Question

1. What is the most common referral pathway for patients to the ED?

A GP
B Self-referral
C Community nurse
D Via 111

Question 2. What proportion of patients are children in the ED?

A 10%
B 25%
C 50%
D 75%

Question 1. What is the most common method of transport used by patients to access the Emergency
Department?

A Helicopter
B Ambulance
C Patient/carer's own transport
D Single responder's car

Question 2. On arrival at an incident, what task must pre-hospital personnel undertake first?

A Patient assessment
B Scene assessment
C Care provision
D Patient handover

Question 1. The system of ‘triage’ is based upon which of the following principles?

A Treating patients in order of priority

B Treating first come first served
C Treating the quickest and easiest first
D Treating those that complaint the most first

Question 2. Which of the following statements about triage is true?

A Triage is a low-risk activity and can be safely undertaken by junior staff with little training
B Triage is a detailed assessment which should lead to a clinical diagnosis
C Triage should be undertaken as soon after arrival in the ED as possible
D Triage only ever needs to be undertaken once in a patient's ED journey

Question 1. The ABCDE approach is based upon which of the following principles?

A The ABCDE approach is a method for carrying out a detailed physical assessment
B The ABCDE approach assumes that all patients have an airway problem
C The ABCDE approach is a system of sorting ED patients into order of priority
D The ABCDE approach is a systematic method for identifying patient problems in order of priority

Question 2. Which of the following statements regarding deteriorating patients is not true?
A Patients most at risk of deteriorating include those with co-morbidities, the old and the very young
B Deteriorating patients rarely show any signs prior to deteriorating
C The ABCDE approach is well-suited to the initial assessment and management of deteriorating patients
D Early warning scoring systems should be used to help identify deteriorating patients

Question 1. Which of the following statements regarding track and triggers systems is true?

A Track and trigger systems are used for monitoring the physical location of patients
B Track and trigger systems convert physiological measurements into a level of clinical risk and indicate
appropriate action
C Track and trigger systems are used to sort ED patients into order of priority
D Track and trigger systems have no place in the ED

Question 2. Which of the following physiological parameters is not included in the NEWS?

A Urine output
B Systolic blood pressure
C Level of consciousness
D Respiratory rate

Question 1. Which of the following statements regarding pain in the ED is not true?

A Pain is a common reason for ED attendance

B The effectiveness of analgesia should always be re-evaluated
C Pain assessment is a straightforward activity
D Pain management in the ED often falls below standard

Question 2. Which of the following is the initial analgesic drug of choice for a patient who is in severe pain,
with a score of 9 out of 10, due to a fracture?

A IV paracetamol
B Rectal NSAID
C Splint
D IV opiate

Question 1. To correctly size an oropharyngeal airway in an adult, you should:

A Stimulate the gag reflex

B Choose a device with the same diameter as the patient's little finger
C Choose a device which extends from the patient's incisors to the angle of the jaw
D Choose a device which extends from the patient's nares to the tragus

Question 2. A definitive airway should include the following:

A Oxygen enriched assisted ventilation

B Correctly sized endotracheal tube in the trachea with cuff inflated
C Well secured endotracheal tube
D All of the above

Question 3. A patient with facial burns who is talking will not require a definitive airway.
A True
B False

Question 1. Which of the following statements regarding hypoxia is true?

A Hypoxia causes drowsiness initially

B SpO2 of 94-98% is the normal range for all patients
C Cyanosis is a late sign of hypoxia
D Hypoxia and hypercapnia do not coexist

Question 2. During percussion of the chest wall, hyperresonance suggests which of the following?

A Pneumothorax
B Haemothorax
C Pneumonia
D Pleural effusion

Question 1. Which of the following statements regarding emergency oxygen therapy is true?

A Oxygen should be used as a treatment for breathlessness

B Oxygen therapy should always be prescribed
C Non-rebreathe oxygen mask is the delivery device of choice in critical illness
D Nasal cannula is the oxygen delivery device of choice in critical illness

Question 2. Which oxygen device and flow-rate/percentage is recommended for the initial management of
hypoxaemia in a patient with COPD?

A 28% via a Venturi mask

B 60% via a Venturi mask
C 10-15L/min via a non-rebreathe mask
D 2L/min via a simple face mask

Question 1. Which of the following is not a feature of life-threatening asthma?

