Final Exam prep med/surg Chapters 68, 16, 28
Quiz by Kelsey Maier
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- Q1During the primary assessment of a victim of a motor vehicle collision, the nurse determines that the patient has an unobstructed airway. Which action should the nurse take next?Observe the patient’s respiratory effort.Palpate extremities for bilateral pulsesExamine the patient for any external bleedingCheck the patient’s level of consciousness60s
- Q2During the primary survey of a patient with severe leg trauma, the nurse observes that the patient’s left pedal and posterior tibial pulses are absent and the entire leg is swollen. Which action will the nurse take next?Start normal saline fluid infusion with a large-bore IV lineSend blood to the lab for a complete blood count.Assess further for a cause of the decreased circulation.Finish the airway, breathing, circulation, disability survey60s
- Q3After the return of spontaneous circulation following the resuscitation of a patient who had a cardiac arrest, therapeutic hypothermia is ordered. Which action will the nurse include in the plan of care?Initiate cooling per protocol.Rewarm if temperature is below 91° F (32.8° C).Avoid the use of sedative drugs.Check mental status every 15 minutes.60s
- Q4A patient who is unconscious after a fall from a ladder is transported to the emergency department by emergency medical personnel. During the primary survey of the patient, the nurse shouldobtain a complete set of vital signs.ask about chronic medical conditions.attach an electrocardiogram monitor.obtain a Glasgow Coma Scale score60s
- Q5A 19-yr-old patient is brought to the emergency department (ED) with multiple lacerations and tissue avulsion of the left hand. When asked about tetanus immunization, the patient denies having any previous vaccinations. The nurse will anticipate givingtetanus-diphtheria toxoid and pertussis vaccine (Tdap) onlyTIG and tetanus-diphtheria toxoid and pertussis vaccine (Tdap).TIG and tetanus-diphtheria toxoid (Td).tetanus immunoglobulin (TIG) only.60s
- Q6A patient who has experienced blunt abdominal trauma during a motor vehicle collision is complaining of increasing abdominal pain. The nurse will plan to teach the patient about the purpose ofabdominal ultrasonographynasogastric (NG) tube placementmagnetic resonance imaging (MRI).peritoneal lavage.60s
- Q7A patient with hypotension and an elevated temperature after working outside on a hot day is treated in the emergency department (ED). The nurse determines that discharge teaching has been effective when the patient makes which statement?“I’ll move to a cool environment if I notice that I’m feeling confused”“I need to drink extra fluids when working outside in hot weather.”“I’ll take salt tablets when I work outdoors in the summer.”“I should take acetaminophen (Tylenol) if I start to feel too warm.”60s
- Q8A 22-yr-old patient who experienced a drowning accident in a local pool, but now is awake and breathing spontaneously, is admitted for observation. Which assessment will be most important for the nurse to take during the observation period?Palpate peripheral pulsesAuscultate breath soundsCheck mental orientationAuscultate heart sounds60s
- Q9When planning the response to the potential use of smallpox as a biological weapon, the emergency department (ED) nurse manager will plan to obtain adequate quantities ofvaccineatropineantibioticswhole blood60s
- Q10When rewarming a patient who arrived in the emergency department (ED) with a temperature of 87° F (30.6° C), which finding indicates that the nurse should discontinue active rewarming?The core temperature is 94° F (34.4° C)The BP decreases to 86/42 mm Hg.The patient begins to shiverThe patient develops atrial fibrillation60s
- Q11When assessing an older patient admitted to the emergency department (ED) with a broken arm and facial bruises, the nurse observes several additional bruises in various stages of healing. Which statement or question by the nurse should be first?“I need to report my concerns to the police.”“Would you like to see a social worker?”“You should not go home.”“Do you feel safe at home?”60s
- Q12A patient arrives in the emergency department (ED) several hours after taking “25 to 30” acetaminophen (Tylenol) tablets. Which action will the nurse plan to take?Discuss the use of chelation therapy.Give N-acetylcysteineStart oxygen using a non-rebreather mask.Have the patient drink large amounts of water60s
- Q13A triage nurse in a busy emergency department (ED) assesses a patient who complains of 7/10 abdominal pain and states, “I had a temperature of 103.9° F (39.9° C) at home.” The nurse’s first action should be togive acetaminophen (Tylenol) per agency protocol.tell the patient that it will be 1 to 2 hours before seeing a health care provider.assess the patient’s current vital signs.ask the patient to provide a clean-catch urine for urinalysis.60s
- Q14The emergency department (ED) triage nurse is assessing four victims involved in a motor vehicle collision. Which patient has the highest priority for treatment?A patient with paradoxical chest movementA patient with an open femur fractureA patient with bleeding facial lacerationsA patient with no pedal pulses60s
- Q15The following interventions are part of the 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?Remove the patient’s rings.Apply ice packs to both hands.Give diphenhydramine (Benadryl) 50 mg POApply calamine lotion to itching areas.60s