NUR 203 Mod E Emergency
A nurse teaches a client who has severe allergies to prevent bug bites. Which statements should the nurse include in this client's teaching?
"Consult an exterminator to control bugs in and around your home." "Do not swat at insects or wasps."
A nurse wants to become part of a Disaster Medical Assistance Team (DMAT) but is concerned about maintaining licensure in several different states. Which statement best addresses these concerns?
"Deployed DMAT providers are federal employees, so their licenses are good in all 50 states."
After a hospital's emergency department (ED) has efficiently triaged, treated, and transferred clients from a community disaster to appropriate units, the hospital incident command officer wants to "stand down" from the emergency plan. Which question should the nursing supervisor ask at this time?
"Do all areas of the hospital have the supplies and personnel they need?"
A nurse teaches a community health class about water safety. Which statement by a participant indicates that additional teaching is needed?
"I can go swimming all by myself because I am a certified lifeguard."
A nurse cares for clients during a community-wide disaster drill. Once of the clients asks, "Why are the individuals with black tags not receiving any care?" How should the nurse respond?
"In a disaster, extensive resources are not used for one person at the expense of many others."
A provider prescribes diazepam (Valium) to a client who was bitten by a black widow spider. The client asks, "What is this medication for?" How should the nurse respond
"It will relieve your muscle rigidity and spasms."
After teaching a client how to prevent altitude-related illnesses, a nurse assesses the client's understanding. Which statement indicates the client needs additional teaching?
"My partner and I will plan to sleep at a higher elevation to acclimate more quickly."
Chelation therapy for lead poisoning is initiated when a child's blood level is _____ g/dl.
>45
An emergency room nurse is triaging victims of a multi-casualty event. Which client should receive care first?
A 26-year-old male who has pale, cool, clammy skin
A nurse triages clients arriving at the hospital after a mass casualty. Which clients are correctly classified?
A 35-year-old female with severe chest pain: red tag A 60-year-old male with an open fracture with distal pulses: yellow tag
A nurse is triaging clients in the emergency department (ED). Which client should the nurse prioritize to receive care first?
A 45-year-old reporting chest pain and diaphoresis
While at a public park, a nurse encounters a person immediately after a bee sting. The person's lips are swollen, and wheezes are audible. Which action should the nurse take first?
Administer an EpiPen from the first aid kit and call 911.
An emergency department nurse cares for a middle-aged mountain climber who is confused and exhibits bizarre behaviors. After administering oxygen, which priority intervention should the nurse implement?
Administer dexamethasone (Decadron).
A provider prescribes a rewarming bath for a client who presents with partial-thickness frostbite. Which action should the nurse take prior to starting this treatment?
Administer intravenous morphine.
An emergency department nurse plans care for a client who is admitted with heat stroke. Which interventions should the nurse include in this client's plan of care?
Administer oxygen via mask or nasal cannula. Infuse 0.9% sodium chloride via a large-bore intravenous cannula. Obtain baseline serum electrolytes and cardiac enzymes.
An emergency department charge nurse notes an increase in sick calls and bickering among the staff after a week with multiple trauma incidents. Which action should the nurse take?
Arrange for critical incident stress debriefing.
A provider prescribes Crotalidae Polyvalent Immune Fab (CroFab) for a client who is admitted after being bitten by a pit viper snake. Which assessment should the nurse complete prior to administering this medication?
Ask about allergies to pineapple or papaya.
An emergency room nurse cares for a client who has been shot in the abdomen and is hemorrhaging heavily. Which action should the nurse take first?
Assess and maintain a patent airway.
An emergency room nurse assesses a client after a motor vehicle crash and notes ecchymotic areas across the client's lower abdomen. Which action should the nurse take first?
Assess for abdominal guarding or rigidity.
Emergency medical technicians arrive at the emergency department with an unresponsive client who has an oxygen mask in place. Which action should the nurse take first?
Assess that the client is breathing adequately.