A Hypoxia
B Hypocapnia
C Silent chest
D Cyanosis

Question 2. Which of the following statements regarding COPD is true?

A Patients should only be treated for COPD if they have an existing diagnosis
B Peak expiratory flow rate (PEFR) is the assessment of choice in COPD
C COPD is mainly caused by environmental pollution
D Patients with COPD may have chronic hypoxia

Question 1. Which of the following methods of cardiovascular assessment allow estimation of the amplitude
of a pulse?

A Pulse oximetry
B Manual palpation
C Cardiac monitor
D Cardiac auscultation

Question 2. Mean arterial pressure (MAP) is an average blood pressure reading and considered to be a
more accurate indicator of end organ pressure. What is the normal range for MAP?

A 30-50mmHg
B 120-80mmHg
C 2-6mmHg
D 70-100mmHg

Question 1. Which of the following cannulae has the fastest flow-rate?

A 22G (blue)
B 20G (pink)
C 18G (green)
D 14G (brown)

Question 2. Which of the following is a valid rationale for inserting a central venous catheter (CVC)?
A For rapid fluid administration
B For central drug administration
C Because it is quicker than gaining peripheral IV access
D Because it is safer than gaining peripheral IV access

Question 3. Which of the following is not a risk associated with large volume crystalloid infusion?

A Anaphylaxis
B Haemodilution
C Hypothermia
D Oedema

Question 1. What is the key factor which distinguishes decompensated shock from compensated shock?

A Tachycardia
B Tachypnoea
C Hypotension
D Vasoconstriction

Question 2. In the management of sepsis, what is the target timeframe for delivery of the sepsis six,
including IV broad spectrum antibiotics?

A 1hr
B 2hrs
C 6hrs
D 24hrs

Question 3. Which of the following interventions does not form part of the emergency management of
anaphylaxis?

A IV antibiotics
B IM adrenaline (epinephrine)
C IV fluids
D IV anti-histamine
Question 1. A 12 lead ECG consists of 4 limb leads and how many chest leads?

A6
B7
C8
D 10

Question 2. The 12 lead ECG represents which of the following?

A Strength of heart contraction

B Electrical activity of the heart
C Amount of blood pumped from the heart

Question 1. Which cardiac arrhythmia will occur due to damage to the atrioventricular (AV) node?

A Atrial fibrillation (AF)

B Ventricular tachycardia (VT)
C Complete Heart Block (CHB)

Question 2. What risk is commonly associated with atrial fibrillation (AF)?

A Cerebrovascular Accident (CVA)

B Haemorrhage
C ST elevation myocardial infarction (STEMI)

Question 3. What is the most common cause of ventricular tachycardia (VT)?

A Electrolyte imbalance
B Myocardial ischaemia
C Renal failure

Question 1. Which of the following is the most common symptom experienced by patients with ACS?

A Chest pain
B Dyspnoea
C Abdominal pain

Question 2. Which ACS presents with ST depression or T wave inversion on the ECG and a negative
troponin?

A ST elevation myocardial infarction (STEMI)

B Non-ST elevation myocardial infarction (NSTEMI)
C Unstable angina (UA)

Question 3. Which of the following drugs would provide patients with suitable treatment for pain caused by
ACS?

A Oral paracetamol
B IV morphine
C IM morphine
Question 1. What is the most common cause of heart failure?

A Hypertension
B Aortic stenosis
C Myocardial infarction

Question 2. Which respiratory condition is ‘pink, frothy sputum’ most commonly associated with?

A Pulmonary oedema
B Chest infection
C Pneumonia

Question 3. Which clinical term is used to describe ‘shortness of breath whilst lying flat’?

A Dyspnoea
B Syncope
C Orthopnoea

Question 1. Which of the following signs are common in the early stages of cardiac arrest?

A Palpable pulse
B Purposeful movement
C Recordable blood pressure
D Agonal breathing

Question 2. Which of the following is the initial treatment for a shockable rhythm (VF/VT) in cardiac arrest?

A IV adrenaline (epinephrine)
B IV amiodarone
C IV fluids
D Defibrillation

Question 1. A patient's eyes are closed when you approach him, but open when you call his name. What is
his Eye Opening Response in the GCS?

