1. What is the proper procedure for testing visual acu- ity?
2. A 22-year-old man with sickle cell disease is brought into the ED by Campus Police from
... [Show More] his local uni- versity. He is complaining of increasing pain to his bilateral lower extremities, consistent with his past sickle cell pain crisis. Which intervention would you expect the provider to order?
3. TPA would be contraindicated for which of the fol- lowing patients?
4. A 24 year old female, who has recently received methotrexate for a tubal pregnancy, presents to the ED with severe abdominal pain. What would be the PRIORITY nursing intervention?
5. A 3 year old boy with a history of hydrocephalus with a cerebral shunt arrives to the ED with a fever of 102.0°F, an enlarged abdomen, tachycardia and hypotension. The patient is mildly lethargic, however is cooperative with the ED staff. Immediate treatment for this child should include:
6. When caring for a patient who has received a mas- sive blood transfusion, monitoring which of the fol- lowing lab results is a top priority?
*BOTH WRONG*
1) Test the affected eye first, then the unaffected eye with- out corrective lens- es
2) Test the unaffect- ed eye first, then the affected eye with corrective lens- es when available
IV Fluids Normal Saline
80 year old diag- nosed with stroke 2 weeks ago
Prepare to go to the OR
Antibiotics and IV Fluids
Ionized Calcium Level
7. What medication would you anticipate administer- ing to a six month old having an active tonic-clonic seizure?
8. Patient presents to the ED with a snake bite that occurred 30 minutes ago. The snake was identified as a poisonous rattlesnake. What medication would you expect the physician to order for this patient?
9. A 26 year old male with a history of asthma presents
Ativan
CroFab Crotalidae Polyvalent Immune Fab (Ovine)
Give albuterol and
to the ED with dyspnea, audible expiratory wheezes, atrovent nebulizer
substernal retractions, accessory muscle use, with BP-145/72, HR -26, RR-32, O2 Sat 88% on room air. What is the FIRST treatment of choice for this pa- tient?
10. A 40-year-old man presents to the ED with short- ness of breath and a headache, after being sprayed by pesticides while working on a farm. What is the FIRST nursing intervention?
11. Four patients are being transported to the ED after a severe collision between a train and two motor vehicles. Which of the following patients should be triaged for FIRST treatment?
12. A 53 year old female with a history of sarcoidosis presents to the ED after being rescued by firefighters from her burning apartment. She is currently alert and oriented, BP-115/78, HR-110, RR- 24, T-100.4 F,
oxygen saturation 97% on room air. She is currently only complaining of a headache and her carboxy- hemoglobin is 13%. What is the MOST appropriate nursing intervention?
with oxygen
Decontaminate the patient according to hospital procedure
28-year-old with respiratory distress and open chest wound
Place on high-flow non-rebreather
13. A 28 year old, obsterical patient presents at 38 weeks Place patient in left
gestation status post motor vehicle collision. Upon arrival via EMS, you note she is on a backboard and c-collar is in place.
tilt position
What is the immediate nursing intervention for this patient?
14. A 36 year old male presents to the ED with an ampu- tated hand. What should you do FIRST?
15. Of the following patients, which one needs referral to the closest burn center?
Apply direct pres- sure to extremity
Partial-thickness and full-thickness burns involving the genitalia or perineum
16. What are three signs of cardiac tamponade? WRONG
1) Bradycardia, hy- pertension, muffled heart sounds
17. An 11-year-old female is brought to the emergency department with complaints of excessive sleeping, headache, sore throat and swollen neck glands. The patient has no complaints of pain. On exam, you note a pink rash on her torso. Her mother states that her appetite has decreased over the last week. What is the most likely diagnosis
18. An 88 year old male transferred to the ED from a nursing home with a chief complaint of being unable to void for the past 12 hours. He has a history of prostate cancer. Which of the following nursing in- terventions should be performed FIRST?
19. Which of the following would be a primary complica- tion of a bowel obstruction?
20. A 32-year-old woman recently diagnosed with mul- tiple sclerosis presents to the ED with several days of upper respiratory infection and now progressively weakened lower extremities, and vertigo. What is the FIRST line of treatment for this patient?
Mononucleosis
Insert urinary catheter
Dehydration
Methylprednisolone 1 g IV daily
21. Which of the following elevated lab values supports the diagnosis of congestive heart failure (CHF)?
22. A patient presents with blurry vision, seeing floaters and flashes of light. These are symptoms of
23. A 53-year-old female with a history of Addison's disease due to an autoimmune disorder presents with fatigue, generalized weakness, nausea, vomit- ing, and abdominal pain. Which of the following is consistent with an adrenal crisis?
24. Your patient has presented to the emergency depart- ment with pneumonia. You also note an allergy to penicillin. Which of the following medications would you question if ordered by the physician?
25. A 55-year-old man presents with left-sided chest pain that began 30 minutes ago during sexual in- tercourse. The pain radiates to his left shoulder. Upon initial history intake you learn that he has tak- en a phosphodiesterase inhibitor (Viagra) for erec- tile dysfunction. His ECG is concerning for STEMI. Which of the following medication orders should you question if ordered by the provider?
