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Prepared By: Charles Anthony Esteban EMERGENCY ROOM QUESTIONS 1.

A client with multiple injury following a vehicular accident is transferred to the critical care unit. He begins to complain of increased abdominal pain in the left upper quadrant. A ruptured spleen is diagnosed and he is scheduled for emergency splenectomy. In preparing the client for surgery, the nurse should emphasize in his teaching plan the: a. Complete safety of the procedure b. Expectation of postoperative bleeding c. Risk of the procedure with his other injuries d. Presence of abdominal drains for several days after surgery 2. After you managed to stabilize the respiratory function of your burn patient, your next goal is to prevent this you have to replace the lost fluid and electrolytes. In starting fluid replacement therapy, the total volume and rate of IV fluid repalcement are gauged by the patient’s response and by the patient’s response and by the resuscitation formula. In determining the adequacy of fluid resuscitation, it is essential for you to monitor the: a. urine output b. blood pressure c. intracranial pressure d. cardiac output 3. You are a nurse in the emergency department and it is during the shift that Mr. CT is admitted in the area due to a fractured skull from a motor accident. You scheduled him for surgery under which classification? a. Urgent b. Emergent c. Required d. Elective 4. Lucky was in a vehicular acccident where he sustained injury to his left ankle. In the Emergency room, you noticed anxious he looks. You establish rapport with him and to reduce his anxiety, you initially: a. Identify yourself and state your purpose in being with the client b. Take him to the radiology section for x-ray of affected extremity c. Talk to the physician for an order of valium d. Do inspection and palpation to check extent of his injuries 5. The client diagnosed with a mild concussion is being discharged from the emergency department. Which discharge instruction should the nurse teach the client’s significant other? a. Awaken the client every two hours. b. Monitor for increased intracranial pressure. c. Observe frequently for hypervigilance. d. Offer the client food every three to four hours. 6. The client diagnosed with Addison’s disease is admitted to the emergency department after a day at the lake. The client is lethargic, forgetful, and weak. Which intervention should be the emergency department nurse’s first action? a. Start an IV with an 18-gauge needle and infuse NS rapidly. b. Have the client wait in the waiting room until a bed is available. c. Perform a complete head-to-toe assessment. d. Collect urinalysis and blood samples for a CBC and calcium level.

Apply hot compresses to the affected joints. Injuries are minor and treatment can be delayed hours to days. Which nursing intervention would be appropriate when caring for a client who has sustained an electrical burn? a. which action would have the highest priority? a. abdomen and legs. b. Pain. When Eddie arrives in the emergency room. 10. Preparing to administer the chemical antidote 12. Quality of respirations and presence of pulses. the assessment that assume the greatest priority are: a. The nurse may be assigned to crowd control. c. According to the North Atlantic Treaty Organization (NATO) triage system. Level of consciousness and pupil size b. When developing a plan of care. which situation would be considered a level red (Priority 1)? a. is brought to the emergency room after the crash of his private plane. He has suffered multiple crushing wounds of the chest. The nurse may be assigned as a first assistant in the operating room. 9. relax the bronchial smooth muscle d. Eddie. The 10-year-old child whose dad thinks the child’s leg is broken. Injuries are extensive and chances of survival are unlikely. d. 13. decrease bronchial secretions . The triage nurse is working in the emergency department. The nurse may be assigned to the emergency department. c. Injuries are life threatening but survivable with minimal interventions. The nurse may be assigned to ride in the ambulance. A client is admitted from the emergency department with severe-pain and edema in the right foot. c. decrease mucosal swelling c. Applying ice to the burned area b. b. An emergency treatment for an acute asthmatic attack is Adrenaline 1:1000 given hypodermically. It is feared his leg may have to be amputated. Respiratory rate and blood pressure d. His diagnosis is gouty arthritis. d. 11. b. b. The 25-year-old male who cut his hand with a hunting knife. Ensure an intake of at least 3000 ml of fluid per day. 8. c. Flushing the burn area with large amounts of water c. This is given to: a.Prepared By: Charles Anthony Esteban 7. The 58-year-old female complaining of a headache and seeing spots. 40 years old. Injuries are significant but can wait hours without threat to life or limb. Which client should be assessed first? a. Which statement best describes the role of the medical-surgical nurse during a disaster? a. Administer salicylates to minimize the inflammatory reaction. Abdominal contusions and other wounds c. increase BP b. Monitoring the client with cardiac telemetry d. d. d. Stress the importance of maintaining good posture to prevent deformities. The 45-year-old male who is diaphoretic and clutching his chest.