A Eye opening spontaneously

B Eye opening to speech
C Eye opening to pain
D None

Question 2. On re-assessing a patient, she tells you her name and the day and date correctly, but when
asked the name of the hospital, she replies, “I can't remember.” What is her Verbal Response in the GCS?

A Orientated
B Sentences
C Words
D Sounds

Question 3. A patient appears to be trying to speak, but although he is making a noise you cannot clearly
distinguish any specific words. What is his Verbal Response in the GCS?
A Sentences
B Words
C Sounds
D None

Question 4. When you inflict a trapezius pinch, the patient's elbows straighten, and the arms rotate
internally. What is her Motor Response in the GCS?

A Localizes
B Normal flexion
C Abnormal flexion
D Extension

Question 1. What does a poor conscious level indicate about the brain's function?

A The brain function is normal

B The brain function is impaired
C Neither. Poor consciousness tells us nothing about brain function

Question 2. Which of the following statements is correct?

A Patients with low conscious levels are unable to protect their own airways
B Low conscious levels do not pose any special risk to airway patency
C Airway assessment is not a priority when consciousness is low

Question 3. Which of the following statements is not correct?

A Respiratory failure can cause unconsciousness

B Poor conscious levels are often accompanied by altered breathing patterns
C A saturation monitor provides all the information needed to assess respiratory function in the ED

Question 4. Why is careful evaluation of all the body's systems particularly important in poorly conscious
patients?

A It allows us to complete all the necessary forms and assessment charts

B Patients can sue if we miss anything
C Poorly conscious patients cannot describe symptoms or explain their medical histories

Question 1. What does FAST stand for?

A Fingers – Arms – Stomach – Toes

B Fast Acting Stroke Thrombolysis
C Face – Arms – Speech – Time

Question 2. Which of the following is not a common symptom of acute ischaemic stroke?

A Sudden severe headache

B One-sided weakness
C Aphasia
D Impaired swallow

Question 3. Why is CT scanning the crucial early investigation for stroke?

A It is quicker than a full neurological examination
B It indicates what kind of disability a patient might have
C It distinguishes ischaemic stroke from haemorrhage or other intracranial pathologies
D It is easier and cheaper than MRI

Question 4. You are caring for a patient with acute ischaemic stroke in the Resuscitation Room. The
patient's blood pressure is 190 / 100. What should you do?

A Give an oral anti-hypertensive

B Start an infusion of GTN
C Start an infusion of labetalol
D Continue to monitor but do not treat at present

Question 1. When is a diagnosis of epilepsy made?

A After someone has had a seizure

B When a person has a tendency to have recurrent seizures
C When a person thinks they have epilepsy

Question 2. Which of the following can cause seizures?

A Low sodium
B Encephalitis
C Previous head injury
D All of the above

Question 3. During a seizure, what should you do first?

A Open the jaws to stop the patient biting his tongue

B Put an oxygen mask on the patient
C Give sedation
D Prevent injury

Question 4. After a seizure stops, why should patients be supervised until they recover fully?

A There may be a period of low consciousness with risk of airway compromise

B The seizures may recur
C A seizure may be symptomatic of serious illness
D All of the above

Question 1. Secondary headache may be caused by a life-threatening condition.

A True
B False

Question 2. A gentleman in his 30s presents to the ED complaining of a severe headache for the past 2
hours. He states the pain is mostly behind his right eye and reports some tearing on the same side. He
claims to be getting these more frequently over the past few weeks. He appears very anxious and
distressed. What type of headache is he likely to have?
A Migraine
B Tension-type headache
C Cluster headache

Question 1. In which location does pain tend to predominate in appendicitis as symptoms worsen?

A Left iliac fossa

B Right iliac fossa
C Epigastrium
D Right upper quadrant

Question 2. Cholecystitis is an inflammation of which organ?

A Gall bladder
B Liver
C Pancreas
D Kidney

Question 3. Small bowel obstruction is most commonly caused by which of the following?

A Malignancy
B Constipation
C Adhesions
D Pancreatitis

Question 1. Vomiting blood is known as:

A Haemoptysis
B Haematemesis
C Malaena
D Haematochezia

Question 2. What is the commonest cause of GI bleeding?