BNP
Retinal Detache- ment
Hypotension
Ceftriaxone
Nitroglycerin
26. A 26-year-old woman presents with severe eye pain, Slit lamp exam
photophobia, and the sensation of sand in her right eye. She is a contact lens wearer and states that she frequently leaves them in overnight. Which of the following is indicated for this patient?
27. A 28-year old male patient presents with severe dysuria and white, foul smelling drainage from his penis. The symptoms have lasted about one month and have become progressively worse over the last few days. On exam, the patient is noted to have a petechial rash to his bilateral upper extremities. The patient's signs and symptoms are consistent with which of the following?
using fluorescein staining
Disseminated gon- orrhea
28. Which of the following would be the FIRST fluid of choice for a patient in hypovolemic shock secondary to hemorrhaging?
29. RhoGAM would be administered to a pregnant pa- tient for which of the following reasons
30. A pediatric patient was brought in by EMS for seizure activity. The patient is post ictal on arrival. During assessment, the patient begins to have convulsions with body stiffening, jerking motions of legs and arms, loss of consciousness and loss of bladder control. What is your PRIORITY nursing interven- tion?
31. A 54 yr old male with a history of non-insulin de- pendent diabetes, presents to the ED with new onset of confusion, weakness, lethargy and nausea with frequent large volume urine output. Vital signs are BP-102/54, HR-115, RR-12, T- 97.4 and oxygen satura- tion is 97% on room air. Blood glucose is 725 mg/dl. pH is 7.40. What diagnosis would you expect to see for this patient?
32. Your patient arrives hypotensive and tachycardic after a motorcycle collision. His pelvis is unstable upon palpation and a portable pelvic film reveals an open book pelvic fracture. What immediate interven- tion should you expect?
33. A nurse is at end of their shift and has been dealing with a difficult and unruly patient. The nurse threat- ens to place the patient in restraints without justifi- cation. This is an example of:
PRBCs
To prevent an
RH- negative moth- er from forming anti- bodies to RH- posi- tive fetal blood
Lay patient on side to avoid injury and protect airway
Hyperosmolar hy- perglycemic state
Pelvic sheeting or placement of a commercial pelvic binder
Assault
34.
Your patient is an 84-year-old man who presents to the ED with increasing forgetfulness, restlessness, and anxiety, which has become progressively worse over the past 2 months. The patient feels well and is independent with his ADLs but will forget where he placed things. The head CT, labs and ECG are all normal. The diagnosis is likely dementia. Which of the following is correct about dementia?
35. Which of the following fractures is highly associated with child abuse?
36. You enter a patient's room and notice the chest tube has become dislodged
from the patient's chest and is hanging off the bed. The primary intervention is to:
37. An 18 year old female presents to ED unresponsive via private car. Her friends state that she has over- dosed on hydrocodone. BP- 80/40, HR- 58, RR- 8, O2 sat 86% on room air. You expect an order for which of the following medications?
38. A patient with a tension pnuemothorax should have a needle decompression catheter placed
39. An intubated patient becomes extremely agitated and the ventilator begins to alarm. What should you do FIRST?
40. Which of the following is a responsibility of the nurse collecting forensic evidence during the care of a sexual assault patient?
41. A 26 year old male presents to the ED with an alcohol level of 225 mg/dl. The patient also consumed an unmeasured amount of benzodiazepines, is posi-
There is progressive deterioration in cog- nition and/or behav- ior without altered consciousness
Spiral leg fracture of the tibia in an 8 month old
Cover the chest tube site with 4x4 dressing and taping only 3 sides of the dressing
Naltrexone (Nar- can)
IN the 2nd inter- costal space, mid- clavicular line
Check the ventila- tor tubing for discon- nection
Maintaining the evi- dence chain of cus- tody
Call the Poison Con- trol Center for tox-
tive for THC and opiates. An eye witness states that ic ingestion recom-
the patient also consumed bleach while intoxicated. mendations
What is the next most important step to take in order to ensure proper treatment for this patient?
42. A 38 week pregnant patient presents to the ED in active labor. The patient states she has not had any prenatal care. The fetal heart rate is assessed to be 85 beats per minute. What is the PRIORITY nursing intervention?
43. A patient arrives to the ED intubated and decom- pressed on the left side status post gunshot wound to the chest. During the primary survey, the en- dotracheal tube placement is confirmed but breath sounds ae noted to be absent on the right. A
right-sided chest tube is place with immediate return of 500 ml or blood. Which of the following would you perform FIRST?
44. A 22-year old woman pre3sent to the ED appearing disheveled and tearful with obvious bruising to her face and neck. The patient reports that she was as- saulted and raped by an acquaintance several hours ago. What is the PRIORITY nursing intervention?
45. A 35 year old construction worker arrived in the ED after falling from a ladder while working on a
house. He is lying on his back in a co-worker's truck with blood pooling around his head. He has snoring respiration and a GCS of 7. What initial interventions would you perform?
46. An elderly couple present to the ED via EMS. The
Have the patient lay on her left side
and place patient on high flow oxygen
Transfuse 2 unite of uncrossmatched red blood cells
Evaluate the pa- tient's physical in- juries
C-spine stabiliza- tion, assistive venti- lations and prepara- tion for intubation
Arrange a social
husband sustained a broken hip after a fall at home. services consult
The wife states to the nurse :I don't think I can take care of him anymore." What is the most appropriate nurse intervention?
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