A nurse assesses a client recently bitten by a coral snake. Which assessment should the nurse complete first?
Cardiopulmonary status
The school nurse is conducting a class for school-age children on Lyme disease. Which is characteristic of Lyme disease?
Caused by a spirochete that enters the skin through a tick bite
A hospital prepares to receive large numbers of casualties from a community disaster. Which clients should the nurse identify as appropriate for discharge or transfer to another facility?
Client who had open reduction and internal fixation of a femur fracture 3 days ago Client on the medical unit for wound care
An emergency department nurse is caring for a client who has died from a suspected homicide. Which action should the nurse take?
Communicate the client's death to the family in a simple and concrete manner.
A trauma client with multiple open wounds is brought to the emergency department in cardiac arrest. Which action should the nurse take prior to providing advanced cardiac life support?
Don personal protective equipment.
A nurse cares for a client with burn injuries from a house fire. The client is not consistently oriented and reports a headache. Which action should the nurse take?
Draw blood for a carboxyhemoglobin level.
An emergency department nurse assesses a client admitted after a lightning strike. Which assessment should the nurse complete first?
Electrocardiogram (ECG)
A mother calls the emergency department nurse because her child was stung by a scorpion. The nurse should recommend:
keeping the child quiet and coming to the emergency department.
Which is the most commonly used method in completed suicides?
Firearms
An emergency room nurse assesses a client who has been raped. With which health care team member should the nurse collaborate when planning this client's care?
Forensic nurse examiner
A school nurse is conducting a class with adolescents on suicide. Which true statement about suicide should the nurse include in the teaching session?
Gay and lesbian adolescents are at a particularly high risk for suicide.
Which is a clinical manifestation of acetaminophen poisoning?
Hepatic involvement
An emergency department nurse moves to a new city where heat-related illnesses are common. Which clients does the nurse anticipate being at higher risk for heat-related illnesses?
Homeless individuals Illicit drug users Older adults
A hospital prepares for a mass casualty event. Which functions are correctly paired with the personnel role?
Hospital incident commander - Assumes overall leadership for implementing the emergency plan Triage officer - Rapidly evaluates each client to determine priorities for treatment
A teen asks a nurse, "What is physical dependence in substance abuse?" Which is the correct response by the nurse?
Involuntary physiologic response to drug
A father calls the clinic nurse because his 2-year-old child was bitten by a black widow spider. The nurse should advise which to the father?
Take child to emergency department.
The nurse is caring for an adolescent brought to the hospital with acute drug toxicity. Cocaine is believed to be the drug involved. Data collection should include what information?
Mode of administration
A nurse assesses a client admitted with a brown recluse spider bite. Which priority assessment should the nurse perform to identify complications of this bite?
Monitor the client's temperature every 4 hours.
A nurse plans care for a client admitted with a snakebite to the right leg. With whom should the nurse collaborate?
The poison control center
A nurse is field-triaging clients after an industrial accident. Which client condition should the nurse triage with a red tag?
Multiple fractured ribs and shortness of breath
A child has been admitted to the emergency department with an acetaminophen (Tylenol) poisoning. An antidote is being prescribed by the health care provider. Which antidote should the nurse prepare to administer?
N-acetylcysteine (Mucomyst)
An emergency room nurse is caring for a trauma client. Which interventions should the nurse perform during the primary survey?
Needle decompression Initiating IV fluids Endotracheal intubation Removing wet clothing
Emergency medical services (EMS) brings a large number of clients to the emergency department following a mass casualty incident. The nurse identifies the clients with which injuries with yellow tags?
Partial-thickness burns covering both legs Neck injury and numbness of both legs Small pieces of shrapnel embedded in both eyes Bruising and pain in the right lower abdomen
A nurse is teaching parents methods to reduce lead levels in their home. Which should the nurse include in the teaching?
Plant bushes around the outside of the house. Ensure your child eats frequent meals. Ensure that your child's diet contains sufficient iron and calcium.
