Deck 69: Nursing Management: Emergency and Disaster Nursing

Question 1

A patient is admitted to the emergency department after a near-drowning accident in a local lake. The patient received rescue breathing at the site and now has spontaneous respirations. The nurse will observe the patient for several hours to monitor for symptoms of

A) hypernatremia.
B) pulmonary edema.
C) hypothermia.
D) head injury.

Answer 1

pulmonary edema.

Question 2

An unresponsive 78-year-old patient is admitted to the emergency department in a coma during a summer heat wave. The patient's core temperature is 106.2° F (41.2° C), blood pressure (BP) 86/52, and pulse 102. The nurse will plan to

A) apply wet sheets and a fan to the patient.
B) administer an acetaminophen (Tylenol) suppository.
C) start O₂ at 6 L/min with a nasal cannula.
D) infuse lactated Ringer's solution at 1000 ml/hr.

Answer 2

apply wet sheets and a fan to the patient.

Question 3

An unconscious patient is admitted to the emergency department 45 minutes after ingesting approximately 30 diazepam (Valium) tablets. The health care provider prescribes gastric lavage. The first action the nurse will plan when implementing the order is to

A) position the patient on his or her side.
B) insert a large-bore nasogastric tube.
C) assist the health care provider to intubate the patient.
D) prepare a 60-ml syringe with saline.

Answer 3

assist the health care provider to intubate the patient.

Question 4

During the primary assessment of a patient with multiple trauma, the nurse observes that the patient's right pedal pulses are absent and the leg is swollen. The nurse's first action should be to

A) initiate isotonic fluid infusion through two large-bore IV lines.
B) send blood to the lab for a complete blood count (CBC).
C) finish the airway, breathing, circulation, disability survey.
D) assess further for a cause of the decreased circulation.

Question 5

A patient has experienced blunt abdominal trauma from a motor vehicle accident. The nurse should explain to the patient the purpose of

A) magnetic resonance imaging (MRI).
B) ultrasonography.
C) peritoneal lavage.
D) nasogastric (NG) tube placement.

Question 6

A patient is brought to the hospital in cardiac arrest by emergency personnel who are performing resuscitation. The spouse arrives as the patient is taken into a treatment room and asks to stay with the patient. The nurse should

A) have the spouse wait outside the treatment room with a designated staff member to provide emotional support.
B) bring the spouse into the room and ensure him or her that a member of the team will explain the care given and answer questions.
C) explain that the presence of family members is distracting to staff and might impair the resuscitation efforts.
D) advise the spouse that if the resuscitation effort is unsuccessful, the memories may have an adverse impact on grieving.

Question 7

A triage nurse in a busy emergency department assesses a patient who complains of 6/10 abdominal pain and states, "I had a temperature of 104.6º F (40.3º C) at home." The nurse's first action should be to

A) tell the patient that it may be several hours before being seen by the doctor.
B) assess the patient's current vital signs.
C) obtain a clean-catch urine for urinalysis.
D) ask the health care provider to order a nonopioid analgesic medication for the patient.

Question 8

All of the following actions are needed for a patient admitted with multiple bee stings to the hands. Which one will the nurse accomplish first?

A) Give diphenhydramine (Benadryl) 100 mg po.
B) Apply calamine lotion to any itching areas.
C) Place ice packs on both hands.
D) Remove the patient's rings.

Question 9

When preparing to rewarm a patient with hypothermia, the nurse will plan to

A) attach a cardiac monitor.
B) insert a urinary catheter.
C) assist with endotracheal intubation.
D) keep inotropic drugs available.

Question 10

A 67-year-old patient who has fallen from a ladder is transported to the emergency department by ambulance. The patient is unconscious on arrival and accompanied by family members. During the primary survey of the patient, the nurse should

A) assess the patient's vital signs.
B) obtain a Glasgow Coma Scale score.
C) attach a cardiac ECG monitor.
D) ask about chronic medical conditions.

Question 11

During the primary assessment of a trauma victim, the nurse determines that the patient has a patent airway. The next assessment by the nurse should be to

A) check the patient's level of consciousness.
B) examine the patient for any external bleeding.
C) observe the patient's respiratory effort.
D) palpate for the presence of peripheral pulses.