d. When his parents arrive at the hospital. washing the esophagus with large volumes of water via gastric lavage 15. He is pronounced dead on arrival. When developing a plan of care. 16 years old. c. Stress the importance of maintaining good posture to prevent deformities. The appropriate initial action should be to a. Put pressure on the apex of the heart 19. Induce emptying of the stomach d. The Heimlich maneuver (abdominal thrust). A nurse is eating in the hospital cafeteria when a toddler at a nearby table chokes on a piece of food and appears slightly blue. A client is admitted from the emergency department with severe-pain and edema in the right foot. . Apply hot compresses to the affected joints. Perform 5 abdominal thrusts d. for acute airway obstruction. neutralizing the chemical d. Administer salicylates to minimize the inflammatory reaction. ask them to stay in the waiting area until she can spend time alone with them b. John. His diagnosis is gouty arthritis. who has swallowed a Muriatic Acid includes all of the following except a. which action would have the highest priority? a. Ensure an intake of at least 3000 ml of fluid per day. attempts to: a. speak to both parents together and encourage them to support each other and express their emotions freely c. Speak to one parent at a time so that each can ventilate feelings of loss without upsetting the other d. A nurse is performing CPR on an adult patient. the nurse should: a. 18. 16 years old. ask the MD to medicate the parents so they can stay calm to deal with their son’s death. aspirating secretions from the pharynx if respirations are affected c. When his parents arrive at the hospital. lower half of the sternum d. the nurse understands the correct hand placement is located over the a. the nurse should: a. lower third of the sternum 20. upper third of the sternum c. upper half of the sternum b. He is pronounced dead on arrival. Intervention for a pt. Speak to one parent at a time so that each can ventilate feelings of loss without upsetting the other d. speak to both parents together and encourage them to support each other and express their emotions freely c. is brought to the ER after a vehicular accident. Give the child water to help in swallowing c. b. Force air out of the lungs b. is brought to the ER after a vehicular accident. When performing chest compressions. Increase systemic circulation c. ask them to stay in the waiting area until she can spend time alone with them b. Call for the emergency response team 17. 16. Begin mouth to mouth resuscitation b.Prepared By: Charles Anthony Esteban 14. John. administering an irritant that will stimulate vomiting b. ask the MD to medicate the parents so they can stay calm to deal with their son’s death.