The management of a child who has just been stung by a bee or wasp should include the application of:
cool compresses.
A family in the emergency department is overwhelmed at the loss of several family members due to a shooting incident in the community. Which intervention should the nurse complete first?
Provide a calm location for the family to cope and discuss needs.
The nurse is taking care of a child with scabies. Which primary clinical manifestation should the nurse expect to assess with this disease?
Pruritus Scabies is caused by the scabies mite. The inflammatory response and intense itching occur after the host has become sensitized to the mite. This occurs approximately 30 to 60 days after initial contact.
The complex care provided during an emergency requires interdisciplinary collaboration. Which interdisciplinary team members are paired with the correct responsibilities?
Psychiatric crisis nurse - Interacts with clients and families when sudden illness, serious injury, or death of a loved one may cause a crisis Paramedic - Provides prehospital advanced life support, including cardiac monitoring, advanced airway management, and medication administration
A nurse prepares to discharge an older adult client home from the emergency department (ED). Which actions should the nurse take to prevent future ED visits?
Screen for depression and suicide. Complete a functional assessment.
A nurse is providing health education at a community center. Which instructions should the nurse include in teaching about prevention of lightning injuries during a storm?
Seek shelter inside a building or vehicle. Do not take a bath or shower. Turn off the television. Put down golf clubs or gardening tools.
A young child has just arrived at the emergency department after ingestion of aspirin at home. The practitioner has ordered activated charcoal. The nurse administers charcoal in which way?
Serve in an opaque container with a straw.
Which statement is true about smoking in adolescence?
Smoking is related to other high-risk behaviors.
Which is the most significant factor in distinguishing those who commit suicide from those who make suicidal attempts or threats?
Social isolation
On a hot humid day, an emergency department nurse is caring for a client who is confused and has these vital signs: temperature 104.1° F (40.1° C), pulse 132 beats/min, respirations 26 breaths/min, blood pressure 106/66 mm Hg. Which action should the nurse take?
Start an intravenous line and infuse 0.9% saline solution.
A nurse is beginning chelation therapy on a child for lead poisoning. Which intervention should the nurse implement during the time the child is receiving chelation therapy?
Strict intake and output
The nurse suspects that a child has ingested some type of poison. Which clinical manifestation would be most suggestive that the poison was a corrosive product?
Stupor, lethargy, coma
The nurse is teaching parents of toddlers about animal safety. Which should be included in the teaching session?
Teach your toddler not to disturb an animal that is eating.
A nurse wants to become involved in community disaster preparedness and is interested in helping set up and staff first aid stations or community acute care centers in the event of a disaster. Which organization is the best fit for this nurse's interests?
The Medical Reserve Corps
Which is descriptive of central nervous system stimulants?
They can result in strong psychological dependence.
While triaging clients in a crowded emergency department, a nurse assesses a client who presents with symptoms of tuberculosis. Which action should the nurse take first?
Transfer the client to a negative-pressure room.
Which describes a child who is abused by the parent(s)?
Unintentionally contributes to the abusing situation
A nurse is caring for clients in a busy emergency department. Which actions should the nurse take to ensure client and staff safety?
Use two identifiers before each intervention and before mediation administration. Attempt de-escalation strategies for clients who demonstrate aggressive behaviors. Search the belongings of clients with altered mental status to gain essential medical information.
An adolescent girl tells the nurse that she is very suicidal. The nurse asks her whether she has a specific plan. Asking this should be considered:
an appropriate part of the assessment.
Place in order the correct sequence for emergency treatment of poisoning in a child. Provide answer using lowercase letters separated by commas (e.g., a, b, c, d). a. Locate the poison. b. Assess the child. c. Prevent absorption of poison. d. Terminate exposure to the toxic substance.
b, d, a, c
Smokeless tobacco is:
proven to be carcinogenic.
A 3-month-old infant dies shortly after arrival to the emergency department. The infant has subdural and retinal hemorrhages but no external signs of trauma. The nurse should suspect:
shaken-baby syndrome.
