ED ACADEMY FINAL

patient has nausea, vomiting, sedation, increased deep tendon reflexes, and muscle weakness. The emergency nurse suspects what electrolyte imbalance

Hypomagnesemia

When initiating treatment for a patient with a snakebite, the emergency nurse should perform which intervention?

Immobilize the affected limb.

3-year-old patient presents with epistaxis, hematuria, and petechia. The emergency nurse suspects what disorder?

Immune thrombocytopenic purpura

Which assessment finding would be apparent in a patient with a ruptured Achilles tendon?

Inability to plantar flex the foot.

emergency nurse administers the prescribed dobutamine (Dobutrex) to a patient in pulmonary edema. Which finding is a difect indication that the dobutamine is having the desired effect

Increased contractility

When assessing a patient with a cluster headache, the emergency nurse should expect the patient to complain of which symptom?

Intense unilateral pain in the temporal region

Which characteristic would EXCLUDE a patient with an ischemic stroke from receiving fibrinolytic therapy?

Intracranial hemorrhage within the last year

For a patient who sustained a wound from a dog bite, which intervention is most appropriate to cleanse the wound?

Irrigate using high-pressure irrigation.

When medicating a patient for pain, the emergency nurse recognizes which medication as having an analgesic ceiling effect?

Ketorolac (Toradol)

patient who has an untreated dental infection presents with swelling of the anterior and lateral neck with some difficulty breathing. the emergency nurse suspects what disorder

Ludwig angina

assessment of a child with measles, the emergency nurse should expect to note which type of rash?

Maculopapular

For a patient in status epilepticus, which intervention is the priority for the emergency nurse?

Maintain the patient's airway.

the pediatric population, seasonal flu virus causes which condition?

Mild respiratory illness

For a patient experiencing an inferior acute myocardial infarction, the emergency nurse should expect to initiate which intervention?

Monitor blood pressure frequently.

When caring for a trauma patient with a chest drainage system, the emergency nurse should perform which intervention?

Monitor the pattern of bubbling in the water seal chamber.

When assessing the heart tones of a patient with pericardial tamponade, the emergency nurse expects to hear which sound?

Muffled heart tones

middle-aged female patient presents with sudden onset of epigastric pain after eating. Which additional sign or symptom would you expect to assess in this patient

Murphy sign

patient with increased fatigue complains of double vision and droopy eyelids. The emergency nurse suspects what disorder?

Myasthenia gravis

For a patient with obstructive shock due to a tension pneumothorax, which intervention is the first priority for the emergency nurse

Needle decompress the chest.

For a patient with controlled external bleeding, which assessment is the first priority for the emergency nurse?

Patency of airway

When assessing a patient with dyspnea and unilateral chest pain, which factors should increase the emergency nurse's suspicion that this patient has a spontaneous pneumothorax

Patient is a smoker.

When assessing a pediatric patient with epiglottitis, which sign or symptom should cause the emergency nurse the most concern?

Patient is drooling.

child presents with fever and malaise. Which assessment finding should cause the emergency nurse the highest suspicion for bacterial meningitis

Petechiae that do not blanch

mother reports that her 4-week-old infant is always hungry but has projectile vomiting after feedings. The emergency nurse suspects what disorder?

Pyloric stenosis

When assessing a patient with acute pancreatitis, the emergency nurse should expect which description of pain by the patient?

Radiating to the back

Which finding should cause the emergency nurse to suspect septic shock in a patient with a fever and tachycardia?

Refractory hypotension

pediatric patients, which vein is commonly used for venous access?

Saphenous vein

When assessing a fernale patient with suspected syphilis, the emergency nurse should expect to facilitate which type of test?

Serology test

emergency nurse initiates the prescribed treatment for a patient with organophosphate exposure. Which finding indicates that this treatment is having its intended effect

Skin is decontaminated

first-trimester pregnant patient presents with severe abdominal cramping and heavy vaginal bleeding. The emergency nurse suspects which condition

Spontaneous abortion

For a patient who has been sexually abused, which intervention is the priority for the emergency nurse?

Stay with the patient.

For a patient presenting with chest pain which finding causes the emergency nurse to suspect unstable (preinfarction) angina?

T-wave inversion is present.

When approaching a family about the opportunity for organ donation of their loved one, the emergency nurse must first make sure which event has occurred?

The family is aware that the patient has died.

emergency nurse administers the prescribed norepinephrine (Levophed) to a patient in septic shock. Which measurement is the best indication that this medication is having the desired effect

The mean arterial pressure (MAP) is greater than 65 mm Hg

The emergency nurse performs needle decompression on a patient with a tension pneumothorax. Which finding is the best indication that this intervention is having its intended effect

The patient can suddenly breathe easier.

