Exam 5 burns/emergency
Reposition the victims airway
A community health nurse is at the site of a mass casualty incident and is triaging victims. The nurse is evaluating an adult victim who is unconscious and not breathing spontaneously. Which of the following actions should the nurse take?
Disasters often overwhelm the availability of local resources
A community health nurse is discussing disasters with a group of new nurses. Which of the following statements by one of the new nurses indicates an understanding of the info?
Ensure that multiple nurses are present for the physical exam
A nurse in ED is caring for a child who reports being sexually abused by a family member. Which action should the nurse take?
Initiate seizure precautions
A nurse is caring for an adolescent who has hypothermia. Which of the following actions should the nurse take?
Tell the client "you see to be very upset"
A nurse is teaching a new nurse about caring for clients in the ED. Which of the following actions should the nurse include in the teaching about interacting with a client who is aggravated, pacing, and speaking loudly?
Radiation exposure
A nurse is working in a community clinic and observes that numerous clients have come to the clinic reporting nausea, vomiting, and blisters on their skin. Which of the following conditions should the nurse suspect?
Determine the medical needs of the incoming clients through the ED
A nurse on med surg unit is notified that a mass casualty event has occurred in the community. Which actions should the nurse plan to take
1st degree superficial
A patient has a burn on the back of the torso that is extremely painful and red but no blisters are present. When you press on the skin it blanches. You document the burn as?
Assess airway
A patient has experienced full thickness burns to the face and neck. As the nurse the priority is to?
Hemoglobin and myoglobin
As the nurse providing care to a patient who experienced a full thickness electrical burn you know to monitor the patients urine for?
Risk for infection
Patient is in acute phase of burn management. The patient had full thickness burns to the perineum and sacral area. In the patients plan of care, which nursing diagnosis is priority at this time?
Elevate and extend extremities
Pt has full thickness burns on the front and back of both arm and hands. What is a priority nursing intervention?
25 y/o female with partial thickness burns on the front of the head, neck, back, and torso
Which patient is at most risk for complications following a burn?
2nd degree partial thickness
You receive a patient who has experienced a burn on the right leg. You note the burn contains small blisters and is extremely pinkish red and shiny/moist. The patient reports severe pain. What type of burn would you document?