Rocky Mountain spotted fever is caused by the bite of a:
tick.
A nurse is evaluating levels and functions of trauma centers. Which function is appropriately paired with the level of the trauma center?
Level II - Located within community hospitals and provides care to most injured clients
An emergency department nurse is caring for a client who is homeless. Which action should the nurse take to gain the client's trust?
Listen to the client's concerns and needs.
The emergency department team is performing cardiopulmonary resuscitation on a client when the client's spouse arrives at the emergency department. Which action should the nurse take first?
Ask the spouse if he wishes to be present during the resuscitation.
An emergency department (ED) nurse is preparing to transfer a client to the trauma intensive care unit. Which information should the nurse include in the nurse-to-nurse hand-off report?
Mechanism of injury Diagnostic test results Isolation precautions
A client presents to the emergency department after prolonged exposure to the cold. The client is difficult to arouse and speech is incoherent. Which action should the nurse take first?
Administer warmed intravenous fluids to the client.
A 3-year-old child is hospitalized after a submersion injury. The child's mother complains to the nurse, "Being at the hospital seems unnecessary when he is perfectly fine." The nurse's best reply should be:
"The reason for this is that complications could still occur."
A nurse is teaching a wilderness survival class. Which statements should the nurse include about the prevention of hypothermia and frostbite?
"Wear synthetic clothing instead of cotton to keep your skin dry." "Wear sunglasses to protect skin and eyes from harmful rays." "Know your physical limits. Come in out of the cold when limits are reached."
The hospital administration arranges for critical incident stress debriefing for the staff after a mass casualty incident. Which statement by the debriefing team leader is most appropriate for this situation?
"You are free to express your feelings; whatever is said here stays here."
A client who is hospitalized with burns after losing the family home in a fire becomes angry and screams at a nurse when dinner is served late. How should the nurse respond?
"You seem upset. I have time to talk if you'd like."
A nurse is caring for a client whose wife died in a recent mass casualty accident. The client says, "I can't believe that my wife is gone and I am left to raise my children all by myself." How should the nurse respond?
"You sound anxious about being a single parent."
A nurse is triaging clients in the emergency department. Which client should the nurse classify as "nonurgent?"
A 62-year-old with a simple fracture of the left arm
A nurse is triaging clients in the emergency department. Which client should be considered "urgent"?
A 75-year-old female with a cough and a temperature of 102° F
A young boy is found squirting lighter fluid into his mouth. His father calls the emergency department. The nurse taking the call should know that the primary danger is which result?
Bronchitis and chemical pneumonia
The nurse is caring for a neonate with suspected meningitis. Which clinical manifestations should the nurse prepare to assess if meningitis is confirmed?
Bulging anterior fontanel Weak cry Poor muscle tone
While on a camping trip, a nurse cares for an adult client who had a drowning incident in a lake and is experiencing agonal breathing with a palpable pulse. Which action should the nurse take first?
Deliver rescue breaths.
An emergency department (ED) charge nurse prepares to receive clients from a mass casualty within the community. What is the role of this nurse during the event?
Direct medical-surgical and critical care nurses to assist with clients currently in the ED while emergency staff prepare to receive the mass casualty victims.
A hospital unit is participating in a bioterrorism drill. A "client" is admitted with inhalation anthrax. Under what type of precautions does the charge nurse admit the "client"?
Droplet Precautions
Which is the most frequent source of acute childhood lead poisoning?
Lead-based paint
An emergency department (ED) case manager is consulted for a client who is homeless. Which intervention should the case manager provide?
Provide referrals to subsidized community-based health clinics.
A hospital responds to a local mass casualty event. Which action should the nurse supervisor take to prevent staff post-traumatic stress disorder during a mass casualty event?
Provide water and healthy snacks for energy throughout the event.
Acute salicylate (ASA, aspirin) poisoning results in:
disorientation and loss of consciousness.
