Deck 69: Nursing Management: Emergency, Terrorism, and Disaster Nursing

Question 1

When planning the response to the potential use of smallpox as an agent of terrorism, the emergency department ( ED ) nurse-manager will plan to obtain sufficient quantities of

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

Answer 1

vaccine.

Question 2

The following actions are part of the routine emergency department ( ED ) protocol for a patient who has been admitted with multiple bee stings to the hands. Which action should the nurse take first?

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

Answer 2

Remove the patient's rings.

Question 3

A patient who is unconscious after a fall from a ladder is transported to the emergency department by family members. During the primary survey of the patient, the nurse should

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

Answer 3

obtain a Glasgow Coma Scale score.

Question 4

When rewarming a patient who arrived in the emergency department ( ED ) with a temperature of 87° F, which assessment indicates that the nurse should discontinue the rewarming?

A) The patient stops shivering.
B) The BP decreases to 85/40 mm Hg.
C) The patient develops atrial fibrillation.
D) The core temperature is 94° F ( 34.4° C ).

Question 5

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 6

During the primary assessment of a trauma victim, the nurse determines that the patient is breathing and has an unobstructed airway. Which action should the nurse take next?

A) Observe the patient's respiratory effort.
B) Check the patient's level of consciousness.
C) Palpate extremities for capillary refill time.
D) Examine the patient for any external bleeding.

Question 7

A patient who experienced a near drowning accident in a local lake, but now is awake and breathing spontaneously, is admitted for observation. Which action will be most important for the nurse to take during the observation period?

A) Listen to heart sounds.
B) Palpate peripheral pulses.
C) Auscultate breath sounds.
D) Check pupil reaction to light.

Question 8

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) have sympathomimetic drugs available.

Question 9

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

A) Apical pulse
B) Lung sounds
C) Body temperature
D) Level of consciousness

Question 10

An unresponsive 78-year-old is admitted to the emergency department ( ED ) 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 initially will plan to

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

Question 11

The emergency department ( ED ) triage nurse is assessing four victims of an automobile accident. Which patient has the highest priority for treatment?

A) A patient with absent pedal pulses
B) A patient with an open femur fracture
C) A patient with a sucking chest wound
D) A patient with bleeding of facial lacerations

Question 12

During the primary survey of a patient with multiple traumatic injuries, the nurse observes that the patient's right pedal pulses are absent and the leg is swollen. Which of these actions will the nurse take next?

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

Question 13

A patient who has experienced blunt abdominal trauma during a car accident is complaining of increasing abdominal pain. The nurse will plan to teach the patient about the purpose of

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

Question 14

An 18-year-old is brought to the emergency department ( ED ) with multiple lacerations and tissue avulsion of the right hand. When asked about tetanus immunization, the patient denies having any previous vaccinations. The nurse will anticipate administration of

A) tetanus-diphtheria toxoid ( Td ) only.
B) tetanus immunoglobulin ( TIG ) only.
C) TIG and tetanus-diphtheria toxoid ( Td ).
D) TIG and tetanus-diphtheria toxoid and pertussis vaccine ( Tdap ).

Question 15

When assessing a patient admitted to the emergency department ( ED ) 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) "Is someone at home hurting you?"
B) "You should not return to your home."
C) "Would you like to see a social worker?"
D) "I have to report this abuse to the police."

Question 16

A patient arrives in the emergency department ( ED ) a few hours after taking "20 to 30" acetaminophen ( Tylenol ) tablets. Which action will the nurse plan to take?

A) Give N-acetylcysteine ( Mucomyst ).
B) Discuss the use of chelation therapy.
C) Have the patient drink large amounts of water.
D) Administer oxygen using a non-rebreather mask.

Question 17

Gastric lavage and administration of activated charcoal are prescribed for an unconscious patient who has been admitted to the emergency department ( ED ) after ingesting 30 diazepam ( Valium ) tablets. Which action will the nurse plan to take first?

A) Administer activated charcoal.
B) Insert a large-bore orogastric tube.
C) Prepare a 60-mL syringe with saline.
D) Assist with intubation of the patient.

Question 18

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

Question 19

After resuscitation, a patient who had a cardiac arrest is nonresponsive to commands and therapeutic hypothermia is prescribed. Which action will the nurse include in the plan of care?

A) Rapidly infuse cold normal saline.
B) Avoid the use of sedative medications.
C) Check neurologic status every 30 minutes.
D) Rewarm if temperature is >91° F ( 32.8° C ).

Question 20

A patient with hypotension and temperature elevation after doing yard work on a hot day is treated in the ED. After the nurse has completed discharge teaching, which statement by the patient indicates that the teaching has been effective?

A) "I will take salt tablets when I work outdoors in the summer."
B) "I should take acetaminophen (Tylenol) if I start to feel too 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 21

A patient's family members are in the patient room when the patient has a cardiac arrest and emergency personnel start resuscitation measures. Which action is best for the nurse to take initially?

A) Have the family wait outside the patient room with a designated staff member to provide emotional support.
B) Keep the family in the room and assign a member of the team to explain the care given and response questions.
C) Ask the family members about whether they would prefer to remain in the patient room or wait outside the room.
D) Advise the family members that patients are comforted by having family members present during resuscitation efforts.

Question 22

These four patients arrive in the emergency department after a motor vehicle crash. In which order should they be assessed? Put a comma and space between each solve choice (a , b , c , d , etc.) ____________________

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

Question 23

Following an earthquake, patients are triaged by emergency medical personnel and are transported to the hospital. Which of these patients will the nurse need to assess first?

A) A patient with a red tag
B) A patient with a blue tag
C) A patient with a yellow tag
D) A patient with a green tag