A Peptic ulcer disease (PUD)

B Oesophageal varices
C Oesophagitis
D Haemorrhoids

Question 3. Which treatment for peptic ulcer disease cannot be delivered via endoscopic therapy?

A Injection with epinephrine (adrenaline)

B Thermal haemostasis
C Mechanical clips
D Triple therapy

Question 1. Which of the following is the initial analgesic of choice in renal colic?

A IV opiates
B Oral paracetamol
C Rectal NSAID
D Entonox

Question 2. Urinary tract infection (UTI) is least common in which of the following groups?

A Women
B Men
C Patients with an indwelling urinary catheter
D Patients with co-morbidities

Question 1. Which of the following types of AKI is common in the ED and results from decreased renal
perfusion caused by hypovolaemia or reduced cardiac output?

A Pre kidney injury

B Intrinsic kidney injury
C Post kidney injury

Question 2. Which life-threatening electrolyte disorder commonly occurs in AKI?

A Hyponatraemia
B Hypernatraemia
C Hypokalaemia
D Hyperkalaemia

Question 1. Which of the following processes in DKA is responsible for the development of acidosis,
acetone breath and abdominal pain?

A Hyperglycaemia
B Hypotension
C Ketonaemia
D Hypovolaemic shock

Question 2. Hypoglycaemia is defined at what level?

A <2mmol/L
B <4mmol/L
C <6mmol/L
D <8mmol/L

Question 1. Pregnant women are at increased risk of DVT due to:

A Increased rest
B Increased blood volume
C Hypercoagulability

Question 2. A woman presents to the ED with headache and blurred vision and appears agitated. Which
pregnancy related condition should be considered?

A Hyperemesis
B Pre-eclampsia
C Miscarriage
D Ectopic pregnancy
Question 3. A woman has just delivered in the ED. The baby has not cried. What should the nurse do?

A Place the baby on the mother's chest

B Wrap the baby in a towel and rub
C Ask the father to call for help

Question 1. Activated charcoal does not adsorb the following substances:

A Paracetamol
B Iron
C Amitriptyline
D Enteric-coated diclofenac

Question 2. Elimination of drugs following overdose can be achieved through the use of:

A Gastric Lavage
B Single-dose activated charcoal
C Haemodialysis
D A, B and C

Question 3. The commonest cause of pinpoint pupils in the poisoned patient is:

A Organophosphate poisoning
B Carbon monoxide poisoning
C Opiate overdose
D Aspirin overdose

Question 1. Tricyclic antidepressant (TCA) overdose commonly causes:

A Nystagmus
B Vomiting
C Tachycardia
D Tinnitus

Question 2. A cocaine-induced myocardial infarction is best treated with:

A Percutaneous Coronary Intervention (PCI) / angioplasty

B Glyceryl trinitrate
C Thrombolysis
D Cardiac pacing

Question 3. Peak paracetamol toxicity presents how long after ingestion:

A. 3-5 days
B. 6-12 hours
C. 24-72 hours
D. Within 30 minutes

Question 1. The commonest features of exposure to moderate carbon monoxide levels is:
A Headache
B ‘Cherry-red’ skin colour
C Watery eyes
D Haemoptysis

Question 2. Antifreeze poisoning is treated with:

A Activated charcoal
B Ethylene glycol or methanol
C Urine alkalinisation
D Ethanol or fomepizole

Question 3. Where a child is involved in an accidental poisoning episode, which of the following is not an
appropriate response?

A Providing the parent with advice on child safety in the home

B Considering activation of safeguarding and information sharing protocols
C Reassuring parents
D Inducing vomiting in the child

Question 1. Acutely intoxicated patients may require:

A Intubation
B Monitoring in a side room
C A sternal rub to elicit level of consciousness
D A lecture from nursing staff

Question 2. Wernicke's Encephalopathy (WE) is treated with:

A Niacine
B Vitamin B1, B2, B3, B6 and Vitamin C
C Chlordiazapoxide
D Parvolex

Question 3. Severe alcohol withdrawal can cause:

A Seizures
B Hallucinations
C Tachypnoea
D All three

Question 1. HIV symptoms are similar to influenza

A True
B False
Question 2. A father brings his 4 year old daughter to the ED concerned about sores forming on her lips
and nose. She is seen to scratch the sores. He states a few children at nursery have had the same
problem. What condition is she likely to have?