Question 12

A 24-year-old is brought to the emergency department with multiple lacerations and tissue avulsion of the right hand after catching the hand in a produce conveyor belt. When asked about tetanus immunization, the patient says, "I've never had any vaccinations." The nurse will anticipate administration of tetanus

A) immunoglobulin.
B) and diphtheria toxoid.
C) immunoglobulin, tetanus-diphtheria toxoid, and pertussis vaccine.
D) immunoglobulin and tetanus-diphtheria toxoid.

Question 13

When planning the response to the potential use of smallpox as a biologic weapon, the emergency department manager will focus on obtaining sufficient quantities of

A) blood.
B) antibiotics.
C) vaccine.
D) antitoxin.

Question 14

A patient has been brought to the emergency department with a gunshot wound to the abdomen. In obtaining a history of the incident to determine possible injuries, the nurse asks

A) "Where did the incident occur?"
B) "What direction did the bullet enter the body?"
C) "How long ago did the incident happen?"
D) "What emergency care was started at the scene?"

Question 15

A patient arrives in the emergency department after exposure to radioactive dust. Which action should the nurse take first?

A) Place the patient in a shower.
B) Obtain the patient's vital signs.
C) Determine the type of radioactive agent.
D) Obtain a baseline complete blood count.

Question 16

Four victims of an automobile crash are brought by ambulance to the emergency department (emergency department). The triage nurse determines that the victim who has the highest priority for treatment is the one with

A) severe bleeding of facial and head lacerations.
B) an open femur fracture with profuse bleeding.
C) a sucking chest wound.
D) absence of peripheral pulses.

Question 17

A 77-year-old patient is brought into the emergency department unconscious and with a core temperature of 89° F (31.6° C). During rewarming measures, the nurse determines that the goals of treatment are being met when the patient

A) has a core temperature of 95° F (35° C).
B) shivers involuntarily to raise body temperature.
C) regains consciousness.
D) has a blood pH within normal limits.

Question 18

During the summer, a patient with heat cramps is treated in the emergency department. The nurse determines that discharge teaching regarding the prevention of another episode of heat cramps has been effective when the patient states,

A) "I will take salt tablets when I work outdoors in the summer."
B) "I should double my water intake when the weather gets warm."
C) "I should have sports drinks when exercising outside in hot weather."
D) "I will get into a cool environment if I notice that I am feeling confused."

Question 19

A patient is admitted to the emergency department with multiple bruises of the face and arms and an obvious deformity of the right upper arm. A friend accompanying the patient tells the nurse that the patient's spouse was responsible for the injuries. The nurse's role in this patient's care is

A) to inform the patient of safe houses and other options.
B) to encourage the friend to have the patient report the abuse.
C) to notify the local law enforcement agency.
D) limited to the treatment of the patient's injuries.

Question 20

When caring for a patient with head and neck trauma after a motorcycle accident, the emergency department nurse's first action should be to

A) suction the mouth and oropharynx.
B) immobilize the cervical spine.
C) administer supplemental oxygen.
D) obtain venous access.

Question 21

These four patients arrive in the emergency department after a motor-vehicle crash. In which order should they been assessed?

A) A 22-year-old with fractures of the face and jaw
B) A 30-year-old with a misaligned right leg
C) A 45-year-old complaining of 6/10 abdominal pain
D) A 72-year-old with palpitations and chest pain

Question 22

When a patient is admitted to the emergency department after a submersion injury, which assessment will the nurse obtain first?

A) Lung sounds
B) Oxygen saturation
C) Body temperature
D) Apical pulse

Question 23

A patient arrives at the emergency department after being bitten by a poisonous snake. Initially, the nurse will plan to

A) start a large-bore IV line.
B) administer analgesics.
C) draw blood for laboratory testing.
D) administer tetanus prophylaxis.

Question 24

When rewarming a patient who arrived in the emergency department with a temperature of 87° F, which assessment indicates that rewarming should be stopped?

A) The patient develops atrial fibrillation.
B) The BP decreases to 85/40 mm Hg.
C) The core temperature is 95.2° F.
D) The axillary temperature reaches 96° F.

Question 25

When assessing a patient admitted to the emergency department with a broken arm and facial bruises, the nurse notes multiple additional bruises in various stages of healing. Which statement or question by the nurse is most appropriate?

A) "You should not return to your home."
B) "I have to report this abuse to the police."
C) "Would you like to see a social worker?"
D) "Is someone at home hurting you?"