tetanus-diphtheria toxoid and pertussis vaccine (Tdap) only d. TIG and tetanus-diphtheria toxoid and pertussis vaccine (Tdap)

D

A 22-yr-old patient who experienced a drowning accident in a local pool, but now is awake and breathing spontaneously, is admitted for observation. Which assessment will be most important for thenurse to take during theobservation period? a. Assess heart sounds. b. Palpate peripheral pulses. c. Check mental orientation. d. Auscultate breath sounds.

D

During theprimary survey of a patient with severe leg trauma, thenurse observes that thepatient's left pedal and posterior tibial pulses are absent, and theentire leg is swollen. Which action will thenurse take next? a. Send blood to thelab for a complete blood count. b. Assess further for a cause of thedecreased circulation. c. Finish theairway, breathing, circulation, disability survey. d. Start normal saline fluid infusion with two large-bore IV lines.

D

Which finding indicates that thenurse should discontinue active rewarming of a patient admitted with hypothermia? a. The patient begins to shiver. b. The BP decreases to 86/42 mm Hg. c. The patient develops atrial fibrillation. d. The core temperature is 94F (34.4C).

D

A patient arrives in theemergency department (ED) several hours after taking ―25 to 30‖ acetaminophen (Tylenol) tablets. Which action will thenurse plan to take? a. Administer N-acetylcysteine. b. Prepare for chelation therapy. c. Start oxygen using a non-rebreather mask. d. Have thepatient drink large amounts of water.

A

An unresponsive 79-yr-old patient is admitted to theemergency department (ED) during a summer heat wave. thepatient's core temperature is 105.4F (40.8C), blood pressure (BP) is 88/50 mm Hg, and pulse is 112 beats/min. Which action would thenurse plan to take? a. Apply wet sheets and a fan to thepatient. b. Provide O2 at 2 L/min with a nasal cannula. c. Start lactated Ringer's solution at 1000 mL/hr. d. Give acetaminophen (Tylenol) rectal suppository.

A

An unresponsive patient is admitted to theemergency department (ED) after falling through theice while ice skating. Which assessment will thenurse obtain first? a. Pulse b. Heart rhythm c. Breath sounds d. Body temperature

A

Following an earthquake, patients are triaged by emergency medical personnel and transported to theemergency department (ED). Which color tag indicates that thenurse need to assess that patient first? a. Red b. Blue c. Black d. Yellow

A

The emergency department (ED) nurse is requested to plan for a response to thepotential use of smallpox as a biological weapon. Which resource would thenurse recommend be obtained? a. Vaccine b. Atropine c. Antibiotics d. Whole blood

A

The urgent care center protocol for tick bites includes thefollowing actions. Which action will thenurse take first when caring for a patient with a tick bite? a. Use tweezers to remove any remaining ticks. b. Check thevital signs, including temperature. c. Give doxycycline (Vibramycin) 100 mg orally. d. Obtain information about recent outdoor activities.

A

Which interventions will the nurse plan for a comatose patient who will have targeted temperature management/therapeutic hypothermia? (Select all that apply.) a. Assist with endotracheal intubation. b. Insert an indwelling urinary catheter. c. Begin continuous cardiac monitoring. d. Prepare to give sympathomimetic drugs. e. Obtain a prescription for patient restraints.

A,B,C

When assessing an older patient admitted to theemergency department (ED) with a broken arm and facial bruises, thenurse observes several additional bruises in various stages of healing. Which statement or question would thenurse provide first? a. ―You should not go home.‖ b. ―Do you feel safe at home?‖ c. ―Would you like to see a social worker?‖ d. ―I need to report my concerns to thepolice.‖

B

The emergency department (ED) nurse is starting targeted temperature management/therapeutic hypothermia in a patient who has been resuscitated after a cardiac arrest. Which actions in thehypothermia protocol can be delegated to an experienced licensed practical/vocational nurse (LPN/VN)? (Select all that apply.) a. Evaluate changes in heart rhythm. b. Insert a urinary catheter to drainage. c. Assess neurologic status every 2 hours. d. Place cooling blankets above and below patient. e. Attach rectal temperature probe to cooling blanket control panel.

B,D,E