A Cellulitis
B Impetigo
C RSV

Question 1. What is the time frame for reporting notifiable diseases?

A 24 hours
B 3 days
C 5 days
D 7 days

Question 2. A patient presents to the ED with lethargy increasing over the past few days, fever, sweats and
headache. The patient denies having a cough. The patient has recently returned from Asia. Which
infectious disease should the patient be tested for?

A Tuberculosis
B Whooping cough
C Malaria

Question 1. STIs are most common in which age group?

A 14-17 year olds

B 18-25 year olds
C 40-60 year olds

Question 2. If a patient presents with a STI they should be screened for other STIs

A True
B False

Question 1. Domestic abuse only affects women

A True
B False

Question 2. A woman presents to the ED with facial and upper arm injuries. She states she was assaulted
but denies knowing her attacker. Her husband has accompanied her and wants to be present during the
assessment. What should the nurse do?

A Report domestic abuse to social services and the police

B Tell the nurse-in-charge and ask them to report the abuse
C Speak to the patient in a private room and ask if she has been abused by her husband
Question 1. A patient who presents following sexual assault with non-life threatening injuries should be
cared for in which area of the ED?

A Resus
B Majors curtained cubicle
C Majors doored cubicle

Question 2. Responsibility for collecting evidence and maintaining a chain of custody lies with:

A ED doctor
B ED nurse
C Police/Forensic Medical Officer
D Social Worker

Question 1. People present to the ED with symptoms of mental disorder because of which of the following
reasons?

A Physical illness
B Alcohol or drug intoxication
C Underlying mental health conditions
D All of the above

Question 2. Under which section of the Mental Health Act may a police officer detain someone who
appears to be suffering from mental disorder and in immediate need of care or control and take them to an
ED as a place of safety?

A Section 4
B Section 72
C Section 136
D Section 83

Question 1. What percentage of patients commit suicide within 10 years of self-harming?

A 1-2%
B 2-3%
C 4-6%
D 7-10%

Question 2. Which of the following reflects the highest risk during mental health assessment?

A Strong and immediate plans regarding suicidal intent

B Evidence of alcohol intoxication
C History of mental health problems
D Known to local mental health services

Question 1. Which of the following disorders is characterised by episodes of extreme mood swings,
featuring both mania and depression?
A Acute psychosis
B Bipolar disorder
C Depression
D Borderline personality disorder

Question 2. Which of the following is a feature of acute psychosis?

A Feelings of hopelessness
B Feelings of worthlessness
C Hallucinations
D Fatigue

Question 1. A patient with dementia does not have capacity to consent for treatment in the ED

A True
B False

Question 2. Key aspects of a dementia friendly environment include which of the following?

A Lighting to reflect day and night

B Long walk to bathroom to encourage exercise
C Private room away from family

Question 1. Diagnostic overshadowing is described as:

A Concerning shadows seen on a chest x-ray

B Making assumptions that certain behaviours are linked to the patient's intellectual disability and not their
clinical condition
C The over use of blood tests

Question 2. A hospital passport is a vital document for patients with an intellectual disability. What is
included in a hospital passport?

A Allergies
B How the person experiences and responds to pain
C Usual behaviours
D All of the above

Question 1. When older children in the ED are asked how involved in their own care/ decision making they
feel, they most commonly reply that they feel:

A Included
B Ignored
C Trusting of professionals
D Confused
Question 2. Play is seen as an essential part of caring for a child, which is endorsed by:

A The Children's Act (2004)

B Working Together to Safeguard Children (HM Government, 2013)
C The United Nations Convention on the Rights of the Child (United Nations General Assembly, 1989)

Question 1. How many children are dying from maltreatment/ abuse in our society?

A 1% of child population
B 2 children per day
C 1 child per week

Question 2. Which of the following is apparently not an indicator to suspect NAI (non-accidental injury) in a
child?

A Toddler with bruised shins

B Unknown injury mechanism
C Multiple injuries
D Injury on a child <1yr of age

Question 1. Which of the following is not a sign of circulatory failure?

A Pallor
B Skin mottling
C Central cyanosis
D Tachycardia

Question 2. The most common initial indicator of an increased work of breathing in a child is:

A Tachypnoea
B Grunting
C See-saw breathing

Question 1. The most common chronic illness in children is:

A Croup
B Asthma
C Fever
D Febrile convulsion

Question 2. Which of the following is apparently not an effective method of managing pyrexia in children?