When triaging an alert patient brought by ambulance, the emergency nurse should document the chief complaint according to what standard or format?

The patient's own words

The emergency nurse administers the prescribed treatment for a patient experiencing an asthma exacerbation. Which finding is the best indication that the treatment is having its intended effect

The peak expiratory flow measurement improves

When assessing a patient with a peritonsillar abscess, the emergency nurse should expect to note which finding?

Thickened, muffled voice

patient's electrocardiogram shows a regular rhythm with an atrial rate of 80 beats per minute. P waves and QRS complexes are both present with no relationship to each other. the emergency nurse identifies which dysrhythmia?

Third-degree atrioventricular block

For a patient in diabetic ketoacidosis, the emergency nurse should administer what prescribed treatment first?

Two liters of intravenous normal saline

Diltiazem (Cardizem) would be indicated for a patient with which condition?

Uncontrolled atrial fibrillation

The emergency nurse prepares the prescribed lidocaine with epinephrine as a local anesthetic for wound closure. Which finding indicates that the epinephrine has achieved its intended purpose

Wound hemostasis occurs.

When caring for a patient with an amputation of the right second digit, the emergency nurse should prepare to do what with the severed part?

Wrap in saline-moistened gauze and place it in a plastic bag, and place the bag on top of crushed ice.

When assessing a patient with acute angle-closure glaucoma, the emergency nurse should expect to note which finding?

a fixed and slightly dilated pupil

For a patient with suspected tuberculosis, which intervention is the priority for the emergency nurse?

airborne precautions

Targeted temperature management is initiated for a patient with return of spontaneous circulation after cardiac arrest. The emergency nurse should expect to maintain the hypothermic state for how long after the resuscitation?

at least twenty-four hours

The emergency nurse initiates the prescribed treatment for a patient with a dissecting aortic aneurysm. Which condition indicates that this intervention is having the desired effect

blood pressure is controlled

When caring for a patient in cardiac arrest, which intervention should the emergency nurse initiate first?

chest compressions

For a hypotensive patient in hypovolemic shock, the emergency nurse should administer which bolus of intravenous fluid first?

crystalloid fluid

Which factor is most important for the emergency nurse to ask about when assessing a patient who presents with heartburn and regurgitation?

current med use

When assessing a patient for suicidal ideation, which question is most important for the emergency triage nurse to ask?

do you own a gun

To increase contractility and cardiac output for a patient with heart failure, the emergency nurse anticipates orders for which medication?

dobutamine (dobutrex)

A patient involved in a motor vehicle crash is complaining of chest pain. His cardiac monitor tracing demonstrates normal sinus rhythm with occasional premature ventricular complexes. the nurse should anticipate an order for which diagnostic procedure?

echocardiogram

When caring for a victim of a house fire who has 13 percent second degree burns to the arm, singed nasal hair, and restlessness, the emergency nurse should prepare for what initial intervention

endotracheal intubation

For a patient with a gunshot wound to the spleen, which intervention is the first priority for the emergency nurse?

establish vascular access

patient involved in a motor vehicle crash develops pain, difficulty breathing, and paradoxical chest wall motion. The emergency nurse suspects what disorder?

flail chest

patient who recently lost his job presents with mild agitation and vague symptoms of abdominal pain. The emergency nurse suspects what disorder

grief reaction

An athlete who has been running on a hot day presents with a temperature of 104 degrees F (40 degrees C). The patient is unable to dissipate heat to cool down. the emergency nurse suspects what condition

heat stroke

The emergency nurse administers the prescribed epinephrine (Adrenalin) to a patient with an anaphylactic reaction. Which finding is the best indication that this medication is having the desired effect

increased blood pressure

third trimester pregnant patient has frank vaginal bleeding and suspected abruptio placentae. Which prescribed procedure should be the first priority for the nurse

initiate a large-bore iv

emergency nurse administers the prescribed dose of mannitol (Osmitrol) for a head injured patient. Which finding indicates that this treatment is having its desired effect

intracranial pressure decreases

emergency nurse administers the prescribed beta blocker to a patient with a hyphema. Which finding indicates that this treatment is having the desired effect

intraocular pressure decrease

For a patient with chest pain and a history of gastrointestinal reflux disease (GERD), the emergency nurse should expect to initiate which action first?

obtain electrocardiogram

patient who fell has a deformed left forearm with a puncture wound at the site of the deformity. The emergency nurse should suspect what type of fracture?

open fracture

A patient has pinpoint pupils, respiratory depression, hypotension, and visual hallucinations. The emergency nurse suspects abuse of which substance?

opiates

patient complains of a fever and sternal chest pain that is worse when lying down. For this patient, the emergency nurse suspects which disorders?

