Deck 11: Care of Patients With Common Environmental Emergencies

Question 1

The emergency department nurse assesses a middle-aged mountain climber who reports headache,nausea,vomiting,and "feeling winded." What is the nurse's priority intervention?

A) Administer acetazolamide (Diamox).
B) Administer prochlorperazine (Compazine).
C) Perform a neurologic assessment.
D) Assess for bowel sounds.

Answer 1

Administer acetazolamide (Diamox).

Question 2

While on a camping trip,the nurse provides care for a camper who was bitten by a black widow spider.What is the priority action of the nurse?

A) Apply ice to the site of the bite.
B) Apply a loose tourniquet to the limb.
C) Give acetaminophen (Tylenol) for pain.
D) Cover the camper with a warm blanket.

Answer 2

Apply ice to the site of the bite.

Question 3

The nurse is planning care for a client admitted with a snakebite to the right leg.With whom should the nurse collaborate?

A) The facility's neurologist
B) The regional poison control center
C) The physical therapy department
D) A herpetologist (snake specialist)

Answer 3

The regional poison control center

Question 4

The nurse is providing emergency care to a client with frostbite.Which intervention is performed first?

A) Wrap the affected area in a warm, dry blanket to rewarm.
B) Rewarm the affected area in a 104° F water bath.
C) Elevate the affected area above the heart to decrease tissue edema.
D) Use a splint to immobilize the affected area.

Question 5

A client presents to the emergency department after prolonged exposure to the cold.The client is shivering,has slurred speech,and is slow to respond to questions.Which treatment will the nurse prepare for this client?

A) Dry clothing and warm blankets
B) Administration of warmed IV fluids
C) Peritoneal lavage with warmed normal saline
D) Continuous arteriovenous rewarming

Question 6

A community nurse assesses a client,who has an allergy to bees,after a bee sting.The client's lips are swollen,and wheezes are audible.What is the priority action of the nurse?

A) Elevate the site and notify the client's next of kin.
B) Remove the stinger with tweezers and encourage rest.
C) Administer diphenhydramine (Benadryl) and apply ice.
D) Administer an EpiPen from the first aid kit and call 911.

Question 7

The nurse is teaching a community health class about water safety.Which statement by a participant indicates that additional teaching is needed?

A) "I can go swimming all by myself because I am a certified lifeguard."
B) "I cannot leave my toddler alone in the bathtub for even a minute."
C) "I will appoint one adult to supervise the pool at all times during a party."
D) "I will make sure that there is a phone near my pool in case of an emergency."

Question 8

While the nurse is visiting the community pool,an adult swimmer is pulled out of the pool,unconscious and cyanotic.What is the priority action of the nurse?

A) Begin chest compressions.
B) Move from the pool area.
C) Give two rescue breaths.
D) Check for a carotid pulse.

Question 9

The nurse is teaching a client with severe allergies how to prevent bug bites.Which statement by the client indicates that additional teaching is needed?

A) "I will avoid wearing perfume when I go outside."
B) "I will put the picnic food out when we are ready to eat."
C) "I will keep my car windows up at all times."
D) "I will wear sandals whenever I go outside."

Question 10

The nurse is assessing a client admitted with a brown recluse spider bite.What priority assessment should the nurse perform?

A) Ask the client about pruritus at the bite site.
B) Inspect for a bluish purple vesicle.
C) Assess for redness and swelling.
D) Obtain the client's temperature.

Question 11

The nurse is working at a first aid booth for a spring training game on a hot day.A spectator comes in,reporting that he is not feeling well.Vital signs are temperature 104.1° F (40.1° C),pulse 132 beats/min,respirations 26 breaths/min,and blood pressure 106/66 mm Hg.He trips over his feet as the nurse leads him to a cot.What is the priority action of the nurse?

A) Encourage drinking of cool water or sports drinks.
B) Sponge the victim with cool water and remove his shirt.
C) Administer Tylenol (acetaminophen), 650 mg orally.
D) Encourage rest, and reassess in 15 minutes.

Question 12

The nurse is teaching a wilderness survival class.Which statement by a participant indicates that additional teaching is needed?

A) "If I get too cold, I can have some brandy to help me get warmed up."
B) "My climbing partner should let me know right away if my nose turns white."
C) "If my partner can't think straight, we should descend to a lower altitude."
D) "It is okay to feel a little short of breath when I am climbing, but not at rest."

Question 13

The nurse is caring for a drowning victim after resuscitation.What focused assessment will the nurse perform to identify complications from drowning?

A) Palpation of abdominal cavity
B) Inspection of skin color
C) Auscultation of lungs
D) Palpation of pulse strength

Question 14

The nurse is caring for a client who had a near-drowning incident in a lake.Which action will the nurse take to monitor for possible complications?

A) Assess the client's temperature every 4 hours.
B) Check the client's blood glucose level before meals.
C) Assess the client's bowel sounds three times daily.
D) Check the client's skin for petechiae daily.

Question 15

On a hot,humid day,several clients present to the emergency department with symptoms of heat exposure.Which client will be treated first? A client who:

A) Has normal mental status and flu-like symptoms
B) Is diaphoretic with nausea and vomiting
C) Is hypotensive and tachycardic
D) Is anxious and confused

Question 16

The emergency department nurse assesses a client in extreme pain with an apparent snakebite of the leg.Vital signs are stable.What is the priority action of the nurse?

A) Call the regional poison control center.
B) Administer IV pain medication.
C) Place a tourniquet around the leg.
D) Apply an immobilization splint.

Question 17

A nurse is at the scene of a lightning strike during a thunderstorm.Which is the priority action of the nurse?

A) Make sure that victims are not electrically charged.
B) Assess victims for second- and third-degree burns.
C) Start emergency resuscitation on anyone not breathing.
D) Move victims and first aid responders to a sheltered area.

Question 18

The nurse is assessing a client recently bitten by a coral snake.Which assessment is the priority?

A) Peripheral edema and swelling
B) Evaluation of clotting times
C) Respiratory rate and depth
D) Electrocardiogram rhythm

Question 19

The nurse working at a first aid booth during a summer marathon sees several runners.Which runner should be seen first? A runner who:

A) Has fallen several times
B) Is fatigued
C) Thinks he has the flu
D) Has tachypnea

Question 20

The nurse is working in the emergency department on a hot,humid day,when a hiker is brought in after collapsing.The hiker is confused and tachycardic with a temperature of 105.6° F (40.9° C).Which IV solution and medication will the nurse have ready for the client?

A) Normal saline and methylprednisolone (Solu-Medrol)
B) Lactated Ringer's solution and morphine sulfate
C) Normal saline and lorazepam (Ativan)
D) Dextrose 5% and diphenhydramine (Benadryl)

Question 21

The nurse is assessing a group of clients.Which clients are at greater risk for hypothermia or frostbite?

A) A young man who has just consumed six martinis
B) A young man with a body mass index (BMI) of 42
C) An older man who smokes a pack of cigarettes a day
D) A young woman who is anorexic
E) An older woman with hypertension
F) A young woman who is diabetic

Question 22

An emergency department nurse moves to a new city,where heat-related illnesses are common.Which clients should the nurse anticipate as at higher risk for heat-related illness?

A) Homeless individuals
B) Illicit drug users
C) Whites
D) Hockey players
E) Older adults
F) Put down golf clubs or gardening tools.

Question 23

The 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?

A) Seek shelter inside a building or vehicle.
B) Seek shelter under a tall tree.
C) Do not take a bath or shower.
D) Turn off the television.
E) Remove body piercings.
F) Put down golf clubs or gardening tools.