A Tepid sponging
B Delayering of clothing
C Antipyretic medication
Question 1. The most common cause of cardiorespiratory arrest in children is:

A Dehydration
B Cardiac problems
C Hypoxia

Question 2. The most effective action to open a child's airway is using a:

A Head tilt
B Oropharyngeal airway
C Jaw thrust manoeuvre
D Neutral head position

Question 1. One of the following is not known to be a common injury presentation in children

A Limb injury
B Burn/ scalds
C Lacerations
D Bruised ribs

Question 2. The area of the body that is most frequently fractured in children is:

A The elbow
B The ankle
C The wrist

Question 1. What discharge advice would you give to a patient who has sustained a sprain to their ankle?

A Sit in a chair with their foot down, hop around

B Continue to mobilise as normal
C Rest, Ice, Compression and Elevation, taking regular analgesia

Question 2. When should a practitioner order an x-ray for a knee injury?

A If the patient is 30 years old, limping and in pain

B If the patient is 60 years old, is tender at the head of the fibula and is unable to flex the knee to 90
degrees
C If the patient is able to walk up some stairs but is tender generally

Question 1. What should the initial management of patients with traumatic neck pain and C-spine
tenderness be?

A Analgesia
B Hard neck collar
C ECG
D Seen immediately by a doctor
Question 2. The majority of neck pain can is managed by which of the following?

A Rest
B Simple analgesia
C Avoiding strenuous exercise
D All of the above

Question 3. What observations should be undertaken on an injured limb when assessing the blood supply
and sensation?

A Capillary refill
B Distal pulses
C Temperature
D All of the above

Question 4. ‘Pulled elbows’ are common in what age group of patients?

A Elderly
B Toddler
C Adults
D New born

Question 1. If a patient has sustained a corneal abrasion what colour will the fluorescein stain highlight the
abrasion?

A Orange
B Bright green
C Fluorescein does not stain a corneal abrasion

Question 2. What immediate action should be taken if a patient presents with a chemical injury to their eye?

A Check the visual acuity and ask the patient to wait

B Stain the eye with fluorescein
C Irrigate the eye immediately

Question 1. A nasal tampon should be inserted vertically.

A True
B False

Question 2. A patient presents with sore throat, fever, drooling and trismus. What condition are they likely to
have?

A Tonsillitis
B Quinsy
C Epiglottitis
Question 1. During assessment and management of the trauma patient, the purpose of the primary survey
is:

A To assess the number of injuries the patient has

B To assess the number of injured patients
C To identify and treat life threatening injuries
D To map the scene of an accident

Question 2. Trauma is the highest cause of death in which age group

A All ages
B >60 years
C 40-60 years
D 0-40 years

Question 1. During airway assessment, which of the following suggests partial airway obstruction?

A Gurgling
B Patient responds verbally
C Well-fitting false teeth
D A poorly fitting cervical collar

Question 2. Cervical spine immobilisation can be discontinued if:

A The patient vomits

B The patient is log-rolled
C The semi-rigid collar is poorly fitting
D Cervical spine injury has been excluded

Question 3. During assessment of breathing and ventilation in the trauma patient:

A Pulse oximetry is a reliable indicator of oxygenation

B Respiratory rate, inspection, palpation, percussion and auscultation and saturations should be performed
C Tracheal deviation is an early indicator of tension pneumothorax
D Respiratory rate may be omitted in the conscious patient

Question 1. Appropriate early cervical spine immobilisation includes the following:

A Asking the patient not to move

B Spinal board
C Hard collar

Question 2. You have been asked to initiate neuroprotective measures for a head injured patient. Which of
the following interventions will you use?

A High flow oxygen

B Provide adequate analgesia
C Controlling environmental stimulation
D All of the above
Question 1. The presence of a tension pneumothorax,

A Is a type of haemorrhagic shock

B Will always be associated with tracheal deviation
C Is treated definitively with needle decompression
D Is treated definitively with a chest drain

Question 2. A massive haemothorax is defined as:

A More than 500ml of blood in the chest cavity

B More than 750ml of blood in the chest cavity
C More than 1000ml of blood in the chest cavity
D More than 1500ml of blood in the chest cavity

Question 3. A patient has had a chest drain inserted. Which of the following should the ED nurse not do?