pericarditis

When immediate reimplantation is not possible for an alert adult patient with a tooth avulsion, which is an appropriate intervention for the emergency nurse

place tooth in milk

When assessing the tissue damage from a gunshot wound to the abdomen, the emergency nurse should note which factor?

quadrant of abdominal wound

When assessing a patient with severe aspirin toxicity, the emergency nurse should expect which blood gas findings?

respiratory alkalosis and metabolic acidosis

Before discharging a patient with urinary calculi, the emergency nurse should teach the patient to avoid what food?

spinach

For a patient with a pulmonary embolus, the emergency nurse should initiate which prescribed treatment first?

supplemental oxygen

sixteen-year-old male patient complains of abdominal pain, nausea, and vomiting. The patient complains of increased pain when the scrotum is elevated. The emergency nurse suspects which disorder

testicular torsion

The emergency nurse initiates the prescribed intravenous nitroprusside sodium (Nipride) for a patient with hypertensive crisis. Which systolic blood pressure reading indicates that this medication is having its intended effect

160

When ordered to administer tissue plasminogen activator (tPA) to a 120-kilogram patient with an ischemic stroke, the emergency nurse prepare how many milligrams of the tPa

90 milligrams

According to the Emergency Medical Treatment and Active Labor Act (EMTALA), every patient who presents to the emergency department must be provided with which of the following

A medical screening exam

emergency nurse administers the prescribed treatment for a patient with hypokalemia. Which electrocardiogram changes indicate that this treatment is having its intended effect

Absence of U waves

For a patient with decompression sickness, the emergency nurse should expect to initiate which intervention?

Administer aspirin.

For a patient with an acute subdural hematoma, the emergency nurse should prepare to facilitate which intervention?

Administer propofol (Diprivan) and morphine, as prescribed.

The emergency nurse assists with a closed reduction procedure for a child with a radius fracture. Which finding indicates that this reduction had its intended effect?

Anatomic alignment is restored.

For a patient with a gunshot wound to the upper chest, the emergency nurse should perform which intervention?

Apply paper bags to the patient's hands.

When treating a patient with suspected compartment syndrome of the lower leg following a fracture, the emergency nurse prepares for which intervention

Assist with compartment pressure measurement.

patient has a wound with full-thickness skin loss and no potential for approximating the wound edges. The emergency nurse identifies which type of wound

Avulsion

When assessing a patient with a leaking abdominal aneurysm, the emergency nurse expects the patient to complain of pain in which region

Back

For a patient with an acute panic disorder, the emergency nurse should expect orders to administer which class of medication?

Benzodiazepine

victim of exposure to a chemical agent reports smelling bitter almonds. The emergency nurse suspects which type of agent?

Blood agent

patient complains of worsening dyspnea, an increase in sputum production, and an increase in sputum purulence. The emergency nurse suspects what disorder?

COPD

patient with an incomplete spinal cord injury has greater loss of function in the upper extremities than in the lower extremities. The emergency nurse suspects what disorder

Central cord syndrome

For a child with a ventricular shunt malfunction, the emergency nurse should anticipate orders for which diagnostic study to determine the presence of infection

Cerebrospinal fluid analysis

When assessing a patient with sickle cell disease, which symptom should be most concerning to the emergency nurse?

Chest discomfort

Which activity is an important aspect of prevention in disaster management?

Conducting hospital evacuation drills

patient is breathing spontaneously at his or her own rate and own tidal volume while the ventilator maintains a constant pressure throughout the respiratory cycle. the nurse identifies this as what method of ventilation?

Continuous positive airway pressure (CPAP)

a patient with a chemical burn to the eye, the emergency nurse should anticipate performing which initial intervention?

Copiously irrigate the eye.

When assessing a pediatric patient with pneumonia, the emergency nurse should expect to note what symptom(s)?

Crackles that do not clear with coughing

The emergency nurse initiates the prescribed magnesium sulfate for a patient with preeclampsia. Which finding indicates the treatment is having the desired effect

Decreased seizure activity

trauma patient has vasodilation and loss of sympathetic tone. The emergency nurse suspects which type of shock?

Distributive

After administering the prescribed haloperidol (Haldol) to a psychotic patient, the emergency nurse should evaluate the patient for which side effect

Dystonia

For a patient with hemophilia A and hemarthrosis of the right knee, which is the priority intervention?

Elevate the right knee.

When assessing a patient with a urinary tract infection, which symptom alerts the emergency nurse to suspect renal involvement?

Fever and chills

patient complains of abdominal pain and shows drug-induced toxic effects after arriving in the United States from another country. the emergency nurses suspects what disorder

Gastrointestinal foreign body

When assessing a patient with carbon monoxide exposure, the emergency nurse should expect to note which finding?

Headache