relationship and the purpose of being with the client. 4. 6. medical-surgical nurses can provide first aid and be required to work in unfamiliar settings 11. irritability. 9. all clients experiencing . Elective surgery is scheduled and done at the convenience of client as failure to have surgery is not catastrophic. Answer: D Rationale: Ensure an intake of at least 3000 ml of fluid per day. Gouty arthritis is a metabolic disease marked by urate deposits that cause painful arthritic joints. 10. Answer: D Rationale: New settings and atypical roles for nurses may be required during disasters. 2. which potentially life is threatening.Prepared By: Charles Anthony Esteban ANSWER KEY: ER QUESTIONS 1. immediately without delay to maintain life. and anxiety—all signs of post-concussion syndrome—that would warrant the significant other’s taking the client back to the emergency department. Answer: B Rationale: Emergent surgery is performed. Answer: B Rationale: The triage nurse should see this client first because these are symptoms of a myocar. Answer: A Rationale: Awakening the client every 2 hours allows the identification of headache. 5. lethargy. This prevents confusion and let the client know what to expect. Other indicators of adequate fluid replacement are systolic blood pressure exceeding 100 mmHg. remove damage and stop bleeding. Urgent surgery requires prompt attention and is done few hours but within 24 to 48 hours. This predisposes the client to dehydration and an Addisonian crisis. Answer: A Rationale: to establish the sufficiency of fluid resuscitation. 7. Answer: A Rationale: This client has been exposed to wind and sun at the lake during the hours prior to being admitted to the emergency department. Individuals in this group can progress rapidly to expectant if treatment is delayed. urine output totals of 30-50 ml/hour have been used as resuscitation goals. Required surgery is done within a few weeks as surgery is important. urine output totals an index of renal perfusion. The patient should be urged to increase his fluid intake to prevent the development of urinary uric acid stones. limb or organ. Answer: A Rationale: Introducing self initiates the nurse-patient interaction. Answer: D Rationale: Presence of abdominal drains for several days after surgery Drains are usually inserted into the splenic bed to facilitate removal of fluid in the area that could lead to abscess formation. Answer: D Rationale: This is called the immediate category. thereby reducing anxiety. Optional surgeries are done by preference only.dial infarction. dizziness. Rapid IV fluid replacement is necessary. 3. 8. Answer: C Rationale: Because of the effects of the electrical current on the cardiovascular system. Urine output totals an index of renal perfusion. a pulse rate less than110 beats/min or both.

Vomiting is only indicated when non-corrosive poison is swallowed. Answer: D Rationale: Ensure an intake of at least 3000 ml of fluid per day. The pressure from the thrusts lifts the diaphragm. The patient should be urged to increase his fluid intake to prevent the development of urinary uric acid stones. Answer: C Rationale: Perform 5 abdominal thrusts. answering their questions and listening to them will provide the needed support for them to move on and be of support to one another. They go into a stage of denial and anger in their grieving. gastric emptying procedure is immediately instituted. They go into a stage of denial and anger in their grieving. Measures are taken to immediately remove the toxin or reduce its absorption. This includes gastric lavage and the administration of activated charcoal to absorb the poison. Gouty arthritis is a metabolic disease marked by urate deposits that cause painful arthritic joints. Answer: C Rationale: Acute asthmatic attack is characterized by severe bronchospasm which can be relieved by the immediate administration of bronchodilators. Applying ice is inappropriate for any type of burn. Doing it at the lower third of the sternum may cause gastric compression which can lead to a possible aspiration. Only chemical burns should be flushed with large amounts of water. 20. Basic life functions must be maintained or reestablished 13. 15. Answer: B Rationale: Sudden death of a family member creates a state of shock on the family. These are top priorities to trauma management. Answer: C Rationale: The exact and safe location to do cardiac compression is the lower half of the sternum. Assisting them with information they need to know. 14. Answer: A Rationale: Swallowing of corrosive substances causes severe irritation and tissue destruction of the mucous membrane of the GI tract. 19. At this age. Chemical antidotes may be used for chemical burns for which an antidote has been identified. 17. forces air out of the lungs and creates an artificial cough that expels the aspirated material. Assisting them with information they need to know. Answer: B Rationale: Sudden death of a family member creates a state of shock on the family. answering their questions and listening to them will provide the needed support for them to move on and be of support to one another. 18.Prepared By: Charles Anthony Esteban electrical burns should be placed on a cardiac monitor. such as in muriatic acid where burn or perforation of the mucosa may occur. For corrosive poison ingestion. 16. Answer: D Rationale: Respiratory and cardiovascular functions are essential for oxygenation. the most effective way to clear the airway of food is to perform abdominal thrusts. Answer: A Rationale: The Heimlich maneuver is used to assist a person choking on a foreign object. 12. Administering an irritant with the concomitant vomiting to remove the swallowed poison will further cause irritation and damage to the mucosal lining of the digestive tract. Adrenaline or Epinephrine is an adrenergic agent that causes bronchial dilation by relaxing the bronchial smooth muscles. .