A Monitor breathing and ventilation

B Clamp the chest drain
C Observe the chest drain for bubbling and swinging
D Monitor the chest drain site

Question 1. Realigning a fractured limb in a splint achieves which of the following:

A Reduce bleeding
B Reduce the risk of fat embolism
C Reduce pain
D All of the above

Question 2. How soon after injury should IV antibiotics be administered for an open fracture?

A 1 hour
B 3 hours
C 4 hours
D 6 hours

Question 3. You are caring for a patient with a traction splint for a limb injury. The patient begins to complain
of severe pain, worse than before the splint was applied. What should you do?

A Increase analgesia and reassure patient

B Send the patient to theatre immediately
C Remove the splint, assess and reapply if indicated
D Remove the splint and place a plaster of Paris cast on the limb

Question 4. If an amputated limb is brought to the ED with the patient what should you do?

A Place it in a clinical waste bin

B Clean the limb to remove any large debris, wrap it in saline soaked gauze, placed the limb in a sealable
plastic bag and place it in a clinical fridge
C Clean the limb to remove any large debris, wrap it in saline soaked gauze, placed the limb in a sealable
plastic bag and insert it in cold water

Question 1. What is the diagnostic tool of choice to detect abdominal bleeding in the UK?

A FAST
B CT
C DPL

Question 2. Pelvic binders are used achieve which of the following?

A Minimise bleeding
B Reduce pain
C Assist with re-alignment
D All of the above

Question 1. The management of massive haemorrhage includes which of the following?

A Administration of blood products

B Administration of Tranexamic Acid
C Surgical assessment and intervention
D All of the above

Question 2. Which nursing interventions can reduce the risk of coagulopathy and mortality?

A High-flow oxygen
B Preventing the patient getting cold
C Ensuring blood administered warm
D All of the above

Question 1. Which is the most common type of burn seen in the ED?

A Chemical
B Thermal
C Radiation

Question 2. Superficial burns are not included when calculating total body surface area burned. Why?

A They are usually too small to calculate

B They are not associated with a significant fluid shift
C They are not painful

Question 3. In addition to analgesia, burn care and fluid therapy which interventions should the ED nurse
perform in a patient following an electrical burn?
A Nasogastric tube insertion
B ECG and cardiac monitoring
C Administration of Tranexamic Acid
D All of the above

Question 1. When caring for a pregnant trauma patient which of the following statements is true?

A Caring for the foetus takes precedence over the mother

B Caring for the mother takes precedence over the foetus

Question 2. Who should be called to assist when a pregnant trauma patient arrives in the ED?

A Midwife and obstetrician

B Paediatric surgeons
C Paediatric intensive care team

Question 3. Alongside the primary survey which other assessment should occur in an older adult trauma
patient?

A Mobility assessment
B Medical assessment
C Social assessment

Question 1. What should the ED nurse do if a child does not tolerate a hard collar and becomes distressed?

A Assist the doctor to sedate the child

B Offer the child sweets to encourage them to wear the collar
C Have the child sit without a hard collar on the lap of a parent/carer, informing the parent/carer of the
importance of reducing neck movement

Question 2. In children following trauma fluids should be administered using which calculation?

A 5ml/kg
B 10ml/kg
C 20ml/kg
D 30ml/kg

Question 1. The primary role of the ED in a major incident is to:

A Identify casualties
B Receive casualties
C Lead pre-hospital triage decisions

Question 2. During the process of decontamination the agent(s) used to decontaminate patients is/are:

A Chlorhexidine
B Soap and water
C Alcohol
D Warm water

Question 1. The most common type of transfer is:

A Intra-hospital
B Inter-hospital

Question 2. Who should accompany a critically ill patient on an inter-hospital transfer?

A Anaesthetist
B Registered Nurse
C ED Doctor

Question 1. Responsibility for a DNAR order lies solely with the doctor.

A True
B False

Question 2. The Coroner will order a post mortem examination in all patients who die in the ED.

A True
B False

Question 3. If ED staff feel distressed following a death in the ED what should they do?

A Inform senior colleagues

B Request and take part in a debrief
C Contact staff support services
D All of the above